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June 29, 2007

Other, Type 2

Question from Washington, USA:

My 85-year-old mom was just told by her doctor that she has type 2 diabetes. This is the conversation: Doctor, "You have type 2 diabetes. I'm not giving you medication. I want you to try diet and exercise, then come in in three months for a blood test. You will also need a yearly eye exam. I will refer you." Is it just me or did we get the brush off? There were no pamphlets, no suggestions about diet or seeing a dietician, no mention as to whether she should be testing.


You may be correct. However, I have no idea as to what the intentions of your mother’s physician were. It seems likely that without much education, most patients are prone to fail to have much impact on their blood sugar control. I do not know how your mom is doing physically. However, if she cannot exercise, she may not be able to exercise enough to induce change.

There is another potential message in what he might be saying. He may be saying that your mom has diabetes. However, it may not be associated with high glucose levels and he doesn’t feel that aggressive intervention is necessary. The three-month test he is referring to is called a hemoglobin A1c and it is used to determine the average daily blood sugar over the previous three months. This test is closely aligned with outcomes, including complications. I agree it is a good yardstick for glucose control. These kinds of questions are probably best discussed directly with the physician.