January 12, 2016

Treat Prediabetes as Diabetes

What can we as people with type 2 diabetes do to encourage our doctors and other professionals to help people with prediabetes? This is a difficult question and David Mendosa tackles prediabetes from a different perspective that is interesting to read.

David says, “If you have prediabetes, taking the diabetes drug metformin might stop you from getting diabetes and could also help you in other ways. But persuading your doctor to prescribe it could be a challenge.” Yes, many doctors will not prescribe metformin “off label” and probably because they do not feel this is the correct thing to do.

Lifestyle intervention is not working because most doctors and certified diabetes educators refuse to work with people with prediabetes. Without education and reinforcement, most people will fail here because of the term prediabetes and the lack of seriousness by doctors and CDEs.

The biggest factor hurting people with prediabetes is the American Diabetes Association. The ADA only gives prediabetes a casual mention and even ignores many people with type 2 diabetes when Dr. Robert Ratner, chief scientific and medical officer for the ADA that says, “Many people with type 2 diabetes who are on medications don't need to do home glucose monitoring at all," in talking about oral medications.

It is this attitude that discourages doctors and especially patients when they know that people inside the ADA are not on their side and working to make management of diabetes work for them. Dr. Ratner wants people with type 2 diabetes to manage diabetes in the dark and make diabetes progressive.

Fortunately, many people are learning to buy the testing supplies on their own, are reading on their own to manage prediabetes and type 2 diabetes, and are ignoring the ADA. I have many people that ask me why I cover some of the ADA guidelines when they don't care about people with prediabetes and diabetes. I have to tell them that we still need to be aware of what they are saying and if there is any hope for change. The ADA has changed some in recent years, but still done very little for helping people with prediabetes, which is a group of people they created in 2003 with their experts.

David does cover some of the known side effects of metformin and gives some of the proper warnings. You should take the time to read his blog.


Denise said...

A dear friend of mine was diagnosed as "prediabetic", put on MetforminXL with no home monitoring support, and then taken off the medication 18 months later when her A1c was back below the threshold. But her morning/fasting glucose is still over 100 and she has no idea what her post-meal readings are because she doesn't test since her doctor doesn't think she needs to. Now they're saying she's "cured" her "pre-diabetes" and she's in the clear. The lack of direct, timely action by medical professionals for people with diabetes is just so frustrating!

Bob Fenton said...

This happens more often than many realize and I often think doctors do not want to understand prediabetes. I would suggest that people purchase testing supplies from Walmart as the prices are very reasonable.

I often do this for people that doctors do not tell people with prediabetes to test. I always suggest that they use the test strips to test in pairs to know what different foods do to their blood glucose levels at first and then to use them for fasting blood glucose levels to watch for trends.

With fasting blood glucose readings over 100, this still indicates that is problems and that type 2 diabetes is still possible. Only exception would be carb heavy evening meals.