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“First, Do No Harm”

Jan Chait

August 6, 2013

My granddaughter is packing up and will be moving out Monday, off to college and to her first apartment, which she’ll share with two other people. Grandma is experiencing a bit of empty-nest syndrome, although my grandson will still be here. He’s talking about moving out, too.

Today, the granddaughter has a doctor’s appointment. Just a checkup, although she does have a suspicious-looking mole.

My husband had his checkup last week, which is kind of what this blog entry is about.

When I was writing last week’s piece, about how doctors in the United Kingdom were real casual about adding medicines for people with Type 2 diabetes, I told myself it was, after all, the UK, which has the publicly funded National Health Service (NHS). Surely that wouldn’t happen here. (Yet.)

Well…

So he walks in, hands me a pile of papers and says, “if you want to read them.” It was the visit overview, including lab reports. His HbA1c was 7.4%. His fasting blood glucose was 169 mg/dl.

“Did he add another medicine or increase the dosage?” I asked.

“No.

Long story short, they’re going to wait three months and see how things look then. My prediction? It won’t look any better.

I don’t understand. What about that “first, do no harm” thing that’s connected with the physician’s oath?

It’s been proven, via the Diabetes Control and Complications Trial (DCCT) that keeping blood glucose as close to normal as you can lowers the chance of complications involving the eyes, kidneys, and nerves. The DCCT was for people with Type 1 diabetes.

For those with Type 2, there was the 20-year United Kingdom Prospective Diabetes Study (UKPDS), which came up with the same findings. Plus, it’s good for your heart. You can read all about it in the journal Diabetes Care here.

My favorite quote from the article?

It is time for all health professionals to treat diabetes aggressively. It is also time for patients to take their diabetes with utmost seriousness. And it is incumbent upon the health care system to provide the necessary resources for both to be successful. Compromise or acceptance of a disadvantageous and dangerous status quo in people with diabetes should not be tolerated any longer.

Great thought, huh? It should only be put into practice.

I read once that one in five people seen by a doctor has diabetes. If 20% of my caseload shared a pathology, you’d think I’d find out how to take care of it. I certainly don’t like it that my husband’s doctor put off dealing with a 7.4% HbA1c for three more months.



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