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Metformin for all. Yippee!

Saw my GP the other day for a debate on statins. One of the reasons I gave for not taking them was because they can give people type 2 diabetes, therefore it doesn't sound positive for those already diabetic. Her reply was - but we always give diabetics statins!
Flipping heck, I'd love to have debated the whole "just because we've done it historically, doesn't mean it's right, or even right for EVERYONE" thing LOL. OMG my new GP is going to hate me LOL
 
Probably about 15 years ago, I was at the doctors for a totally unrelated, minor, matter, when she looked up and said, in the sort of horrified tone usually associated with the more traditional sort of school teacher, "YOU HAVEN'T BEEN TAKING HRT (hormone replacement therapy)". At that time, they seemed to want all women of a certain age to take it, whether wanted or needed - it would, apparently, provide protection against all manner of ailments and features of old age. Recently, a younger friend, who believes her life is being destroyed by side effects of the menopause has had to weep, scream and make copious threats on numerous occasions to get HRT. It would, of course, give her breast cancer and all sorts of nasty things.

My point is that doctors do not always know best. There is some bit of research, a band wagon to jump on, the solution to everything, all problems will be solved. Then the down side is found, the research was not quite right, the mechanisms were not fully understood and lots of people have been threatened, cajoled, frightened, medicalised and so on. "We always do it" is just not good enough, nor is the "flavour of the month" approach to medicine.

Sally
 
Saw my GP the other day for a debate on statins. One of the reasons I gave for not taking them was because they can give people type 2 diabetes, therefore it doesn't sound positive for those already diabetic. Her reply was - but we always give diabetics statins!

Well, I think you know my story. After being on Simvastin for 4 years, and seeing neither benefits nor side effects, I managed to negotiate with my DN to come off them altogether if I got my BS down to an acceptable level, which I did. I caught her at a good time - while she was leaping up and down with excitement at my results and they have now been permanently removed from my prescription.

In fact from having nine listed items on my script, I am down to only 2. Metformin and Co-codomol. My pharmacist joked the other day that there will soon be nothing on it!

On the other hand, my grocery shopping list has grown considerably......! Go figure ;)
 
What I object to is the mass medication approach, where everyone over 50 is told to take some type of polypill, irrespective of real need. Treating the herd, rather than the individual. Defining everyone as ill, saying that the human condition is not good enough and should be medicated. The examples, which Noblehead gives above, for example taking Ramipril to protect the eyes of someone with or at high risk of retinopathy is a different issue and is a sensible use of available medicine.
By that same logic you should be willing to stand in the middle of a motorway because there is a chance you might not get killed.

Yes, it's all about chance and that's why we need statistics in the first place: The group of people given a treatment have fewer deaths or whatever, mening that the odds of you surviving are higher if you take the treatment. Do you want good odds of surviving or worse?
 
To continue the analogy of standing in the middle of the motorway ……..

If you are found standing in the central reservation, your life, statistically at least, my be saved by putting on a reflective jacket. It would be a good idea to do so. However, mass medicalisation is the equivalent of getting everyone to put on reflective jackets, even those stood in a field. True, the occasional person, in a field, does get knocked down by a tractor, but to put everyone on a country hike in protective clothing would be excessive.

I believe mass medication, for no genuine individual need, where the treatment of one individual will not protect another individual (i.e. vaccination against contagious disease), is wrong.

Sally
 
By that same logic you should be willing to stand in the middle of a motorway because there is a chance you might not get killed.

Yes, it's all about chance and that's why we need statistics in the first place: The group of people given a treatment have fewer deaths or whatever, mening that the odds of you surviving are higher if you take the treatment. Do you want good odds of surviving or worse?

I'd substitute the word chance for risk. Chance implies a randomness whereas risk conveys the notion that something is not going to happen randomly but through a precursor, or set of precursors being in place.

At that time, they seemed to want all women of a certain age to take it, whether wanted or needed - Sally

So, in this instance a risk had been identified in women of a certain age. If these women are in the middle of the motorway then they are being given the reflective jacket as they are at a higher risk than those in the field......younger women for example. So, it's mass medication for a risk group and those in that group may or may not need it. Is it better to try and protect them all before any of them get hit by a car or wait for the collisions?

I'm not agreeing or disagreeing but kinda typing my thought process. I've been on lisinopril since my mid-thirties due to high-ish blood pressure (was never an issue til I was diabetic!) so I'm in the middle of another motorway wearing a reflective jacket. Do I feel safer? Yes, I think I do.

I think it's better to mitigate as much risk as possible but I am also totally aware that it's easier to feel this way when you haven't suffered any side effects.
 
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