May 3, 2017

Intensifying Treatment of Diabetes

It is almost funny what both doctors and patients are doing to delay intensification of diabetes treatment. Both in the United Kingdom and in the United States, doctors are afraid to intensify diabetes treatment. Then patients are not doing what they should to manage their diabetes. With both patients and doctors not doing what they should, is it any wonder we are facing a diabetes epidemic?

Doctors are fearful their patients may have episodes of hypoglycemia and this keeps them from intensifying treatment. They also believe diabetes is progressive and many feel like - why waste money on these patients.

Patients by contrast, go to the doctor for more medications and expect the doctor to manage their diabetes. How naive patients can be? I have heard many of the excuses offered by patients and this tells me they are looking for that one pill that will allow them to return to their life, as they once knew it. A couple of these excuses are, “my blood sugar is out of control and nothing my doctor tells me will fix it” or “my doctor isn’t listening to me when I say my medication isn’t working.” Do these sound like the patient has taken ownership of their diabetes? Hardly, these excuses sound to me like they expect the doctor to manage their diabetes and it isn't happening and won't happen.

Doctors and patients both need to reconsider their positions and act accordingly. The doctors know from the A1c that the patients are not managing their diabetes. The patients are refusing to take ownership of their diabetes and expecting the doctor to manage it for them. I can only advise patients to take ownership of their diabetes and learn how to manage their diabetes.

Stop expecting miracles from the doctor. Your A1c tells them how you are managing your diabetes and gives them concern that more medications will not help. Start educating yourself about diabetes – start reading and acting, as you should by changing your lifestyle habits. See my blog here about the lifestyle changes that you can or should manage. Find someone that is managing their diabetes and ask for their help. No, I did not say do what they do, as this may not work for you. Learn how they manage their diabetes and try these ideas, but don't become tied to them as something may work better for you. Develop a food plan that works for you. If you are able to afford the extra tests strips, test more often and learn to trust your meter as it will show you what works and does not work in a food plan.

Remember, the diabetes is your diabetes and you must manage it. The doctor can offer suggestions, but you are the only person that can put the suggestions into practice.

Yes, better outcomes happen when doctors work with patients to intensify oral antidiabetic drugs (OADs). Many articles claim that type 2 diabetes is a progressive disease. The only time it is progressive is when the patients with their doctors', refuse to aggressively treat type 2 diabetes and let it get out of control. Treated aggressively, type 2 diabetes can be managed and prevented from becoming progressive.

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