Today's Perspective
Kristin Wiisanen, PharmD, FAPhA, FCCP, Pharmacy Today editor in chief
According to CDC, about 1 in 10 Americans have diabetes and approximately 90% to 95% of them have type 2 diabetes. Disturbingly, another 8.5 million people (23.0% of adults) have undiagnosed diabetes. Despite medical advances and the largest number of available treatments in history, the numbers are only getting worse. In fact, 2021 marked the second consecutive year that diabetes deaths in the U.S. topped 100,000—a record high.
How can pharmacists help? First and foremost, we can help by staying current with emerging evidence on drug therapy for diabetes. This month’s cover article delves into the latest guidance from the American Diabetes Association to provide a timely and important update. One key piece of information: metformin is out and SGLT-2 inhibitors and glucagon-like peptide-1 (GLP-1) agonists are in as first-line treatments. In the words of Susan Cornell, PharmD, FAPhA, from Midwestern University College of Pharmacy, “It’s time to retire metformin.” This is a big change from decades of previous diabetes treatment recommendations. But it makes sense. The vast majority of people with diabetes are overweight or obese and SGLT-2 inhibitors and GLP-1 agonists are particularly effective at treating obesity. Weight loss improves diabetes and goes a long way toward decreasing risks of heart disease and end-stage kidney disease, two diabetes complications.
In this month’s issue of Pharmacy Today, you’ll also read the latest on DEET in insect repellants, whether stinging nettle is beneficial or just a pain, and a call to action in the care of transgender patients. Find out which OTC products may not be effective at all, get tips on avoiding confusion with topiramate oral solution prescriptions, and stay up to date on your CPE with this month’s article on drug-induced photosensitivity.
Another important role for pharmacists in diabetes? Spreading the word about current evidence-based treatment recommendations to patients and prescribers. On average, it takes 17 years for research evidence to reach clinical practice. In the case of diabetes, there may be a tendency to choose metformin over newer agents with a higher price tag and patients may grumble. Know the facts and be an advocate for changing diabetes treatments. A smooth transition to first-line therapy with newer, more effective agents will help tackle the diabetes epidemic.
Have a great Today! ■