August 10, 2012

Reasons Diabetes Patients Need To Be Proactive

Proactive you say? Yes, we as patients need to become more proactive in our care and learn about diabetes, diabetes medications, and the care of ourselves. This means that we should learn and review. The new medications that may be coming to market in the next few years will need to be reviewed, as there could be some side effects and some positive results. Just letting your doctor prescribe a new medication may not be in your best interest. You will also need to check with your medical insurance company to see if they are covering it. You should know that the cost will be higher than the current medications on average or even significantly higher. Those on Medicare will still have the “doughnut hole” (though smaller) for a few years and this could be a budget buster for some.

With hospitals continuing to employ more doctors, you can bet the time you will have with your doctor during appointments will continue to shrink. This means less time will be available for the doctor to dispense education and even cover the topics necessary.  The recent guidelines from the American Diabetes Association (ADA), which shows a lot of stacking of medications, may not work for many patients. See this blog by Tom Ross for the chart, or follow his link to view how ADA is stacking oral medications. This makes it even more important for patients to educate themselves to know what the side effects of medications are. It is also important that patients learn self-monitoring of blood glucose (SMBG) and other important management skills.

It is also important to understand that just because a doctor does not mention or talk about something, there are areas that are important and should not be ignored. Exercise is one of these areas and I admit that I am tired of hearing other patients with type 2 diabetes saying, “It must not have been that important as the doctor never talked about it.” This phrase just seems to roll of the lips of patients and I can understand as either they don't wish to follow some recommendation, or in fact, the doctor did not have time to talk about it. Nutrition is also a topic most doctors do not talk about, yet for people with type 2 diabetes, nutrition is very important to great diabetes management.

Another topic doctors often don't talk about unless they are prescribing insulin is hypoglycemia. They seem to overlook the fact that this can happen and does happen to patients with type 2 diabetes on oral medications, especially sulfonylureas. A recent blog should also raise this concern. Even this short article talks about hypoglycemia, but other than list the symptoms, gives no indication of what to watch for in your blood glucose readings. This is important and many of the symptoms could be indicators of other medical problems. One check of your blood glucose will resolve this issue. If your blood glucose reading is below 70 mg/dl (3.9 mmol/L), you are in the hypoglycemia area and should take action immediately by chewing on a glucose tablet.

Just to keep this in front of you as a reminder, here are many of the symptoms of hypoglycemia,
Feeling dizzy or shaking,
Sweating and having pale skin.
Developing a headache.
Feeling hungry.
Showing sudden changes in behavior.
Moving clumsily.
Having a seizure.
Feeling confused or having difficulty paying attention.
Feeling a "tingling" sensation around the mouth.

This blogger believes we will need to become e-patients, meaning empowered patients. Her book e-Patients Live Longer, helps explain her and her beliefs, but it is a good read. Whether you have diabetes or breast cancer, it helps to be an e-patient.

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