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January 24, 2002

Community Resources

Question from Phoenix, Arizona, USA:

I've been reading the type 2 diabetes questions and answers on this site, and it seems that no matter how stringently I diet and exercise, how little food I survive on, or what kind, the end result is the same pills, insulin, and death. It boils down to a question of whether I care if I go sooner or later. Oh, and I love all the references to "your diabetes team." How about being told, "You have diabetes. Your glucose is.... Make an appointment to see me in six weeks. Take these two medications. Oh, and here's a monitor. We get 'em free from the manufacturer. It has instructions in the box."

Answer:

You shouldn’t tolerate such care — plain and simple. There are doctors who work with diabetes centers who can help control the diabetes. Yes, diet, exercise, pills and even shots may be needed, but they work.

LD
Additional comments from Dr. Philip Ledereich:

No, it does matter. The studies all show that people with type 2 diabetes who take better care of themselves (lower hemoglobin A1c) do better and have fewer complications. (See DCCT. and UK Prospective Diabetes Study [UKPDS]).

In fact, the Diabetes Prevention Program (DPP) proved that exercise and proper diet can help preserve beta cell beta cell function longer.

Just because your physician is too rushed to take the time to take care of you, means you should get a new physician or call him on it. I read a recent paper by Dr. James Gavin, past president of the American Diabetes Association who calls your situation “physician whimsy”, meaning the physician does not properly diagnose type 2 diabetes for several years, and then under treats it. Studies have shown patients who are cared for by an endocrinologist do better than those cared for by primary care physicians (no matter how caring they may be, specialists do better).

PSL

[Editor’s comment: It appears that you have been newly diagnosed and may have gotten off to a bad start. Both your anger and lack of appropriate diabetes education are quite evident and need to be dealt with as soon as possible. In this day and age, treatment of type 2 diabetes is complex. There is a plethora of options to choose among, and the treatment plan needs to de devised in such a way to optimize blood glucose control, compromising lifestyle as little as possible. As the physicians have said, you would benefit great from seeing and experienced diabetes team that can and will take the time to assess your needs and help you devise an individualized treatment plan.

Also see the ADA Clinical Practice Recommendations to assess your current level of care.

SS]