Professor Stefano del Prato, a globally recognized diabetologist and researcher, recently shared his invaluable insights on the evolving landscape of type 2 diabetes care. With decades of experience in diabetes research and clinical practice, professor Stefano del Prato highlighted the transformative advancements in treatment, the critical role of prevention, and the promising future of personalized medicine. His reflections underscore the importance of innovation, collaboration, and patient-centered approaches in addressing the challenges of diabetes care.
A new era in type 2 diabetes treatment
Professor del Prato recalls the momentous time when the United Kingdom Prospective Diabetes Study (UKPDS) highlighted the importance of glycemic control, setting the tone for future management strategies. While controlling blood glucose remains vital, he emphasizes that a remarkable transformation in type 2 diabetes treatment has occurred over the past two decades. Newer pharmacological agents now provide not just glycemic management but also measurable protection against major complications like cardiovascular and renal diseases. For the professor, “what has really changed is the more effective way to reduce the burden of complications in people with diabetes.”
Personalization: The promise of individualised medicine
Looking ahead, Professor del Prato envisions further personalization of diabetes therapies. New drug classes, such as dual incretin agonists, are rapidly emerging, with many more innovations on the horizon. This solidifies a shift toward holistic treatment, where physicians tailor interventions based on individual risk profiles and personal characteristics. According to him, “We are likely moving toward a more ‘precision medicine’ era, where risk is identified early, and the safest, most effective treatment is individually chosen.”
Between guidelines and individual care
Lifestyle, culture, age, and social determinants all affect how diabetes presents and progresses. For Professor del Prato, choosing the right treatment means understanding a patient’s unique cultural background, habits, and clinical features. “Guidelines are very important,” he notes, “but we must remember these are derived largely from clinical trials involving selected populations. Real-life patients, especially at the extremes of age or with multiple comorbidities, are more diverse. Ongoing dialog between doctor and patient remains pivotal to optimal care.”
Prevention: The cornerstone of diabetes care
Central to Professor del Prato’s perspective is the concept of prevention: both preventing diabetes in at-risk individuals and preventing complications in those already diagnosed. He cites compelling findings from the Diabetes Prevention Program (USA) and the Finnish Diabetes Prevention Study, which both demonstrated that lifestyle modifications alone can reduce the onset of diabetes by 50% or more. Going further, he is optimistic about “precision prevention,” where at-risk subgroups can be identified earlier for tailored interventions.
Polypharmacy and diabetes
The Digital Doctor Survey 2023, which gathered responses from over 9,300 healthcare professionals, revealed critical insights into the issue of polypharmacy, the use of multiple medications, often seen in patients with chronic conditions like diabetes.
More than half of respondents identified aging populations as a primary driver of polypharmacy, while others pointed to insufficient awareness of potential drug interactions. Professor del Prato acknowledges the complexity of managing multiple medications, emphasizing the need for tools to support clinicians.
Picture 1: The main reasons for polypharmacy according to the Digital Doctor survey 2023 results.
“With the growing number of effective drugs, it’s impossible to retain all potential interactions in our minds,” he notes. “Digital tools, such as interaction checkers, are invaluable for ensuring safety and optimizing treatment plans.”
Interestingly, the survey also revealed a divide in how doctors perceive polypharmacy: 50% view it as an offensive approach (proactively addressing multiple risk factors), while the other half see it as a defensive strategy (reacting to existing conditions). Professor del Prato attributes this split to differences in specialties, with chronic disease specialists like diabetologists often favoring a more offensive approach to prevent complications.
Read also: Polypharmacy and quality of life
Workload and the healthcare system puzzle
During the pandemic, work satisfaction among healthcare providers was challenged by exceptional demands. Now, faced with a shortage of physicians in many regions, the workload remains high. Problems like limited access to public healthcare settings and a rising shift toward privatization concern many professionals. Professor del Prato stresses the need to “restructure systems for better physician support,” highlighting that burnout not only affects individual wellbeing but also compromises patient care.
The Digital Doctor Survey 2023 sheds light on these challenges, revealing that work overload remains the biggest issue for doctors, with 72% identifying it as their top concern, only slightly down from 76% in 2022. Compensation concerns have risen sharply, from 31% in 2021 to 58% in 2023, reflecting growing dissatisfaction.
The role of artificial intelligence in diabetes care
Artificial intelligence (AI) has the potential to revolutionize healthcare, and Professor del Prato sees it as a powerful tool for improving diabetes care. While concerns about losing the human touch in medicine persist, he believes that AI can assist physicians in analyzing large datasets, identifying patterns, and making informed decisions. He urged active collaboration between healthcare professionals and AI developers to maximize the potential of these technologies, particularly in managing chronic diseases like diabetes.
Conclusion
As Professor del Prato looks to the near future, he champions hope and progress. Recalling the importance of investing in research and collaboration, he encourages healthcare systems to uphold prevention, innovation, and education as guiding principles. Heading into a new year, he shares a simple yet profound wish:
“All the best for a productive, peaceful year. There is no better investment than in health.”
Professor Stefano del Prato’s insights provide a compelling vision for the future of diabetes care. From the integration of personalized medicine and AI to the prioritization of prevention and systemic reforms, his expertise highlights the transformative potential of innovation and patient-centered approaches. As we move forward, his call for continued research and collaboration will undoubtedly shape the next chapter in diabetes treatment, paving the way for more effective and personalized care for patients worldwide.
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