August 1, 2013

Good Advice Doesn’t Guarantee Good Control

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horseYou can lead him to water but you cannot force him to drink. This is what a new study says in Patient Preference and Adherence about diabetes control and doctors prescribing adequate prescriptions.

Leading a horse to water in Lithuania is not really the purpose of this study. However, researchers did want to evaluate  the effects of prescribing oral medications, insulin, or both in Lithuanian patients with T1D or T2D and poor blood glucose control.

For 3 months, information was collected from 26 endocrinologists in Lithuania, with specialized questionnaires. The study evaluated 865 patients with diabetes and an HbA1c greater than7%. In total, there were 95 patients with T1D  and 770 with T2D.

People with T1D had a weak trend towards higher doses of insulin reflecting lower HbA1c values. Although the average dose of insulin before an endocrinology consultation was less,  even with a greater insulin dose per day, people with T1D did not have a lower HbA1c.

The trend observed in people with T2D after an endocrinology consultation was a higher dose in insulin, as well. However, both treatment protocols of insulin and/or oral medication did not seem to have a significant lowering in HbA1c. However, the insulin treated group did gain weight.

Without jumping on a soapbox about diabetes control, it’s tremendously interesting how exercise can enhance the body’s insulin sensitivity, lowering the daily dose required and lowering HbA1c. Exercise does not require a prescription, either.

With diabetes control, it’s going to be your decision to have good or better control. Your healthcare professional can give you the best advice, guidance, and prescriptions in the world but if you choose not to manage your glucose, it’s on you.

Visit Your Diabetes Health for more resources about health.