October 14, 2014
Managing Diabetes When Pills Aren't Working
Sometimes, articles are published just when you need them. When wrote my blog on May 8, 2013, about helping a veteran get assistance and get on insulin, I was feeling great. She is happy to be on insulin and says her last A1c was 5.8%. Since then I have corresponded via email with two doctors that are against insulin use for type 2 diabetes until it becomes necessary. They have their reasons and it is not what I usually hear – the fear of hypoglycemia. They have told me that as long as a person with type 2 diabetes is producing insulin, they need oral medication to help in the utilization of that insulin and not additional insulin.
We have agreed to disagree because they are not afraid of insulin and do not wait until it is too late to prescribe insulin. They also agree that insulin should never be the medication of last resort, but they do agree that the tests of A1c and insulin produced do need to be done when the A1c gets above a certain point. They claim this should also be age dependent, but agree that there are individual variances.
We have discussed using insulin at diagnosis to help the pancreas recover, but they say that is not proven. I also say that the side effects of many oral medications are unacceptable and still questionable. Claim and counter-claim is the reason we have agreed to disagree. All three of us were in agreement that much information has been deleted from the National Diabetes Information Clearinghouse and even they are suspicious about what has been deleted and not added. All of the warnings required in the product packages have been removed and several products that had warnings, but are still on the market like Victoza that is no longer on the site.
The correspondence has been open and they appreciated that I was giving URLs for information on my side. We had some good discussions about a few studies and when they referenced one study, I asked why they would rely on junk science. I sent the URL to my blog on the study and another blog by someone else calling this junk science. Just testing was the response and then the discussions got serious. When I did not have access to a study, but only the abstract, I told them this. Occasionally, I was able to provide other blogs on the topic.
Rather than make this a very long blog, read this article in WebMD about overcoming objections to injections.