It is seldom that I think that the
people making comments are more knowledgeable than the author of the
blog, but this blog site seems to be more this way the longer it
stays in existence. I say bravo to the people good enough to make
comments to a decidedly lackluster blog.
The question is why insulin is only
considered after oral medications are shown not to work any longer.
All we need do is look back at the April 2012 American Diabetes
Association (ADA) and the European Association for the Study of
Diabetes (EASD) hyperglycemia guidelines for an answer. Tom Ross
blogged about it here and later I blogged about it. In addition,
this has been part of the ADA guidelines for several years. They
want oral medications used until insulin becomes necessary for type 2 diabetes..
Then if you add to this, the threat of
insulin that doctors use to keep patients on oral medications, it is
easy to comprehend why diabetes becomes progressive. Insulin should
never be use as a threat and as a medication of last resort. This is
the reason I enjoy listening to and reading information put out by
Dr. William H. Polonsky of the Behavioral Diabetes Institute of San
Diego, California. He correctly says diabetes causes nothing; it is
the lack of diabetes management that causes the complications people
develop. For those people interested, I would encourage you to use this link and subscribe to at least their newsletter.
I agree with a comment to the blog that
recommends reading Dr. Richard K. Bernstein's book, "Diabetes
Solution". This will help in understanding the importance of
insulin as well as food plans to avoid blood glucose spikes. The
author of this blog takes the safe route by using ADA
recommendations, which are far from ideal for patients that wish to
keep diabetes from becoming progressive. Insulin should be the
medication of choice for many patients long before most doctors are
ready to prescribe it.
The blog author lists some reasons that
doctors are hesitant to prescribe insulin and some are probably true.
Most doctors do have a strong fear of hypoglycemia (low blood
glucose level) and this causes them to avoid prescribing, as they
themselves do not know how to handle hypoglycemia. Many doctors also
do not have the time available or access to diabetes educators and do
not want the deal with the complexity of insulin therapy.
It is true that some doctors fear
insulin more than the patients fear insulin. Even if this is a Canadian study, many US doctors fall in to this category.
Image courtesy of timeinsulin.com [Image like now broken]
The author is correct in her statement,
“Taking insulin doesn't mean that you've
failed to manage your blood sugar.” And, remember
diabetes is progressive – only if you do nothing to manage it.
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