Can Baby Boomers Cope With Type 2 Diabetes?

Survey Reveals Diagnosis Comes Nearly

Two Decades Sooner Than Parents' Generation

Jan 20, 1998, 00:00 ET from Warner-Lambert

    MORRIS PLAINS, N.J., Jan. 20 /PRNewswire/ -- As America's first generation
 to avoid many life-threatening childhood diseases such as small pox and polio,
 Baby Boomers have matured into adults who are concerned about maintaining good
 health.  Rather than worrying about how to stay alive, Baby Boomers have
 learned to be more concerned about sustaining health and being in control of
 their lives.  According to a new survey of people with type 2 diabetes,
 conducted by Roper Starch Worldwide, these attitudes put Baby Boomers in a
 better position than their parents to manage chronic diseases.  That's good
 news for the 76 million Baby Boomers entering middle age, because they have a
 greater risk of becoming type 2 diabetics than their parents did when they
 were their age.
     Baby Boomers in this survey were diagnosed with type 2 diabetes almost two
 decades earlier than their parents' generation.  "As a whole, Baby Boomers are
 more likely than older age groups to consider diabetes a serious disease and
 to appreciate the benefits of early detection and treatment," said Gerald
 Bernstein, MD, associate clinical professor of medicine, Albert Einstein
 College of Medicine, director, Harold Rifkin Diabetes Center.  "This is
 positive news for Baby Boomers because they have more time to learn about the
 disease, learn about new treatments, understand the benefits of blood sugar
 control and practice a healthy lifestyle."
     More than any other generation, Baby Boomers are more aware and more
 concerned with avoiding serious complications of diabetes such as heart
 disease, blindness and amputation, according to the study.
     This information comes at a critical time as the largest number of Baby
 Boomers approach age 45, a risk factor for type 2 diabetes.  Other risks
 include being overweight and leading a sedentary, "couch-potato" lifestyle.
 Chances of developing diabetes increase if there is a family history of the
 disease; if a person is African American, Hispanic, Native American or Asian;
 or has related health problems such as hypertension and low HDL cholesterol
 levels.   Women who have delivered a baby weighing more than nine pounds are
 also at risk.
     New ADA Guidelines Target Baby Boomers
     New guidelines endorsed by the American Diabetes Association (ADA) now
 urge all adults age 45 and older to be tested for type 2 diabetes, and if
 normal, to be tested again at three-year intervals.  The guidelines also lower
 the threshold for diagnosis of type 2 diabetes from 140 to 126 mg/dl
 (milligrams of glucose per deciliter of blood).  According to the ADA, the new
 recommendations will cast a wider net and could dramatically increase the
 numbers of Baby Boomers with type 2 diabetes.  "We believe early diagnosis and
 treatment can reduce the risk of diabetic complications by as much as 50 to 75
 percent," said Dr. Bernstein.
     Type 2 diabetes occurs when the body is unable to make enough insulin or
 the body is resistant to the insulin that is available.  Type 2 diabetes can
 be managed through a variety of treatments including diet and exercise, and
 prescribed medication in order to maintain recommended blood glucose levels.
 The ADA treatment guidelines recommend therapy be adjusted when hemoglobin A1c
 (HbA1c) levels are greater than 8 percent with the ultimate goal being levels
 of less than 7 percent.
     Baby Boomers:  'Not My Parents' Generation'
     Baby Boomers' liberating and life-altering experiences like rock and roll,
 the sexual revolution and the advent of television, combined with such
 shocking experiences as Watergate, have shaped their views and attitudes
 making them less trusting of authority but more willing than previous
 generations to take risks, and more intent on fulfilling personal goals.
 These attitudes are significantly different than their parents' generation
 which share a set of values shaped by the blight of the Depression and pride
 of World War II: self-denial, respect for authority, hard work and social
     Today, a majority of Baby Boomers are grappling with their new health
 realities like type 2 diabetes, while balancing first, second and third
 careers; marriage, divorce, and remarriage; and parenting their children while
 caring for their aging parents.  "Juggling these myriad responsibilities day
 after day adds tremendous stress to the lives of Baby Boomers and causes them
 to be less optimistic about the future," said Jonathan Berry, editorial
 director of Roper Reports and Public Pulse, and an expert on the Baby Boomer
     Negative Emotions Translate Into Action
     Baby Boomers reported experiencing a range of emotions more intensely than
 older patients when they were diagnosed with type 2 diabetes.  Compared to
 their parents' generation, Baby Boomers were 35 percent more likely to be
 angry (35 percent vs. 26 percent) and 53 percent more likely to be depressed
 about having the disease (49 percent vs. 32 percent).  True to their
 generational outlook, Baby Boomers were less likely to be optimistic (55
 percent vs. 67 percent) and less likely than their parents' generation to be
 confident about their prognosis (56 percent vs. 65 percent).
     Although Baby Boomers with type 2 diabetes are diligent in their diabetes
 care, they judge themselves more severely than their elders.  Of those
 surveyed,  only 76 percent of the Baby Boomers vs. 90 percent of their older
 counterparts think they are making an honest effort to do all they can to keep
 their diabetes in check.
     However, the fact is, Baby Boomers are so diligent in trying to maintain
 blood sugar that they are nearly twice as likely as their parents to report
 reactions to mild or serious low blood sugar levels.  Interestingly, as a
 result of their efforts, one-third (32 percent) of Baby Boomers report their
 condition has gotten better compared to just 23 percent of their parents.
     An Information Generation
     Rather than rely solely on the knowledge and recommendations of their
 physicians, "self-involved" Baby Boomers believe their health is "their
 responsibility."  Baby Boomers typically spend hours researching information
 about their diseases and treatments.  Armed with research gathered from
 medical journals, diet and exercise books, radio and television talk shows,
 community health fairs, and the Internet, Baby Boomers are more knowledgeable
 about their disease than their parents and are better equipped to "consult"
 with their health care providers about treatment decisions.  For instance,
 according to the survey, 14 percent of the older generation were aware of
 Rezulin (troglitazone), a new drug for type 2 diabetes, but more than half of
 them (51 percent) could not specify what they heard or read about it.  Yet,
 one out of five (20 percent) Baby Boomers with type 2 diabetes are aware of
 Rezulin but also know that Rezulin can improve glucose control (14 percent),
 that it can eliminate the need for insulin injections in some patients
 (12 percent), and that it treats an underlying cause of type 2 diabetes
 (11 percent).
     Fear Of Losing Control
     While 93 percent of Baby Boomers with type 2 diabetes look forward to
 "whatever the future will bring," 58 percent worry about having to go on
 insulin some day.  "This concern may be a 'control' issue," said Berry.
 "These patients may equate insulin use with their inability to control their
 blood sugar levels, which goes to the core of every Baby Boomer - the need to
 control all aspects of their lives."
     A New Diabetes Treatment For Baby Boomers And Parents
     Before this decade, health care providers had limited means to treat
 diabetes.  Today Baby Boomers and their parents have options that will help
 them reach ADA targets.  One such option, in addition to diet and exercise, is
     Rezulin is the first medication in the thiazolidinedione class.  It is
 valued by health care professionals because it can be used in a wide range of
 type 2 diabetes patients.  It is an oral medication that reduces insulin
 resistance via a unique nuclear mechanism.   Insulin resistance is an
 important underlying cause of type 2 diabetes; it is a defect in the body's
 ability to use insulin as it should to metabolize glucose.  Over time,
 patients lose their ability to produce enough insulin to overcome that
     Rezulin can help some type 2 diabetes patients on insulin reduce or
 eliminate their daily insulin injections.  Rezulin may also be used
 concomitantly with a sulfonylurea to improve glycemic control and as
 monotherapy as an adjunct to diet and exercise to lower blood glucose.
 Rezulin should not be used as monotherapy in patients previously well-
 controlled on sulfonylurea therapy.  For patients inadequately controlled with
 a sulfonylurea alone, Rezulin should be added to, not substituted for, the
     In clinical studies, Rezulin was well-tolerated.  The incidence of
 withdrawals during clinical trials was similar for patients treated with
 placebo or Rezulin (4 percent).  Most adverse reactions to Rezulin therapy
 were comparable to placebo.  The most common adverse events included infection
 (22 percent placebo vs. 18 percent Rezulin), headache (11 percent placebo vs.
 11 percent Rezulin), and pain (14 percent placebo vs. 10 percent Rezulin).  In
 rare cases, Rezulin has been associated with serious liver problems which are
 usually reversible.  In very rare cases, these have resulted in liver failure
 including fatality.  Therefore, Rezulin patients should be monitored regularly
 for liver function.
     Rezulin has a unique mechanism of action that is dependent on the presence
 of insulin for activity.  It is therefore not appropriate in the treatment of
 type 1 diabetes where the patient does not produce insulin, or for the
 treatment of diabetic ketoacidosis, a build-up of acid and ketones in body
 tissues and fluids.
     In premenopausal anovulatory patients with insulin resistance, Rezulin
 treatment may result in resumption of ovulation.  These patients may be at
 risk for pregnancy.
     Rezulin has not been tested in patients with New York Heart Association
 (NYHA) Class III and IV cardiac status; therefore, Rezulin is not indicated
 unless the expected benefit is believed to outweigh the potential risk to
 these patients.
     Management of type 2 diabetes should begin with and include diet control.
 Caloric restriction, weight loss and exercise are also essential for the
 proper treatment of diabetes.
     Rezulin is available in 200, 300 and 400 mg. tablets.  Rezulin was
 discovered by Sankyo Company, Ltd. of Japan and co-developed in the U.S. by
 Parke-Davis and the Sankyo U.S.A. Corporation.  Parke-Davis co-promotes
 Rezulin in the U.S. with Sankyo/Parke-Davis, a joint venture that was
 announced in September 1996.
     The survey was commissioned by Parke-Davis, a division of Warner-Lambert
 Company.  Parke-Davis is devoted to discovering, developing, manufacturing and
 marketing quality pharmaceutical products.  Its central research focus is on
 heart disease, diabetes, infectious diseases, disorders of the central nervous
 system, and women's healthcare.  Warner-Lambert is a worldwide company
 employing approximately 42,000 people, and along with Parke-Davis, is
 headquartered in Morris Plains, N.J.
     The survey of 503 type 2 diabetes patients aged 35 and older was conducted
 by telephone between March 20 and April 6, 1997, by Roper Starch Worldwide
 Inc.  The findings are nationally representative and projectable to this
 population within a margin of sampling error of +/- 4.4 percentage points on
 the totals at the 95% confidence level.

SOURCE Warner-Lambert