October 10, 2014
Managing Diabetes When Money Is Limited
Many people just do not understand how to manage diabetes when money is very limited. This doctor, writing for the Empower Our HealthMagazine of the American Association of Clinical Endocrinologists starts the topic off on the right note, but fails to cover many possibilities. I will cover what the doctor says and then in other blogs cover some of the many points she ignores.
For a doctor on a fellowship that says she was focusing on how to help the low-income, uninsured persons struggling to maintain their health, I don't understand why she totally ignores some points. Then she makes some statements that I am sure time and experience will correct. She says that even on limited income, there are many cost-effective ways to control diabetes, high blood pressure, and high cholesterol. I have no disagreement so far, but when she says increasing physical activity, I have to wonder why there is no precaution of with the doctor's permission.
The other statement is one that I have a constant complaint with all doctors and that is the salt debate. It seems this is so standard and not reflective of many recent studies. It is obvious that the doctor does not know diabetes and does not make any precautions about blood glucose levels safe for exercising. This also seems standard for most doctors, as even simple precautions are seldom included in any discussion.
I am surprised in her cost-saving tips for medications, but apparently, she is not aware of programs available from drug manufacturers that can help save money. There is nothing wrong with generics, but sometimes there is none that can be used. This is when manufacturer programs can be valuable.
I have no complaints about her discussion of treating high blood pressure. While some of the foods listed need to be avoided by people with diabetes, the rest of her advice should be followed. Of course, the salt should be moderate and this debate is still on going.
“Exercise, minimizing salt in your diet, losing weight and minimizing stress are important ways to prevent as well as treat high blood pressure. The same exercises used for treatment of diabetes can be used for hypertension. Foods such as tamarind drink, spinach, beans, sunflower seeds, bananas, spinach, squash, cantaloupe, garlic, celery, lemon, honey, ginger, cumin seeds, and cayenne pepper may help to reduce blood pressure because they are rich in magnesium and potassium. Also, avoid over indulging in alcohol — it can increase blood pressure. For those requiring medication, splitting higher dose pills to get a smaller prescribed dose is another means for cost savings, but this should not be done with pills marked as “extended release” or “slow release.””
When Dr. Noorhasan talks about cholesterol, she does not push statins, yet. Again, she promotes exercise, herbs, and foods which can reduce cholesterol. These include dandelion root, pumpkin seed, oats, sunflower seeds, whole grain breads, broccoli, cabbage, carrots, oranges, and salmon. Of course, whole grain breads, oats, carrots, and oranges need to be limited or avoided by people with diabetes.
There is much research needed for more blogs, but I will eventually have more.