Diabetes costs 'out of control'

[Northerner]

Thought I'd repeat this news item here:

http://www.bbc.co.uk/news/health-10740224

I agree with the last statement about health economics - getting better control is going to save money long term, to say nothing of improving quality of life, which should also be of huge value and often seems to be ignored in these reports.

I wouldn't be surprised if a part of the problem is lack of education in some HCPs - many here have said their doctor put them straight on meds without allowing a period of diet and exercise. Some doctors are also swayed by the pharma perks, no doubt. There are good doctors and nurses out there, we need to raise the bar so more of them perform well!

 

[Caroline]

My docotr put me straight on pills without a chance to try anything else.

Education and support are the way forward. My doctor is not too keen to send people on anything that might help them get better control and thereby reduce the meds needed and ultimately the costs.

We are lucky withthis forum as we support each other, but many people have no support at all. There have been posts asking about support groups in a particular area. My nearest support group is two buses away for me and finishes quite late, making it a very long day if I decide I want to go. I start work at 7am, so something that finishes at 10 or 10.30 pm is often out of bounds for me!

 

[Copepod]

responsibilities as well as rights

There are also patient responsibilities eg not asking / demanding items on prescription and then failing to use, allowing for the fact that use must be taught. Eg using items in date order - I get my insulin about every 6 months, so I use the soonest to expire items first, and have never had to throw away any out of date items. Personally, I'm still using the remnants of 700 lancets I was prescribed for a 4 month expedition in 2003/04, and choose not to change lancets (or needles) with every use - not every would want to do that, I know. Less waste also reduces costs of disposal. And, 15 years since diagnosis, still no complications, so my lack of resource (over) use is not at the expense of failing to monitor myself.
Plus, more exercise means I need less insulin. I have just had to ask for a replacement pen device, as my 4 year old one hasn't been working properly since it got a bit wet and gritty during a mountain marathon 3 weeks ago.
My dad certainly benefitted from diet and exercise when he was diagnosed type 2 - lost a couple of stone weight, kept as active as ever, knees have benefitted from less weight to carry, too. We'd been telling him to cut down on excess food for years, trying not to let it sound like nagging, but it wasn't until diagnosis that he took notice.

 

[AlisonM]

My original doctor put me straight on meds because my readings were astronomical: 28.4 when I was carted off to hospital, 18.4 when he tested the day I was diagnosed and an initial HbA1c of 11.7 (I think, see my siggy). He didn't think diet and exercise would be enough on their own. As it turned out I'm not a Type 2 after all so it definitely wouldn't have worked, but if it had been a possibility I'd have jumped at the chance. After all, who wants to spend their life taking pills if there's an alternative?

 

[MargB]

The practice nurse thinks it is wasting time to ask a patient to control things through diet and exercise. I was 7.3 on diagnosis and brought it down to 5.8 3 months later - I would rather not be taking Metformin.

 

[Andy HB]

Whether someone is put on medication immediately should depend on the circumstances.

Personally, I think that my care was spot on. Gliclazide to get things under control, then metformin to maintain control and then diet & exercise now that my levels are consistent (although that was more driven by me!).

Andy 🙂

 

[sofaraway]

There is also an issue with GP's not stopping medications when others are added. like keeping people on gliclazide once they are on basal/bolus insulin. I think it's good that these new expensive medications come with a 6 month trial period, so that they are stopped if they aren't working.