New medicines save diabetics time, money

With diabetes affecting more people under the age of 50 than ever before, researchers at Ohio State found that newer, more expensive medications result in a lower risk of hospitalization and lower overall healthcare costs.

A new study concluded that patients with type 2 diabetes who took thiazolidinediones are more likely to take their medications as prescribed and are hospitalized less often. TZDs can cost as much as 10 times that of generic versions of medications currently on the market.

"Use of medicine as prescribed by physicians can actually curb healthcare costs," said Rajesh Balkrishnan, lead author of the study and a Merrell Dow professor of pharmacy at OSU. "Medicine accounts for only 15 percent of total health care costs, yet (insurance companies) are quick to cut access to medicine."

Those who are uninsured, underinsured and those who are on Medicaid have lesser access to new medications, which cost more because there is no generic version available.

Newer drugs often have fewer side effects, control symptoms faster and are more popularly prescribed to patients, Balkrishnan said. The result is fewer hospital visits. Many patients wait until acute symptoms force them to the emergency room where costs can add up quickly, he said.

"People diagnosed with diabetes account for enormous economic burden on the health care system," said Rahul Shenolikar, a graduate research associate and co-author of the study. "We feel that these are avoidable and that appropriate interventions can reduce costs and save some money for the diabetics, and these resources can be used in other healthcare areas. With this feeling in mind, we conducted this study."

Participants who took TZDs saved between $920 and $1,760 annually versus those taking the older medications. The total costs included all medications, physician charges, hospital and emergency room visits. The results also showed a 10 percent reduction in the likelihood of hospitalization for those taking TZDs.

People diagnosed with type 2 diabetes are insulin resistant. Blood sugar levels remain high because the body cannot use the insulin that it makes. Older medications, such as metformins, lower blood sugar levels in the body while the newer TZDs work with the body to make cells more receptive to insulin. Generic metformin may cost patients as little as $10 per month compared to as much as $100 per month for a brand name TZD.

Diabetics are at increased risk for heart disease, cardiovascular disease, blindness and amputation due to infection.

Lifestyle factors, such as diets high in fat and sugar, lack of exercise and obesity along with a genetic predisposition, have led to increases in diabetes diagnosis. Another factor affecting the rate of increase in diabetes is "lower patient awareness and less of a preventative health mentality," Balkrishnan said.

"(Diabetes) runs in my family. I think about it, but not every day," said Moni Woods, a post-graduate student in English. "But, I try not to eat a lot of sugar, white starch or sodas."

Alcohol also has an effect on a person with diabetes. Moderate amounts of alcohol should not cause much concern, but excessive drinking can interfere with the body's ability to release sugar into the bloodstream when necessary, Balkrishnan said.

Drinking can also hinder one's ability to recognize the signs that his blood-sugar level is elevated or has dropped to the point of having a hypoglycemic episode. Slurred speech, blurred vision, feelings of dizziness and confusion characterize both hypoglycemia and intoxication.

To reduce the risk of developing diabetes Balkrishnan suggests losing weight, eating right and getting moderate exercise.