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Are Diabetics Overmedicated?
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Exchange_Blogs_Admin posted:
Are diabetics overmedicated ? It's very easy for health care providers and patients to rely on medications to get the numbers in line, without paying due attention to lifestyle change. Read Dr. Dansinger's thoughts on the subject in his latest blog post . Then come back here to share your comments.
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xring responded:
Many certainly are, in my opinion. My first two doctors wrote prescriptions & said "goodbye -" didn't say one word about diet, lifestyle or weight. I doubt they were rare exceptions. It makes for a very brief visit.
 
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betaquartz responded:
My early experience with my Dr. was a prescription of metformin which I refused. One month later he told me it was obvious I could control the diabetes with diet and exercise. Not an apology, but relented. Later discussion indicated that too many of his patients would not make lifestyle changes so he went the easy route-prescription. Since then we have a new understanding, now I am working on him about my Lipitor. We'll see how that turns out in the Spring. So the answer here is possibly, but Dr.'s need to treat each new diabetic as a separate case not pile all of us in the same basket.
 
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DavidHueben replied to betaquartz's response:
Beta:

It has been suggested that the use of statins is completely a "hoax" perpetrated by the pharmaceutical industry and the doctors who ostensibly benefit from their sales and only intended to increase sales.

Do you subscribe to that theory?

If you can reduce or eliminate the use of any prescription medication, then I think that is great. Good luck.

David
 
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rebitzman responded:
While I'm sure there are doctors and patients who seek an "easy way", I am not of the opinion that it is the norm, nor am I of the opinion that this is one that we can lay on the doctors.

Im my opinion, it is the responsibility of the patient to be engaged - to get educated - and to be responsible for his/her own health care in partnership with their physician. If that means medications - then that means medications.

In my opinion - "he didn't tell me" is not a valid excuse on the patient side, and "too many of his patients would not make lifestyle changes" is not a valid excuse on the physician side.

I accept that there ARE doctor who don't want to be part of a partnership - change doctors - do not blame ALL doctors.

I accept that there are patients who will not give up HoHo's - monitor and treat based on what they do, not on what the last guy did.

So for me - I suppose I think the question itself (Are diabetics overmedicated?) is one that can only be answered on an individual basis, and one that no one here is qualified to answer on the broader scale you seem to imply.
 
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xring replied to betaquartz's response:
Exactly, Betaquartz.

The RN who runs my support group said "Doctors know patients won't follow their dietary & lifestyle recommendations, so they don't waste their time discussing them." As I explained to her, "That's a very lame excuse because a doctor who assumes that for every patient will be a complete failure for their patients who are willing to make lifestyle changes."

I'm well aware that some diabetics don't want to hear it & will even become angry & feel insulted, but it's wrong to assume all their patients will react that way.
 
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rebitzman replied to DavidHueben's response:
It has been suggested that the use of statins is completely a "hoax" perpetrated by the pharmaceutical industry and the doctors who ostensibly benefit from their sales and only intended to increase sales.

I felt Dr. Dansiger addressed this directly and convincingly.

On the subject of - he (Dr. Dansiger) is an excellent example of the sort of Dr. I was describing - one who engages his patients in their own treatment - and I truly do not believe he is the exception.

COULD be it is because of the three physicians I see regularly - ALL of them treat their patients that way. When diagnosed, the decision to go on meds was mutual - the decision later (as in 40 pounds later) to go off them was mutual as well. Glucose levels holding steady in the 80's - A1C is in the low 5's, and a doctor who checks my progress on line regularly - asks and listen because I ask and listen.

Won't work for everyone - NOTHING works for "everyone" - but it works for me.
 
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rubystar2 replied to rebitzman's response:
I agree, Reabitzman, I think it IS the responsibility of the patient to arm themselves with information. But many don't or can't and blindly follow their doctor's recommendation. Which in some cases means taking the meds without knowing there may be alternatives for them. Don't we see new people posting here quite often saying they were diagnosed with diabetes and they have no idea how to get a meter or if they do get one, they don't know when to test or what numbers they should be working towards.........let alone receive any diet information.

I think we see way less here on this diabetes exchange of diabetics being overmedicated and underinformed simply because the people who join her ARE seeking information. Just think of all the thousands of diabetics who choose NOT to join here and arm themselves with knowledge. There are so many diabetics out there, I'm sure, who take their pills, eat whatever they want and think they are doing the right thing. Take my ex- husband, for example. He thinks because he's "only a type 2 diabetic" that it doesn't really matter what he eats. He eats whatever, whenever and however much he wants and thinks as long as he takes his pills, he's fine. He is one of thousands of diabetics who think that way. We just don't see too many of those here on WebMd. But believe me, they are out there.
 
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rebitzman replied to rubystar2's response:
Just think of all the thousands of diabetics who choose NOT to join here and arm themselves with knowledge.

Could be that there are just as many that are comfortable with the info they are getting from their healtcare provider, and I guarantee that for every one who posts, there at a minimum of 5 lurkers (national stats on "self help" or "support" boards). Further, while the "1" who posts stays rather constant - the "5" Lurkers are a rather dynamic lot - with a great deal of turnover. over the period of a year, it is not unreasonable to assume that to every you and me, there are 100 "lurkers" who wander through over the course of a year.

So thefootprint is bigger than you might suppose.

There are some fantastic studies that have been done as to the why people visit and participate on these boards, and surprisingly enough - the pursuit of knowledge isn't the top one. Empowerment is - and that does not require that you have a "voice" on the board. For those with a voice, they primarily want to INFORM - not learn. At best (depending on the study) the pursuit of knowledge finished around 3rd in most studies.

Sorry about your ex-husband, but he is a shining example of what I am talking about when I say "patient responsibility". I too know of too many people who have this condition and complain loudly that they can't lower their sugar levels - while eating cookies, and you can't blame the doctor for "over medicating" them, because the alternative is to just let them die (or go blind, or rot, or.....).

At the same time, to say "all they have to do is......" is simply judgemental - because maybe they simply can't.

And maybe because there's nothing about Type 2 diabetes that's simple.
 
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phototaker responded:
When I was pre-diabetic, my doctor didn't caution me or send me to a pre-diabetic class. That would have done it. Yes, I "knew" better in some little ways, because my mom was diabetic. When I became diabetic, I went totally strict...so careful, and brought my A1c down within months to 6.1. Now, I'm at an A1c of 5.8, but am just starting to gain back a little weight. My doctor the whole time didn't want me to go on medicine for my diabetes, even though I asked her a few times in the beginning about whether I needed it. Her husband is diabetic. She didn't really explain anything to me either. I got most of my information on WebMD and reading some research. I also attended diabetes classes(at my expense)and went to a dietician twice. The first one was no help. The 2nd one taught me how to read labels better and gave me a little better information.

I do feel it's important for us to read up on things, but I certainly don't want to bash anyone who doesn't. I feel helping them when they're new to understand about diabetes is so important. Otherwise, they may give up and just take the pills.
Some people aren't great at researching. Maybe no one ever taught them how to do that on the computer or in libraries.Some are so busy with their lives, children, illnesses, or taking care of aged parents. We should never assume anything.

We're here to help ourselves first, and learn together. I've gleamed so much from all of you. I hope my experiences have helped others, too, even if it's what NOT to do.

If I eat really strictly and healthy, my numbers stay at an even keel. Unhealthy for me could be having too many slices of pineapple. Each person's tolerance of different foods is what they have to look at. Someone else could do a lot more fruit than I can.

We always have to remember that each diabetic is different.
If someone reads things on here, they have to try it with that in mind. What works for one person, might not work for someone else. Don't get discouraged, but just try and try until you find out what works for you.
 
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betaquartz replied to DavidHueben's response:
I prescribe to the theory that less is better. I don't like to take anything for a headache, or a stomach upset, or twinges in the muscles or bones. I do take vitamins and minerals, including fish oil, and cinnamon, and garlic. I take a baby aspirin every other day as my blood is too thin for every day. The Lipitor is prescribed by my Dr. because of my cholesterol numbers. He wants them lower before he will discuss removing me from it. I'll go along with him at this point. I don't know what the damage if any. I have printed out the information that has been reported the last month and given it to him with my questioning concerns, but he is my Dr., and at this point I am willing to listen.
 
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laura2gemini2 responded:
I believe that a lot of people are being heavily medicated, and not knowing what the medication really is or why the doctor put them on it. I work for a pharmacy, and the sheer number of people that call in and either 1. dont know the names of the medications they are on, or 2. dont know what they are for are astounding.

Definitly more education should be offered once someone is diagnosed. I feel that if I had all the knowledge then that I have now, my pancreas wouldnt have shut down at the age of 25. (That, and a really bad endocrinologist probably deserves most of the blame, but that is a long story...)
 
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betaquartz replied to tcable's response:
Went to your link, sent me, got no address.
 
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Manoj_in_Bangalore replied to betaquartz's response:
This article appears to be ghost written. The text mentioning LDL is standard text in all the websites promoting statins. No physician who has taken the Hippocratic Oath of practicing medicine ethically, would recommend lowering cholesterol levels when they are immaterial, and the medicines that are unnecessarily prescribed to reduce cholesterol increase insulin resistance and make the type 2 diabetes worst.

Quotes from TIME magazine article dated March 16, 2010:
"Doctors at the annual meeting of the American College of Cardiology in Atlanta on Sunday got some surprising news on their first day of sessions. Researchers presented three studies revealing that some of the most widely prescribed medications to reduce the risk of heart disease in Type 2 diabetes patients appeared not to provide much benefit at all."

.
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But the primary lesson that clinicians can take away from the new findings is that the blind push to lower all risk factors such as blood pressure or cholesterol isn't necessarily healthy, says Dr. Christopher Saudek, director of the diabetes center at Johns Hopkins University. That may even mean resisting the commonsense urge to reduce these measures to recommended or normal range in diabetics patients. "To me, it's a matter of having reasonable and patient-oriented individual targets," he says, "rather than trying to push and push and push just to get lower and lower glucose or blood pressure or lipid levels."
Read more: http://www.time.com/time/health/article/0,8599,1972325,00.html#ixzz0lEl973XR
 
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DianeR01 replied to rebitzman's response:
I agree, many are comfortable with the info they are getting from their health care provider, but it is up to them to be uncomfortable and ask questions to ensure the best care possible.

When I was first diagnosed I was given a 2 sided card which had the very basics of a 1200 calorie diet, 5 minutes with a nurse on how to use the meter and a prescription for metformin. Hmm, not a total disaster but not encouraging. I fumbled with the meter for a few days not remembering when to test, came up with a few readings in the 400's and was totally frustrated. I called the nurse for better directions on the meter, went to the library to learn more about diabetes and made another appointment with my doctor.

When I got back to the doctor a couple of weeks later I was armed with a list of questions and a pencil to write down the answers. At that point our relationship changed dramatically and now there is discussion about treatment, weight and diet. He then sent me to the diabetes education program at our local hospital which for me was worth every minute I spent there.

I am a firm believer medical care is a partnership and not one sided. We need the knowledge and experience of the health care professional but they need our active participation to make it work.

So are we overmedicated? Probably. There are many people who are very passive in their care and health care providers who have seen too many passive patients.

my thoughts


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