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?