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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