1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2021 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
  4. Guest, stay home, stay safe, save the NHS. Stay up to date with information about keeping yourself and people around you safe here and GOV.UK: Coronavirus (COVID-19). Think you have symptoms? NHS 111 service is available here.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Are doctors too quick to prescribe meds over supporting lifestyle change?

Discussion in 'Diabetes Discussions' started by Bebo321, Aug 10, 2015.

  1. Bebo321

    Bebo321 Family member · Well-Known Member

    Messages:
    1,001
    Likes Received:
    1,565
    Trophy Points:
    178
    • Like Like x 8
  2. graj0

    graj0 · Guest

    I wonder if they make assumptions of a person's lifestyle which is exactly what my endocrinologist did back in '97, and went for the meds straight away. He didn't ask about my diet and was only mildly interested in the amount of walking that I did at the time. He didn't actually make any attempt to advise me to cut down on carbs which might have been a good start. He didn't even tell me anything about my diabetes except "you can't believe everything you read on the internet", true, but I knew that anyway.
    I'd like to think that there is a change in that attitude,
     
    • Like Like x 6
  3. Bebo321

    Bebo321 Family member · Well-Known Member

    Messages:
    1,001
    Likes Received:
    1,565
    Trophy Points:
    178
    Let's hope so @graj0 - it will be interesting to hear what experience those who have recently been diagnosed have had.
    Personally, I think social media - forums like this, facebook, twitter etc has been hugely beneficial in changing attitudes and behaviours - informing and empowering those with diabetes along with influencing the shape of treatment given by healthcare professionals (and there are some excellent HCPs out there).
    There is still a lot of dogma to be swept away though and a lot of unfortunates out there who don't have the curiosity to question what they are told - I cringe to hear what you experienced on diagnosis! Hopefully it will be an enlightening chat. Make sure you join in! :)
     
    • Like Like x 4
  4. Phlogiston

    Phlogiston Gestational · Well-Known Member

    Messages:
    163
    Likes Received:
    287
    Trophy Points:
    103
    My GP encouraged me to make lifestyle changes, only meds are lisinopril.
     
    • Like Like x 6
  5. Munkki

    Munkki Type 2 · Well-Known Member

    Messages:
    463
    Likes Received:
    3,401
    Trophy Points:
    158
    I have had several GP's and therefore several experiences. When I started having health problems a few years ago, I felt very judged and very quickly put on medications. The worst prospect were beta blockers. Since the diabetes diagnosis, I am somewhat better cared for, I feel. The first GP was a youngster, and he seemed to be very informed about the current research and sensible in his advice. He was almost about to prescribe medications and asked me about my opinion. I was absolutely against them. The second GP was older and has diabetes, too. He was very relaxed and basically reclassified me into prediabetes. He also said that I need to live and not starve myself, etc.

    Now that I have read a bit about diabetes, I do not consider medication to be that evil any more. High BC levels do damage, so it might be most important for some to stop doing that damage as soon as possible. Lifestyle changes can still be made, but they take time and effort, e.g. education, trial and error, commitment, building new habits, etc. People can get off medication. I am aware, though, that some medication can result in weight gain and make things more difficult.
     
    • Like Like x 6
  6. Bebo321

    Bebo321 Family member · Well-Known Member

    Messages:
    1,001
    Likes Received:
    1,565
    Trophy Points:
    178
    That's good @Phlogiston - out of interest, how much and what sort of exercise did they suggest? I see lisinopril is used to treat elevated blood pressure.
     
  7. Bebo321

    Bebo321 Family member · Well-Known Member

    Messages:
    1,001
    Likes Received:
    1,565
    Trophy Points:
    178
    Hi @Munkki
    Meds obviously have their place and can be used as a useful tool in the management of blood glucose levels.
    I sometimes wonder however if doctors were a bit more open with their patients about diabetes and the reality of how some drugs worked - for example "sulphonylureas work by making your already overworked pancreas to secrete even more insulin in order to bring your BGs down" and instead chose to address the fundamental issue that their body can no longer manage the carbohydrate that they eat - here's a diet plan/a support group/gym pass etc to help support and encourage you to make the significant lifestyle changes that will enable you to live a complication free life, would people take a different view and be more prepared to make the changes they need - or at least give it a really good go?

    It seems to me that some meds are used rather like a sticking plaster on an ulcer - it gives the appearance of being an improvement but the fundamental issue hasn't been addressed and before long it will need the next phase of treatment. What concerns me most is the idea that perhaps some patients walk blindly down 'complication alley' without ever really having understood how they got there in the first place and have accepted the widely but (in my view) wrongly held belief that 'diabetes is a chronic condition'.

    It should be an interesting tweet chat!;) Hope you can join in.
     
    • Like Like x 4
  8. Bebo321

    Bebo321 Family member · Well-Known Member

    Messages:
    1,001
    Likes Received:
    1,565
    Trophy Points:
    178
  9. Celeriac

    Celeriac Type 2 · Well-Known Member

    Messages:
    1,065
    Likes Received:
    2,192
    Trophy Points:
    178
    I was stuck on Metformin and Aspirin 4 days after diagnosis. I knew nothing about diabetes so I didn't challenge him.

    I'm the only patient with diabetes in his practice who low carbs, the only one who has gone down three dress sizes and improved her retinopathy and the only one eating organic food.

    The GP and other HCPs I come across do seem to regard me as an exception. One DSN said that the majority of people she sees in this town don't eat a green vegetable from one week to the next and they are highly resistant to dietary changes. She gets the attitude that the meds should cure/control diabetes.

    I suspect that my GP was so used to treating people like that, he forgot that I would have a different attitude.

    I went low GI straight away but it didn't work for me. I think it's probably harder to try and reverse diabetes after being on meds for some time, because they probably mess with your body a lot.
     
    • Like Like x 6
  10. Bebo321

    Bebo321 Family member · Well-Known Member

    Messages:
    1,001
    Likes Received:
    1,565
    Trophy Points:
    178
  11. Bebo321

    Bebo321 Family member · Well-Known Member

    Messages:
    1,001
    Likes Received:
    1,565
    Trophy Points:
    178
    That's great to hear you've made lifestyle changes that are going to pay huge dividends in the long run. :D Hats off to you for having the curiosity to question - it sounds as though there are plenty of other people locally to you who haven't though. :-(
    May I ask what region of the country you are in? - Others have quite different experiences and it occurs to me that perhaps attitudes and treatment is different according to where you are based. (Apologies if I have made a wrong assumption and are not in fact UK based - and no worries if you would rather not share.:))
     
    • Like Like x 2
  12. Celeriac

    Celeriac Type 2 · Well-Known Member

    Messages:
    1,065
    Likes Received:
    2,192
    Trophy Points:
    178
    I live in a commuter town in Kent. I can see sheep grazing from my front door so close to country too. Since moving here I have noticed many more obese people than in the villages we lived in previously but we couldn't afford to buy in a village.

    Thanks for the kind words, it's a journey !
     
    • Like Like x 2
  13. SunnyExpat

    SunnyExpat Prefer not to say · Well-Known Member

    Messages:
    2,230
    Likes Received:
    1,704
    Trophy Points:
    178
    'Are doctors too quick to prescribe meds over supporting lifestyle change?'

    Depends on your point of view.

    Either prescribe meds that they know will reduce blood sugar, decrease the onset on possible complications, and then reduce the meds if the patient can commit to lifestyle changes that improve their condition at future reviews, or alternatively agree to let a patient try a 'lifestyle change' that may or may not work, if the patient can even commit to the said change, and review after 3 months to a year of more damage?

    Fortunately for me, I was in the prescribe, then reduce group, after I found a 'lifestyle change' that suited me, but I had the benefit of low blood sugars prior to said change.
     
    • Like Like x 4
  14. Phlogiston

    Phlogiston Gestational · Well-Known Member

    Messages:
    163
    Likes Received:
    287
    Trophy Points:
    103
    They made no recommendations about exercise.
    The DN was more concerned about roasted meat than carbs, although she did stipulate pretty small portions of carbs.
     
    • Like Like x 2
  15. AloeSvea

    AloeSvea Type 2 · Well-Known Member

    Messages:
    1,508
    Likes Received:
    1,691
    Trophy Points:
    178
    Roasted meat? Good lord! I got told to avoid pork. Of all the food out there. What a hoot. Based on..... nothing reasonable, no studies. It would make more sense to be told not to drink sugary carbonated drinks, or processed food. But no! (Yes, your DN must be pretty good to stipulate the low carbs. I wish I had heard that a lot earlier than when I came on here. Diabetes Nurses can be quite marvellous.)

    I have two GPs in 2 countries. One never ventures into nutrition, well - not with me. Not since the low-fat diet for my high cholesterol debacle back in 2007 :eek::). The second made the pork comment. I just looked at her. I may have gently nodded. I have never met a doctor IRL who knows the first real thing about nutrition. They get it in med school for about three hours or something. (The importance of moving muscles probably gets nothing!) And we all know how important diet and exercise is for diabetes control. They're just out of their element. Be marvellous if they actually said that! And quit on the pathetic food avoidances to send you out of the office with, along with the prescription for statins and metformin. Doctors are good for prescriptions! Which yes, truly have their place.

    But gee, thank goodness for the internet - I can't imagine managing diabetes without it. (And not to forget the library!)
     
    • Like Like x 2
  16. smcc

    smcc Type 1 · Well-Known Member

    Messages:
    59
    Likes Received:
    29
    Trophy Points:
    78

    Celeriac, you are absolutely right. In my experience as a now retired GP most type 2s are extremely unwilling to change the dietary habits of a lifetime even when the most severe of possible complications is pointed out to them. It is well known that the huge increase in the incidence of type 2 diabetes in recent times is largely due to overeating and lack of exercise. The only real answer to the epidemic is prevention.
     
    • Like Like x 6
  17. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

    Messages:
    3,291
    Likes Received:
    4,026
    Trophy Points:
    178
    This is a myth that never seems to die. Medical education includes a lot of nutrition training, as there are several diseases where it is an important part of management. The reason doctors don't tend to say much about the details of what we eat is that it's not terribly relevant or important to the tasks of diagnosing and treating most illness. A lot of the beliefs about food that the public have are not based on scientific research, they are just beliefs passed around, including by non medical "alternative" websites. Clearly, low carbing helps with diabetes, and doctors will slowly catch up with this as more research is done and shared with them, and as they see patients like us improving.
     
    • Like Like x 2
  18. AloeSvea

    AloeSvea Type 2 · Well-Known Member

    Messages:
    1,508
    Likes Received:
    1,691
    Trophy Points:
    178
    Heard it from more than several doctors themselves! (Re the three hours or so of nutrition.) They may have been under-exaggerating?

    I hope you are right re doctors slowly catching up with the effect of low-carb diets, and with the power of eat and metering. The pharmaceutical companies don't make any money from us low carbing though! And they may see themselves as losing money from it. And doctors and big pharma are very close buddies. But I hope you are right.
     
  19. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

    Messages:
    3,291
    Likes Received:
    4,026
    Trophy Points:
    178
    I don't think doctors are sitting back and thinking "I know low carbing will make this person healthier but my big pharma buddies will make more money if we get them to stay sick". I think it's more a case of them not knowing that it's possible to send diabetes into remission through dietary changes and also them not thinking many of their patients will have the commitment level to see it through and stick with it. The people we read about at this forum are the minority of patients who understand that remission is possible and how to do it. I would say a majority of people with T2 diabetes have no idea it's possible and a good proportion of them are not motivated enough to do it long term. We see the tip of the iceberg here and it gives us a skewed view.
     
    • Like Like x 4
  20. SunnyExpat

    SunnyExpat Prefer not to say · Well-Known Member

    Messages:
    2,230
    Likes Received:
    1,704
    Trophy Points:
    178
    I suppose you can make the leap of faith, and believe that every doctor is part of a global conspiracy, who has sold out his profession, and disregarded the oath they made, and now choose to actively conspire with 'big pharma' to harm and eventually kill the patients they care for, but even so, I'd like to believe there would possibly still be one or two the would be whistle blowers and would expose the vast amount of bribery 'big pharma' must be paying to those doctors who have sold their souls.

    Either that, or maybe believe not all patients have the commitment to change, and the doctor is simply doing the best they can, with someone who is probably resisting the changes to even start down the road?
     
    • Like Like x 7
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook