Thursday, September 23, 2010

Would you trade your heart for normal blood sugars?

The increased risk of heart attack is one of the biggest incentives for diabetics to closely monitor and control their blood sugars. So why would you want to take any medication that makes it more likely that you'll have a heart attack, even if it does do a good job of lowering your sugars?

That's what I don't understand about why the FDA has chosen to keep Avandia on the market. The increased risk of heart attack is documented, so why would they allow the company to continue selling the drug, even if it is on a more restricted basis?

I wouldn't be surprised if someone is pressuring the FDA to keep the drug on the market...

Monday, September 20, 2010

Being diabetic BEFORE Lantus

I got an ugly look recently at what it used to be like to be type 1 diabetic.

On Friday, for a study I am participating in, I was put on an older 12-hour insulin called NPH. I've heard that when Lantus replaced these older long-acting insulins, they revolutionized the way a diabetic lives, but I had no idea how true this was until this weekend. I was diagnosed shortly after Lantus came out, and never had to use anything else.

Well, let me tell you, NPH sucks. This is why diabetics didn't used to be able to delay or skip meals! Good heavens. I fight crashing from lunchtime until well after dinner, but when I wake up in the morning, my blood sugar is sky high. I rarely ever have readings over 400, but I've woken up with my blood sugar that high two mornings in a row now.

It is destroying my life. I have to snack and purposely run my sugars high, so that I won't crash while I'm doing something like riding my horse. Then I feel like crap all the next morning while my blood sugar comes down from its ridiculous high.

Luckily, I'm only on NPH for a week, and let me tell you, I can't wait to get back on a real long-acting insulin! If you still take NPH — and I know there are type 1 diabetics out there who do — do yourself a favor and ask your doctor about switching to Lantus and a short-acting insulin such as Humalog. You'll be amazed at the freedom you get from more modern insulins.

Tuesday, September 7, 2010

Avoiding too much medication

One of my big beefs is how much medication we, as Americans, take. It actually made top headlines the other day, too: Prescription drug spending doubled in less than a decade.

Now, obviously part of this has to do with out-of-control health care costs. The cost of prescription drugs is rising rapidly.

But part of it also has to do with how many more drugs we are taking now. For instance, the percentage of people who took five or more drugs in the past month doubled as well, from 6 percent to 11 percent in 10 years. (Increases in those who took one or two drugs in the last month are more modest, but when you think about what this means in terms of the big picture, I think it's still pretty alarming.)

Why are Americans taking so many more drugs now? The most commonly used drugs are what you might expect: statins, antidepressants, and for children and teens, medications for asthma and ADD/ADHD.

I personally feel that as a society, we are overmedicating ourselves. Now there is a fine line to draw between what is actually needed, and what is too much. For instance, I really do need insulin, because my body no longer makes it (or at least not enough to keep me alive). A cancer patient really does need chemo, and someone who has had an organ transplant really does need the medications that keep his body from rejecting the new organ.

(You'll have to forgive me if there is a medication you really need that I haven't mentioned. I don't pretend to know much about other diseases, even if I know a lot about my own, and I'm sure many people are the same way.)

But where to draw the line? Do we medicate little Johnny to keep him from acting out in class, or do we try harder to work with him? Do we give someone statins to keep their cholesterol low, or do we encourage them to improve their diet and their lifestyle? Isn't the route of less medication, if it's available, always the healthier choice?

Friday, September 3, 2010

How empowered are you?

There was an article on USAToday.com that I found encouraging: More 'empowered patients question doctors' orders. Apparently it is becoming increasingly more common for patients to do their own research, and want to have some input in their treatment.

The article talks about how people's attitudes and involvement in their own health care have changed over the years, as out-of-pocket costs have gone up — and as information has become easier to come by. For instance, one source mentions longtime diabetics who don't know what an A1c is or why they need it.

Doctors seem to disagree as to whether this is a good thing. Some doctors don't like it, while others — such as the one who talked about diabetics not knowing about the A1c — think it's a good thing for people to be more interested in their own health care.

I've talked before about my decision to get off Lipitor, which was made independently of my doctor. I've also talked about my first doctor, whose overbearing and accusatory bedside manner convinced me to switch. Clearly I am one of those "empowered" patients. However, I also know many people who seem to accept their doctors' orders blindly.

Where do you fall on the scale?