Thoughts on why doctors often prescribe meds for T2 diabetes

[ButtterflyLady]

Since a discussion on this started in another thread, to avoid getting off topic in that one I am continuing it here.

CatLadyNZ, theirs is just so much of your post I disagree with, so I’ll address each point in turn.

“…. but it is better to be on the safe side and start out at least on Metformin, then if the patient improves they can look at reducing or stopping ….”

Why is it better to start on Metformin? My personal view is it is better to start without meds, and see what we can do for ourselves. The mental and physical benefits of self healing are massive, and, in my view, far better for my mental health than being told I have a long term condition and take these tablets. If you are like me, taking no medication whatsoever, the prospect of meds for life was far, far more depressing than the prospect of having a condition I had to learn to control. And that’s before I even consider the impact of Metformin’s toilet tethering potentials. How many people do we see coming onto the forum who are more concerned about their medication side effects than their diabetes?

How will one ever learn what our own bodies can do if we immediately start flooding them with chemicals? How do we know what’s actually making the improvements? Especially when we hear, anecdotally, so often of DN’s saying “we can control that with mdes”.; and especially chemicals that can themselves add unpleasant symptoms.

“…. If they start going back up again, meds will be needed again…..” I would just say, not always. Most people I see coming on here where their numbers have degraded, admit to at least a margin of slippage in their control. Of course, I’m not saying everyone can stay meds free, nor am I saying that going onto, or back onto drugs is a terrible thing, I just don’t think it should be the base line assumption. It isn’t on Planet Breathe.

“….all the current scientific indicators are that when a person has diabetes that long, insulin will be needed later in life….” I would like to see your scientific evidence to back that up, but that said, I could believe it being said today. But. And it’s a very big but, diabetes management; particularly the understanding and treatment of T2 has come such a long way in recent years that I am hoping the percentages of T2s requiring strong medication will significantly reduce over time. I am currently 58 and I hope I can live the rest of my life in my current state; that being running in non-diabetic levels, meds-free. Of course, I may not achieve that, but that is my absolute aim. I do not have any expectation of needing insulin, even if I reach over 80, but I daresay if I had a proven physical deterioration, rendering control impossible without chemical assistance, then I would weigh up the option. I consider my life is likely to be overall healthier and happier if I am able to avoid chemical interventions as much as possible, never mind the fact that introducing any management regime introduces the potentials for a whole new set of side-effects and complications.

Doctors have to work on a worst case scenario and take the conservative approach. Not in my world they don’t! If my Doctor wants to treat me along the lines of the lowest common denominator, then she/he will have a few tough conversations coming along her/his way. A fundamental part of any consultation is listening as well as talking – for both parties. Patients who feel their Docs don’t listen have to work out a way of communicating their concerns in such a way their point gets home. Before any appointment I have with my doctor, I do my preparation. I know what I want to discuss (yes, discuss), the questions I want to ask and the things I want to tell her/him. Where necessary, I make notes or a list, and share that with her. A Doc/Patient relationship is not a Master/Servant relationship, in my view, and we all have a part to play in managing how our Doctors view us, and the level of service we receive.

Most people do not have the desire to lose a large amount of weight and heavily restrict their food choices. I would say most people have the desire to lose weight, but not restrict their food choices, long term. I do worry about the current EatWell Plate, but again, I do hope this is becoming old-fashioned. Where the patient is told they have diabetes, they’re going to have it forever and probably end up on insulin, where is the real incentive to make a seismic change? Patients should be informed of the options available to them, and the pros and cons of each approach, so that they can evaluate their preferred route to living with this condition. Sometimes those choices will be around the best of a bad lot, but to assume the person in front of them is going to do nothing borders on abusive, in my view.

But they have work on the assumption that most people won't make it, in which case it is cheaper for the taxpayer in the long run that those people take meds to avoid complications. I think my last response covers this too.

CatLady, all in all I found your post to be very depressing. If those are your beliefs, then I’m unlikely to be able to change them, but I feel sad for you.

Finally, before writing any of this, I looked at your profile to understand a little more about you, but it doesn’t hold much to help me with the context, relating to this post. Could I ask how long you have been diagnosed?

I've been diagnosed for 3 years, but I'm not sure why you think that's relevant. This isn't about me, this is about trends in healthcare services and the practice of medicine. I am looking at these issues from a whole-of-population context, not a context of the small group of people motivated and articulate enough to post on this forum. I think we get a slightly slanted view here... that's not a criticism at all, it's just to note that the people here tend to be more aware of best practice in diabetes management than those who never come here. It's just happens to cause a slanting of perspective.

I was trying to give some context about maybe why these doctors approach diabetes the way they do, so that people might understand them better, instead of constantly criticising them and implying their work is worthless. I'm not saying you do that. It's just a sense I get from some threads here. I agree with much of your post, I too, discuss things in depth with my doctors, and they work together with me to manage a pretty complex medical picture.

The worst aspects of the NHS approach, eg over-reliance on drugs and telling people to eat carbs at every meal, are terrible. But the whole picture is more complex than that. Yes, we need to speak out and do what we can to help people who have been misled about carbs, for example, but I think we should also not throw the baby out with the bathwater.

Not every patient these doctors see is willing to do what it takes to lose a large amount of weight and restrict their food choices long term. When they meet one who is, great. But if you are a doctor faced with someone you have known for years, and you have reason to believe they are not likely to see it through with long term changes, then that doctor will probably try to protect them from harm using things they as the doctor can control. If the patient does decide to make big changes and they tell the doctor, then the doctor knows a different approach is called for.

Doctors get criticised if they don't take steps to prevent people from harm. In their circles, saying "but the patient wanted to manage their condition with diet only, so I didn't mention medication" wouldn't cut it. At the very least they have to talk about it, and if the patient declines, then they have to record that, to cover themselves.

Also, a lot of people with T2 diabetes who are overweight and over, say, 45, are likely to already be on some form of medication. Some will be on a lot. For those people, the prospect of taking one more is not daunting, like it is for someone on no medication.

I don't feel sad for me. I am realistic about my current health and possible future health. Maybe it's a personal thing but I am much more comfortable and contented accepting what I think is likely to happen, than I would be wishing and hoping for something, only to be disappointed or worse when it changes. I have been through a lot already and if I have to use insulin in my old age it wouldn't seem so bad compared to stuff I've already been through.

 

[mo53]

Hello. Although I have changed my diet and exercise since diagnosis and lost some weight ( not all I need to) I was very glad the doctor prescribed metformin for me as it gave me an additional boost by reducing my appetite.

 

[Brunneria]

I was prescribed metformin for PCOS, but it gave me unacceptable side effects, so have managed (happily) drug free every since.

Though, to be fair, I have a prescription for something else, which is for me, indispensible.

 

[zand]

I was taking 6 drugs for BP and heart when I was diagnosed 4 years ago aged 53. Now thanks to a heart procedure and following LCHF the only tablet I am taking is a new one, an anti- depressant. I was prescribed this last year.

I asked for a vitamin D test and my GP told me this had come back 'normal'. However since then I have looked at all of my printouts of blood test results and there is no Vit D on there. I recently paid for one to be done privately. It appears that I have an insufficiency in Vit D and am only 1 point off being deficient. So I may not have needed the anti-depressants at all if my GP had done what I asked of him.

It does seem that GP's would prefer to prescribe drugs rather than seek for an alternative.

 

[ButtterflyLady]

Hello. Although I have changed my diet and exercise since diagnosis and lost some weight ( not all I need to) I was very glad the doctor prescribed metformin for me as it gave me an additional boost by reducing my appetite.

Me too. When I got my HbA1c down to 37 I asked my doctor if she thought I should reduce or stop my Metformin. She suggested a wait and see approach for a few months, and I'm glad she did, because I have made the mistake of allowing myself more carbs than I should have, and the Metformin is probably doing some good. I would put money on my next HbA1c being a bit higher than 37, and I'm starting to take myself in hand.

So, in my case, I see Metformin is kind of a buffer or insurance policy, to protect me from myself, if that makes sense. If I can prove to myself that I can eat the right things for a good length of time, I'll ask the doctor again. I'm quite comfortable on Metformin though, because I've never had bad side effects (I am lucky) and I take a number of other meds for other things anyway. So I'm highly unlikely to be able to get completely drug free. That's life, I accept it.

 

[ButtterflyLady]

I was prescribed metformin for PCOS, but it gave me unacceptable side effects, so have managed (happily) drug free every since.

Though, to be fair, I have a prescription for something else, which is for me, indispensible.

I suspect I have PCOS too, because I have most of the signs, and cysts have been found when I have had surgeries for endometriosis. So, hopefully metformin is helping with that, idk.

Sorry to hear you had bad side effects, if that happened to me I would want to stop taking it too.

 

[ButtterflyLady]

I was taking 6 drugs for BP and heart when I was diagnosed 4 years ago aged 53. Now thanks to a heart procedure and following LCHF the only tablet I am taking is a new one, an anti- depressant. I was prescribed this last year.

I asked for a vitamin D test and my GP told me this had come back 'normal'. However since then I have looked at all of my printouts of blood test results and there is no Vit D on there. I recently paid for one to be done privately. It appears that I have an insufficiency in Vit D and am only 1 point off being deficient. So I may not have needed the anti-depressants at all if my GP had done what I asked of him.

It does seem that GP's would prefer to prescribe drugs rather than seek for an alternative.

According to my doctor, Vitamin D deficiency is very common in places where there is not enough sunlight in the day and year, or when our lifestyles don't allow for exposing large skin areas to periods of sunlight every day (which means most of us, I think). Also, I'm wary of sun exposure because I burn very easily and I don't want to get skin cancer. So I take a Vitamin D supplement, after my doctor suggested it. She said they mostly don't even do blood tests for it in our region because it's a waste of money... almost everyone here is deficient.

I hope in your case it helps you and maybe after a while you can look at coming off the anti-depressant, if you are able to and want to. I take a similar drug and probably need it long term along with the Vit D.

I think GP's preferences are changing, slowly, so they are more interested in non-drug treatments. I think there will still be a place for drug treatments, in many conditions.

 

[zand]

According to my doctor, Vitamin D deficiency is very common in places where there is not enough sunlight in the day and year, or when our lifestyles don't allow for exposing large skin areas to periods of sunlight every day (which means most of us, I think). Also, I'm wary of sun exposure because I burn very easily and I don't want to get skin cancer. So I take a Vitamin D supplement, after my doctor suggested it. She said they mostly don't even do blood tests for it in our region because it's a waste of money... almost everyone here is deficient.

I hope in your case it helps you and maybe after a while you can look at coming off the anti-depressant, if you are able to and want to. I take a similar drug and probably need it long term along with the Vit D.

I think GP's preferences are changing, slowly, so they are more interested in non-drug treatments. I think there will still be a place for drug treatments, in many conditions.

I was on a heart drug (amiodarone) for 2 separate periods of 4-6 months. One of the many side effects is sunburn. I once got a blister on my arm through driving 90 minutes with my lower arm exposed on a Winter's day when the sky was white. So I had to keep as covered up as possible whilst I was taking the drug and for a few months afterwards. This is why I suspected vitamin D deficiency myself. It's a shame the doctor didn't listen to me though. I was reassured by the 'test' he said he had done and only retested because a good friend had hers tested and gave me the details of who to contact.

I have cut down to half the dose of anti-depressant already. I will now wait until my vitamin D level increases to stop it altogether.

I'm not against treatment by drugs, but when it's simply a nutritional deficiency at fault drugs won't help. They may harm.

 

[Bluetit1802]

So, in my case, I see Metformin is kind of a buffer or insurance policy, to protect me from myself, if that makes sense. If I can prove to myself that I can eat the right things for a good length of time, I'll ask the doctor again.

I see this "buffer/insurance as a problem, not a solution. Many Type 2's newly diagnosed are sent away to lose some weight and take these tablets, come back in 3 months. They are not told how Metformin works. They assume it is a miracle drug that will allow them to continue eating carbs/sugar. For them, it is a way to carry on much as normal. Some of these people arrive on this forum to ask why the Metformin isn't helping them, why they see spikes after eating. They honestly believe the tablets should be stopping this happening.

If only they were told by the GP that Metformin doesn't work that way, that it is mainly an appetite suppressant and also works on the liver to help reduce liver dumps, to a limited extent, and that carbs are the problem.

I believe prescribing Metformin to newly diagnosed should be accompanied by a full description of how it works, to what extent, and more importantly, what it doesn't do. Otherwise, I see it as the start of a slippery path for many.

 

[ButtterflyLady]

I was on a heart drug (amiodarone) for 2 separate periods of 4-6 months. One of the many side effects is sunburn. I once got a blister on my arm through driving 90 minutes with my lower arm exposed on a Winter's day when the sky was white. So I had to keep as covered up as possible whilst I was taking the drug and for a few months afterwards. This is why I suspected vitamin D deficiency myself. It's a shame the doctor didn't listen to me though. I was reassured by the 'test' he said he had done and only retested because a good friend had hers tested and gave me the details of who to contact.

I have cut down to half the dose of anti-depressant already. I will now wait until my vitamin D level increases to stop it altogether.

I'm not against treatment by drugs, but when it's simply a nutritional deficiency at fault drugs won't help. They may harm.

Yes, quite right, it's better to look at possible deficiencies first. I don't know how long it takes for Vit D levels to normalise but I'm guessing it could take many months. I imagine that if someone had more than mild depression, seeing a benefit in 2-6 weeks would be worth it, as that could help a person get by until their Vit D level was normal.

Thyroid hormone levels is another relevant example. I've seen various doctors over the years for anxiety and depression (I have moved around a lot) and almost all of them ran thyroid hormone tests first off. Also Vitamin B12 and Folate. I have also asked for Magnesium and Zinc to be tested. The only deficiency I've had out of those 4 was B12. I hate the injections because they really sting, so I need to find another way of getting B12, I think.

 

[ButtterflyLady]

I see this "buffer/insurance as a problem, not a solution. Many Type 2's newly diagnosed are sent away to lose some weight and take these tablets, come back in 3 months. They are not told how Metformin works. They assume it is a miracle drug that will allow them to continue eating carbs/sugar. For them, it is a way to carry on much as normal. They believe Metformin is some kind of miracle drug. Some of these people arrive on this forum to ask why the Metformin isn't helping them, why they see spikes after eating. They honestly believe the tablets should be stopping this happening.

If only they were told by the GP that Metformin doesn't work that way, that is mainly an appetite suppressant and also works on the liver to help reduce liver dumps, to a limited extent, and that carbs are the problem.

I believe prescribing Metformin to newly diagnosed should be accompanied by a full description of how it works, to what extent, and more importantly, what it doesn't do. Otherwise, I see it as the start of a slippery path for many.

Yeah, that's a fair summary and opinion, I think. Luckily, I was given an adequate description of how it works, and the role of carbs, so my expectations were appropriate.

Seeing it as a buffer at the start can be a problem. I see it as a buffer now, but that's in the context of a lot more knowledge and experience than I would have had at the start. And, my carb transgressions nowadays are nothing like what they were then.

 

[CollieBoy]

I feel that IMHO the blind following of drug treatment saves the GP two things: time and the need to think! This is not neccesarily a criticism of GPs but of the pressure that they are under, and the abysmal training some rceive. The compounding problem is once the GP/ Practice nurse has pigeonholed your treatment there is little or no incentive fr them to re-asses your med requirements. ( i have in the pst have the GP/Practice nurse/Community pharmacist try to avoid the orders of my consultant!)

 

[Brunneria]

( i have in the pst have the GP/Practice nurse/Community pharmacist try to avoid the orders of my consultant!)

Me too.

When the consultant prescribed 2 new things for me and altered an existing prescription, it took 6 weeks, two appointments and several phone calls to get things sorted out. The surgery had no interest in implementing the clear instructions on the letter, and left me with the impression that they thought the whole thing was nothing but an unnecessary burden on their valuable time.

Of course, if they had just implemented the consultant's instructions, then no time would have been wasted at all!

 

[AndBreathe]

Since a discussion on this started in another thread, to avoid getting off topic in that one I am continuing it here.



I've been diagnosed for 3 years, but I'm not sure why you think that's relevant. This isn't about me, this is about trends in healthcare services and the practice of medicine. I am looking at these issues from a whole-of-population context, not a context of the small group of people motivated and articulate enough to post on this forum. I think we get a slightly slanted view here... that's not a criticism at all, it's just to note that the people here tend to be more aware of best practice in diabetes management than those who never come here. It's just happens to cause a slanting of perspective.

I was trying to give some context about maybe why these doctors approach diabetes the way they do, so that people might understand them better, instead of constantly criticising them and implying their work is worthless. I'm not saying you do that. It's just a sense I get from some threads here. I agree with much of your post, I too, discuss things in depth with my doctors, and they work together with me to manage a pretty complex medical picture.

The worst aspects of the NHS approach, eg over-reliance on drugs and telling people to eat carbs at every meal, are terrible. But the whole picture is more complex than that. Yes, we need to speak out and do what we can to help people who have been misled about carbs, for example, but I think we should also not throw the baby out with the bathwater.

Not every patient these doctors see is willing to do what it takes to lose a large amount of weight and restrict their food choices long term. When they meet one who is, great. But if you are a doctor faced with someone you have known for years, and you have reason to believe they are not likely to see it through with long term changes, then that doctor will probably try to protect them from harm using things they as the doctor can control. If the patient does decide to make big changes and they tell the doctor, then the doctor knows a different approach is called for.

Doctors get criticised if they don't take steps to prevent people from harm. In their circles, saying "but the patient wanted to manage their condition with diet only, so I didn't mention medication" wouldn't cut it. At the very least they have to talk about it, and if the patient declines, then they have to record that, to cover themselves.

Also, a lot of people with T2 diabetes who are overweight and over, say, 45, are likely to already be on some form of medication. Some will be on a lot. For those people, the prospect of taking one more is not daunting, like it is for someone on no medication.

I don't feel sad for me. I am realistic about my current health and possible future health. Maybe it's a personal thing but I am much more comfortable and contented accepting what I think is likely to happen, than I would be wishing and hoping for something, only to be disappointed or worse when it changes. I have been through a lot already and if I have to use insulin in my old age it wouldn't seem so bad compared to stuff I've already been through.

Apologies for taking some time to respond, but I have been somewhat busy today. Again, I’ll deal with each point in order.

“….I've been diagnosed for 3 years, but I'm not sure why you think that's relevant….”

Thank you for the information. I wondered how long you had taken to develop your options, and also to gauge how close you might be to 40, and therefore your predicted need for insulin. hank you for the information. Whilst of course, the discussion isn’t about you, but it is about your beliefs and statements you make, so context can be helpful.

“….The worst aspects of the NHS approach, eg over-reliance on drugs and telling people to eat carbs at every meal, are terrible…”

No challenge on this one. But these are their official guidelines, and you talk about the implications of deviation further into your post. I sympathise with their plight on this. I believe GPs have a hard time keeping up with all the chronic epidemics they face every day; hypertension ,back ache, stress, non-diabetic obesity, arthritis to name just a few, and have frequently acknowledged it on these boards..

Not every patient these doctors see is willing to do what it takes to lose a large amount of weight and restrict their food choices long term…. But if you are a doctor faced with someone you have known for years, and you have reason to believe they are not likely to see it through with long term changes, then that doctor will probably try to protect them from harm using things they as the doctor can control…”.

That a doctor predicts or assumes an outcome from a range of options, based on his experience of the most of his patients does not mean he can ignore his responsibilities. In UK, we have a concept of informed consent, which means, his patient must understand what I am being recommended, or prescribed, and that I must also understand the alternatives and implications. Where a patient’s cognitive abilities are impaired, the person giving consent should have all of that information and be making those choices.

In their circles, saying "but the patient wanted to manage their condition with diet only, so I didn't mention medication" wouldn't cut it.

Absolutely not, but it would be utterly acceptable if the patient was informed of the option to medicate, but declined it. Adults need to be accountable for their actions. To treat adults as if they are incapable of making decisions is, to my way of thinking, offensive.

Whilst I no longer practise, I am a former clinician, dealing with and accountable for my patients wellbeing on a daily basis. I would never, ever have written a prescription or performed a procedure without explaining without my patient understanding what and why I was prescribing.

“….Also, a lot of people with T2 diabetes who are overweight and over, say, 45, are likely to already be on some form of medication. Some will be on a lot. For those people, the prospect of taking one more is not daunting, like it is for someone on no medication….”


Of course they might be, but equally plausibly, they could hate being a slave to the pharmacy, or even feel that your “just one more” is the straw breaking the camel’s back.


I’m sure your view is informed partly from your own experience of taking medication, and from your description of other medical conditions, perhaps you already fit the description you paint above, but I value my freedom from regular medication.


“….Maybe it's a personal thing but I am much more comfortable and contented accepting what I think is likely to happen, than I would be wishing and hoping for something, only to be disappointed or worse when it changes…”

I am genuinely happy for you, that you have found a good place in dealing with your condition. I am also in a good place with my own. Where we differ is our current picture of the future. I remain committed to remaining med-free where I possibly can, but I am open minded enough to accept that were I no longer able to deal with a condition without pharmaceutical support, and the implications of not medicating were serious, I would submit.

“….I have been through a lot already and if I have to use insulin in my old age it wouldn't seem so bad compared to stuff I've already been through.”

Please don’t assume that because I am currently extremely fit and well, that this has always been the case. I was a sickly child, and lost a certain amount of school time, early in my education. And in my 20s I was also very ill. And I mean very ill. It’s quite a sobering experience when your parents fly, from another country, to say goodbye to you; such are the expectations of ones’ survival. Nothing will ever erase the look on my either of my parents’ face. There is so much about that period of my life that I do not remember for one reason or another, but I will never forget those expressions.

 

[Lamont D]

I think through my own experience, and of my kids and grandkids. I will give my assessment of how diabetics are treated and why the easiest route for doctors is always meds. Unusually for me, this is not political!

Having been misdiagnosed T2 and the decade plus battle to get a correct diagnosis, my named GPs, didn't have a clue, why my bloods were normal, and I spiked high and then I went hypo! The wife is currently in a battle with everything other than her diabetes! (Yes I have got her in control!)
GPs need because of lack of many reasons to fall back into toeing the line for using the recommended treatment for the many different aspects of diabetic diagnosis and prognosis.
Lack of proper training and understanding, leaves many doctors struggling with how to treat patients. The system should but isn't able to be thus;

You go doctors!
You get possible diagnosis,
Bloods taken.
Treatment recommended to patient, with metformin at head of medication.
Referral to diabetic specialist at clinic or hospital, as they ARE trained as endocrinologist.
Proper diagnosis and treatment.
Either more appointments with clinic or GPs to manage condition.
Dietary information sufficiently designed for patient.
Dsn for continuous support and checks!

But as I say, this just doesn't happen, it's very difficult to get a referral to a specialist.
The rest I don't have to post. There isn't enough of the services to cope with the diabetic numbers! Can't even get a doctor's appointment on the same week!

I'm not a fan of meds, but in my case, I take 4 tablets a day!
Aspirin for my blood.
Irbesarten for hypertension
Piriton for night itch.
Sitagliptin for lowering my glucagon and glycogen levels. Also unbelievably increasing my insulin output! But it works and I believe I will be on it for life!
I don't believe that having to do certain things in life, like having to take meds or a low carb lifestyle should interfere with you having a full life. You have to be adaptable!

Until there is a change in emphasis in how diabetes or other blood glucose conditions are treated, then, the need for this forum will continue!

 

[andcol]

To answer your question bluntly it is down to laziness.

Now let me elaborate. Most patients are too lazy to make the changes needed to wrestle back the control they need or even do the reading they need to. The doctors do not have the time/energy (apathy) to drive these patients into change. Most people have been raised on the believe that western medicine can cure anything (almost) so when a doctor gives you a pill then that will fix it won't it!

GPs are too general to keep up with all the research (again they are out of date) and it is easy to just follow the hierarchies direction and "government is like a super tanker" it will turn but only after another generation are screwed over by the current guidelines.

There is a belief still in the medical profession that T2 is forever and it cannot be reversed despite the evidence in front of them

It all comes down to apathy in most patients and an over-worked medical profession

 

[ladybird64]

Very interesting post CatLady. I can see this from both sides of the coin (how boring is that? lol), in that there is a section of those who are diagnosed, with "lifestyle issues", who will quite happily take the recommended medication which is usually offered and carry on eating the same and acting the same. But it's in that "offer" that the grey area lies I believe - I think it is rarely an offer, more an instruction. I question do they actually get the support to make changes immediately after diagnosis (offer of meter and strips for a trial period for example), regardless of the background? I feel that the magic bean is offered, then all talk of diet (which usually comes down to losing weight) will mostly be ignored because of the faulty belief that Met will keep everything under control - I say Met because I believe it's the usual DOC for T2. How many people that are given Met actually know it's basic action I wonder - that it reduces the levels by such a small amount? I know quite a few that think it's like paracetamol for a headache, eat the food, take a tablet and the any impact from the food eaten will stop. I know there have been many arrive on this forum thinking that this is the mechanism of action, obviously worrying. Bottom line is that we know diabetes does damage but it doesn't happen overnight so surely giving a window of opportunity at time of diagnosis, and before dishing out medication, couldn't hurt? And at the same time, maybe explaining how said medication actually works, that it's not a quick fix solution.

On a personal level, I have had quite serious ill health since I was a toddler, asthma which has had me on life support and for which I have had to take a shed load of medication. I have also always had psychological issues regarding food. I loathe taking medication, really resent it and avoid it if I think I can do without and have had that with me all my life. When I was diagnosed back in 2011 (I think), it came as no surprise. I was very overweight due to the stress I was under caring for a disabled daughter with severe behavioural issues who could be very aggressive, the nature of her syndrome meant our home was on lockdown so there was no escape - and I ate. The doc that I saw, although lovely, commenced with "and we will start you on Metformin and statins"..and that was enough for me - that there was no discussion, just an assumption. I refused the lot, he looked shell-shocked and that was that.

I was 47 then, had found this forum already (my daughter is on insulin, all a bit complicated) and muddled my way around until I found the balance with my diet. I've lost 6 stone, bloods when I (rarely) test are ok and the DN at my new practice has questioned my original diagnosis because my A1c levels have been in normal range for a few years - apparently I'm cured!
I have taken Met on a couple of occasions but the mental stress of taking something that I don't think is needed was too much - if levels were rising I think I could cope with taking it. I take certain meds now, no choice otherwise I wouldn't be able to function, fallout from cancer treatment. The thought of having to take a med if I can avoid it is anathema to me, I'll fight it to the last (into old age I suspect lol) - but I do know I'm a bit extreme with this opinion

 

[Fayefaye1429]

Wow this has been such an interesting topic. As ladybird says I can see both sides.
Doctors mainly not all but most become doctors to help people so their aim is to cute or manage. I guess in light of day their training is all broke fix and medication is what they know. However there are a lot of doctors developing to more free way of thinking and organic like therapies. It's really down to the individual doctor. I would also says it's about management doctrinal are under various pressures to meet various medical and financial outcomes. I feel doctors have a really tough balance and they all tend to come from a place of helping. Some are not. Its very hard when you know someone isn't looking after themselves to sit back when they know a solution. However I feel this is where the other side of the argument comes in. What is it that prevents people from either taking a pill? Or finding an organic way diet e t c to help themselves. A guy called bernes said it is all to do with gimmick which means deep meanings we have about something written into our psychie as children we must be a good patient we must do what they say or we must rebel against it. I guess this is where discovering your own take on it is essential.

I personally when reading the posts thought you all had good insightful views and give a real deep view of all sides of the coin.
I am a great believer in knowledge is power so whatever way it is for you organic or not all that matters is is it right for you? And is it truly what you want? Or are you feeling you need to comply? Which isn't bad because it can change for the future.

I guess what I am saying is it's about you and your feelings. I personally even in hospital do not allow medication unless I know what it is had time to research it. Reason because I have been given medication in the past that caused me issues and for me doctors are human and are definitely allowed to make mistakes but it's up to me to have power in knowing what I am having and taking responsibility for that. /sorry a little rant but I do see both sides and value all your options as they make sense and are true

 

[Totto]

It's all good or would be if we actually got sensible advice from HPC. The advice many of the forum members got at diagnosis were something like this:

Eat plenty of carbs, avoid butter and other fatty things and don't test your BG.

How helpful is that?

 

[Fayefaye1429]

T2 seems to et a rougher deal than t1 in advice. However saying that it took over 2 years of nagging from me to get a diagnosis to the gps