Insulin, Other Drugs May Do More Harm Than Good for Some Type 2 Diabetes Patients

[Northerner]

For patients with type 2 diabetes - especially those over age 50 - the negative impact of side effects like weight gain and burdens like frequent insulin shots trumps the benefits of drugs, says a new study by the University of Michigan Health System, the VA Ann Arbor Healthcare System, and University College London.

The findings, which appear in today's Journal of the American Medical Association Internal Medicine, show that for many, the benefits of taking diabetes medications are so small that they are outweighed by the minor hassles and risks.

These findings suggest that, contrary to current guidelines for type 2 diabetes that recommend intensifying treatment until a person's blood sugar level reaches a certain goal, the overall benefit of taking a new medicine depends less on blood sugar and more on the hassles, safety and side effects of taking the treatment.

http://www.healthnewsdigest.com/new...-Good-for-Some-Type-2-Diabetes-Patients.shtml

What utter tosh! 😱 So how will it improve their quality of life when they do succumb to the inevitable complications caused by uncontrolled blood sugars? I'd much rather have the 'hassle', a few extra pounds and jelly babies, and two minutes a day spent injecting! And why is it different for Type 2s on insulin? If they need it, they need it just as much as Type 1s, surely?

 

[stephknits]

Grrrrrrrrrrrrrrr

 

[Redkite]

What?!!! How can it be too much hassle to want to stay fit and healthy?!!! And when I heard this piece on the TV, it implied that for elderly people in particular it may be more hassle than it's worth to treat diabetes with drugs. I get fed up of hearing elderly people's health being given a lower priority than younger people - just because they have fewer years left doesn't mean they don't deserve those years to be healthy and good quality! 😡

 

[Northerner]

What?!!! How can it be too much hassle to want to stay fit and healthy?!!! And when I heard this piece on the TV, it implied that for elderly people in particular it may be more hassle than it's worth to treat diabetes with drugs. I get fed up of hearing elderly people's health being given a lower priority than younger people - just because they have fewer years left doesn't mean they don't deserve those years to be healthy and good quality! 😡

Yes, I've heard this idea that older people can be less well-controlled due to the fact that it takes years for complications to take hold, and they may not have a lot of years left. But where do they set the bar? My dad is 86, what if he had been treated this way when he was 70, where would he be now?

 

[Vicsetter]

I suspect that the synopsis of the actual report has been badly written. The point made (especially in the last 2 paras) is valid. As patients get older there is less risk of complications becoming a problem.
This is already happening, my mother was diagnosed at 80 something and not prescribed anything - what is the point of putting elderly patients on a drug which is likely to cause side effects and affect their life when they will probably die before they have problems caused by diabetes. (my mother died at 89 of a heart attack without ever knowing her HBA1c or worrying about the consequences of what she ate or drank)

I think it's equally valid to challenge the rules by which GPs operate where they have NICE targets to meet irrespective of the patients quality of life. Do we really want the elderly having problems rushing to the toilet because of the effects of Metformin?
The report does say that if the condition being treated is sufficiently serious then it should be treated.

 

[Northerner]

My Auntie, who is now 78, was diagnosed T2 a couple of years ago. Since then (and she received her diagnosis via a scribbled note included in a letter concerning another problem ) she has not heard a single word on the matter from her GP, nor is she on any medication. I do think that is taking things to the extreme!

 

[Redkite]

I take your point Vic, but it needs to be the patient who decides whether they wish to take medication or not - there shouldn't be a cut-off age at which doctors simply don't bother to prescribe. And it's not just a question of complications, it's the constant feeling grotty from excessively high BG levels.

 

[cherrypie]

I thought that this was a good article.

Diabetes for the elderly - relax.
http://newoldage.blogs.nytimes.com/...the-elderly-relax/?_php=true&_type=blogs&_r=1

There are pros and cons of tight control for the elderly and this article addresses them. Worth a read.

At 75, with two other chronic conditions, I do not want more medication but less. The side effects can often affect quality of life. Luckily my diabetes is controlled but I have seen elderly people who often make mistakes with administering their medications and insulin doses. Lots of elderly people live on their own and a hypoglycaemic episode can have disasterous consequences for them. A lot depends on support or lack of.