Will your type 2 diabetes get progressively worse? It will if you follow the advice of most doctors.
But you don’t have to go there.
People believe many diabetes myths, so many in fact that Riva Greenberg wrote a book on the subject, “50 Diabetes Myths That Can Ruin Your Life.” Yet she missed the most pernicious one: that diabetes is a progressive disease. It’s the worst one that people with type 2 diabetes face because it can be a self-fulfilling prophecy. So when HealthCentral.com deemed the first week in April as myth-busting week, I jumped at the chance to write about it.
You need to be prepared to learn as much as you can in the typically short office visit when you go to a new doctor for the first time. Some people actually recommend that you go to your first appointment with a list of 19 or 20 questions to ask the doctor. Be sure to ask your most important ones first because getting answers to that many questions would take hours.
A typical appointment with a doctor in the U.S. is 20.5 minutes, according to a 2015 study. But consider yourself lucky if your appointment is even that long.
You may have a big problem when you want to make an appointment with a diabetes specialist. You probably won’t even get an appointment, and if you do, be prepared for a long wait. But you may not need to see one of these specialists.
Doctors who specialize in treating diabetes are called endocrinologists, a mouthful of a word that people with diabetes usually shorten to “endos.” In addition to diabetes, these doctors also treat other endocrine conditions, including osteoporosis and thyroid diseases.
Some endos sub-specialize in diabetes and are called diabetologists. But it’s hard enough to find an endo, and searching for a diabetologist will be even more difficult.
Last year was the hottest year on record, although the temperatures in most of the U.S. seem to be rather chilly now. But even if you aren’t too fond of the cold, this seasonal weather can actually be good for people with diabetes.
But we have to know how to take advantage of the chill. Doing so can be easy and yet challenging.
All we have to do is turn down the thermostat. Researchers have discovered that when we get mildly cold, which they define as being cool without shivering, our bodies burn more calories. As a result, managing our weight can be easier.
Every day more people with diabetes sign up for high-deductible health insurance in hopes that they will save money. Because they have low monthly premiums, these plans are increasingly popular.
But instead of being less expensive, they are more costly for most people with diabetes. This is the conclusion of a study that Frank Wharam, an associate professor at Harvard Medical School, presented this June at the annual convention of the American Diabetes Association in New Orleans. This is the world’s largest scientific meeting focused on diabetes, and I was in the audience to represent HealthCentral.com.
The proportion of people who have high-deductible health insurance is skyrocketing, partly due to the Affordable Care Act. In 2006, only 10 percent of insured Americans had deductibles of $1,000 or more. But this proportion shot up to 46 percent last year, and Professor Wharam says that it is “likely to explode.”
The way that high-deductible health coverage works is by charging a lower monthly premium than what you would have to pay for a standard plan. But when you use your health care coverage, your out-of-pocket costs are higher.
With so many new diabetes drugs available, we could be managing our blood glucose a lot better. In the past 10 years alone, the U.S. Food and Drug Administration has approved more than 40 different diabetes treatments. In some clinical trials of these drugs more than half of the participants reduced their A1C level from an average of 8.4 percent to the American Diabetes Association’s suggested goal of 7 percent.
Yet in this decade there has been virtually no change in the overall percentage of people with diabetes in this country who have an A1C level of less than seven. Only about half of us had an A1C below 7 in the most recent study.
I Interview Dr. William Polonsky
These sobering facts formed the basis of a joint presentation in June 2016 by Steven Edelman, MD, and William Polonsky, PhD, in New Orleans at the American Diabetes Association’s annual convention, the largest annual meeting in the world of diabetes professionals. They addressed a crowd of hundreds of medical professionals on “The Efficacy Mirage in Type 2 Diabetes –Why Do Clinical Trial Results Disappear in Real-World Practice?” in a presentation that I had the opportunity to hear.