Diabetes Self-Management Blog

With a beginning driver in the family, I’m finding that I need to pay more attention to my own driving. After 40+ years driving, and enough familiarity with where I live to go on "autopilot" most of the time, I seem to be getting complacent. Yeah, that’s it: I know too much. Or think I do.

Taking my granddaughter to her driving lesson last week, I came to a red light at an intersection where I needed to make a right turn.

“You’re allowed to turn right on red,” I told her as I inched forward to look for oncoming traffic. “As long as there isn’t a car coming,” I muttered as I backed up just a tad because there was a car coming.

“But the sign says ‘no turn on red,’” she noted.

Oops! (Lousy observant teenager.)

But I can’t complain. In fact, I gave her an “atta girl,” because she’s doing what she should: learning the facts, making her own observations, and questioning me when things don’t quite mesh.

It’s something we should all do—with our health-care professionals, that is: learn the facts, make our own observations, and question. I’m talking specifically about medications here.

Too many people take their doctor’s word as gospel. The problem is, he may not have seen the “no turn on red” sign. Or, in other words, he may not have seen, or remember, the “run this test before prescribing” notice. He may not remember “do not take with ‘X’” (or even that you are taking ‘X’). He may neglect to tell you to keep a watch out for the “no turn on red” sign.

Stuff like that.

I’m bringing this up for two reasons: There has been a flurry of posts and comments about exenatide (brand name Byetta) and pancreatitis on this site (see “Byetta and Pancreatitis: What You Should Know” and “Byetta Garners Pancreatitis Warning.”) In addition, the U.S. Food and Drug Administration (FDA) announced late last week that it has begun posting quarterly reports listing drugs under evaluation for potential safety issues.

Just because a drug has been approved and is on the market doesn’t mean it is without risk. Sometimes problems just plain ol’ don’t come to the fore until the drug is on the market, being consumed by oodles of people under the care of regular, everyday docs.

Presumably, while a drug is in trials, subjects are being monitored by health-care professionals who run the proper tests at the proper times, see the subjects regularly, and keep their ears open for potential risks—and then do something about those complaints.

But once the drug gets out into the “real” world, it may be a different story.

So what can you do? I mean, short of going to medical school (which, in today’s health-care environment, may not be a bad idea). But I digress.

We need to do our own research. We need to ask questions. We need, in short, to look out for ourselves. Are there tests the doctor should be running before the drug is prescribed and at intervals afterwards? (Would troglitazone—brand name Rezulin—have been withdrawn from the market in 2000 for causing liver damage if consumers’ liver enzymes had been checked as recommended?)

Know what the potential side effects are for the drugs you are taking. They’re listed on the patient information sheet that comes with your medications, or you can ask your doctor or pharmacist. Be sure to ask what to do if you experience one of the side effects. If nothing else, you can be a smarty pants when your doc prescribes a diabetes drug that contributes to weight gain (as many diabetes drugs do) and then chastises you for gaining weight. (”Well, you’re the one who prescribed ‘X.’ It can cause weight gain, you know. It says so. Right there.”)

The FDA has a couple of very good publications I would recommend you read. One is on being an active member of your health care team and the other offers tips for talking with your pharmacist. There is some overlap, but both together pretty much cover the gamut of useful recommendations.

One of the most important lessons that having diabetes has taught me is that doctors don’t know everything. They can’t: There’s too much to know.

But we only have ourselves—and maybe a few loved ones—to learn about. We can certainly do what we can to learn about our own little corners of the world and truly become active members of our health-care teams.

For me, the bottom line is that I need to take care of number one. That would be me. If I don’t take care of me, I can’t take care of anybody else. And if I’m not around, who would my granddaughter have to misinform her about driving matters?

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Comments
  1. One of my favorite maxims is that “those who help themselves, help others”.

    Posted by Bahamut |
  2. Some people are good at helping themselves, learning everything on their own and requiring just a little affirmation from doctors that they’re doing the right thing.

    I’m not one of those people! I feel better after talking to friends, posts online, doctors, etc.

    Posted by Dolly |
  3. Jan is right. You need to look out for yourself. Please take the time to talk with your pharmacist about any and all medications. ALWAYS start at a low dose and work up. That way side effects, if they occur, are more manageable and the low dose allows your body to be exposed to the medication slowly and side effects may not occur at all. I find that when I try to counsel patients on their meds, they are too busy or really not paying attention at that time. Be proactive - ask questions.

    Posted by Linda the Pharmacist |
  4. I’m a “sharer”. That means I learn as much as I can, and I want to share that info with others. My family makes a joke of it. I’m unappreciated by them - until, of course, somebody runs across the same problems I’ve researched, then they call me asking questions.

    Posted by Ephrenia |
  5. I totally agree with policing your medicine.
    but I have a problem. I pointed out to my Doctor
    that a medicine He prescribed was on the 8 most
    medicines Doctors won’t take list. and another
    article pointing out it potential problems. He
    informed me to take the medicine anyway. It would
    be o.k. sorry. I do not agree. Doctors are Human
    and are not always right.I am not going to take
    a medicine that could harm me. when this is not
    a life or death situation. I may be looking for a
    new Doctor. the medicine prescribled was advantamed which has rosiglitazone in it. and is the problem. any opinions will be helpful.

    Posted by grannysu |
  6. There’s SO much info online about meds — and health — that I find it much more useful and comfortable to look up stuff online than to interrupt a busy pharmacist, and the doctors’ time is often limited.

    Remember that you don’t have to get any prescription filled right away. Go ahead and take home the prescription slip and look up info online to help you decide. It might ease your mind. Or help you hone in on specific info that you might ask the pharmacist or call the doctor about. If you decide not to get the prescription filled, be sure to let your doctor know soon — he might be able to suggest something that would be less objectionable to you.

    And there are some wonderful, really reliable sites. The way I like to go is to use a search for (name of med) + “prescribing information.” This will pull up the drug company’s monograph for that medication as well as dozens of other sites. And don’t be shy about going to the “medical professionsl” side of the info when they offer both patient and medical professional choices. It’s much more detailed. To me, the most helpful part of the drug company’s info is what are the possible side effects and how often they happened — and how those results compared to placebos. Always consider the source of the info — a site that’s trying to sell you something might not have your best interest first at heart. :) Of course, drug companies are trying to sell their stuff, too. There are some government sites, if you think they’d be more reliable.

    Also, there are are several sites online that give a rundown on specific medications and how they react with other ones and with any supplements you might be taking. These sites are especially good when you take several of either. I don’t know if it’s still there, but I used to go to drkoop.com, because that site had a rating system for how serious a problem might be.

    Posted by marcie |
  7. Dear Jan.

    About five years ago I went to my GP feeling dead tired and totally wipe out and asked him how about hormone replacement therapy? He said toxic for the male, absolutely not, no way.

    Then I asked about HRT for the female. He said wonderful, great, good medecine.

    I told him that nature usually works on the principal of what is good for the goose is also good for the gander.

    Posted by CalgaryDiabetic |

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