July 28, 2015
Treatment of Type 2 Diabetes – Part 1
I think it is time to review the treatment of type 2 diabetes. This article in WebMD covers some great points, but misses many warnings that should have been included and some other points that should have been made. Will I cover them all – doubtful, as my mind is racing and I will probably miss several.
The first point that I want to cover is that diabetes is not your fault. Most doctors insist that you caused it and make it sound very discouraging and say that the diabetes complications will arrive soon enough. This not only will scare you, but many people give up and feel if they can't prevent the complications – so why try? Don't let this happen to you.
If your doctor tries to scare you, it is time to change doctors. Don't let them bully you into giving up and believing you can't manage your diabetes. I know from experience that managing my diabetes is not simple and often is more difficult than I even thought it could be. Yet, because I know that there can be times nothing seems to go right, I try to learn from each case and improve my management.
Now you should understand that you have lots of options to manage your diabetes and every person can be different. Diet (or food plan as I like to use), exercise, and medication (if necessary and there are many medications and strengths of medication) all can work together to help you manage your blood glucose levels.
Your doctor should help you, but never should the doctor set your goals. In the beginning he may help you, but never dictate what your goals should be. This is another reason to change doctors if your doctor insists on setting your goals. They only have about 60 minutes a year available to see you or less if they only see you twice a year.
Your doctor should help you determine if you need to take an oral diabetes medication or insulin. But if he will not listen to you, you will need to consider if the medication is right for you. Ask about side effects and what you need to do if you have one of the lesser-known side effects. Ask if you should take the medication if you are not feeling well and under what circumstances you may still need to take the medication.
Your A1c will probably determine how often you should take the medication and the doctor will suggest accordingly. If you are strong willed and can bring your diabetes under excellent management, will the doctor be willing to change the medication dose and when to take the dose. Also ask if you bring your A1c to within the normal range, will the doctor support you and allow you to stop taking the medication. These questions need answers and not a “we will see” answer.
As you age, the way you handle diabetes may change. Not because you can keep the same management, but your body may not be able to handle the medication or your pancreas may no longer be able to produce the needed insulin. When this happens, don't leave insulin as the 'medication of last resort.'
New medications seem to be approved the FDA more regularly, but I advise caution until they have been on the market for a few years and more of the side effects are known. Then if you agree with the doctor, make the change.
Part 1 of 4 blogs.