D Dealing with iabetes
Dr. Ellen Andrews

The media are so cheerful whenever new treatments for diabetes are approved. We see articles extolling the benefits of the new treatment. This always gets our hopes up, so it's frustrating to learn the treatment won't be available for months yet. And that it is more expensive! Still, over the last 10 years, diabetes treatments have improved substantially. A variety of new medications are available. We are much closer to re-establishing normal levels of glucose and insulin levels for people. Plus, monitoring blood sugar at home is now possible and should be routine. Equipment for this is available everywhere in pharmacies without prescription. Since our doctors and other scientists understand diabetes much better, we expect even better treatments in the next few years.

The issue is not whether good treatments are available, but how to choose the right treatment, pay for it, and use it appropriately. Doctors must understand the stage of the disease. For example, early in the disease, we may still be making our own insulin, but we have to help it work better. Choosing a drug that reduces insulin resistance is key. Another point is that certain medications need to be taken at meal time. They won't work at bedtime or on empty stomachs. Check with your doctor or pharmacist if you're not sure. And then certain medicines target different issues raised by diabetes. Sometimes we use several medicines in combination, attacking diabetes from different directions.

When the media report breakthroughs, doctors expect that many patients will request the new pill. While it may be perfect for some, it won't help everyone. Before starting a new treatment, the wise doctor always reviews the patient's history. This means thinking about the stage of the person's disease, what treatments they've already tried, and whether certain more established treatments may still be more useful than the newest ones. The doctor must also consider the expense, the interactions with other medications, and possible side effects

Newness for its own sake?

and complications.

At every stage of diabetes, strict counting of carbohydrate intake and regular exercise are vital. No medication will work very well unless these steps are part of every day. Most of us have high blood pressure and cholesterol problems, too. Treating diabetes while ignoring those problems is a mistake. And tobacco! Pure poison for diabetics. Even passive smoking or snuff is harmful.

So before rushing to try the newest drug, make sure you've done tried-and-true things. They usually cost less and might work well. It is a good idea to sit down with your doctor to review your treatment once a year. It's like your annual car inspection: it's a way to be sure your equipment meets specifications so that you're safe. You might be thinking ahead to a new car, but taking good care of this one will do nicely for now.

Please join us at Moss Library Wednesday, February 28 or March 28 at 4 p.m. for more help with diabetes at the support group.

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