Quote:
|
From 12 percent to 50 percent of patients interviewed said they were willing to give up 8 of 10 years of life in perfect health to avoid a life with diabetes complications, but between 10 percent and 18 percent of patients said they were willing to give up 8 of 10 years of healthy life to avoid life with treatments.
|
this statement is confusing - the patients interviewed all had type 2 diabetes, therefore they already were not in perfect health - ergo they could not forego 8 to 10 years of perfect health because they did not have it in the first place.
the statement only makes sense if you asked the study group the following questions...
1) how many years of perfect health would you be prepared to give up to avoid complications?
2) how many years of perfect health would you be prepared to give up to avoid treatments.
(although how they came up with ranges 12-50% and 10-18% mystifies me)
Read in this light, it is clear that people are more frightened of the consequences of complications than the consequences of treatment.
However it is a serious question.
Are the effects of complications worse than the effects of treatments?
Note that drug therapies come with side effects, and generally the older you are, the greater the potential for serious side effects, plus the spectre of drug interactions - which can complicate treatment and may necessitate further drugs to alleviate the side effects.
for instance - side effects of statins - include memory loss, muscle cramps, and fatigue. The side effects of ACE inhibitors include fatigue, orthostatic hypotension, hypotension, dry cough, muscle cramps
Note also that treatments only reduce the risk of complications, they do not eliminate the risk - for the individual this actually means that treatment will delay the onset of complications, it is very unlikely that it will eliminate the risk completely.
place yourself in the position of someone taking their medication experiencing the side effects of the medication, AND experiencing complications of diabetes.
you may all be interested to read this article - it is a review of review articles based on the UKPDS (United Kingdom prospective diabetes study) - this is a large study 5,000 patients followed for over 20 years.
What happened to the valid POEMs? A survey of review articles on the treatment of type 2 diabetes -- Shaughnessy and Slawson 327 (7409): 266 -- BMJ
and while the UKPDS did show that good blood sugar control decreased the risks of complications. Many reviews of UKPDS failed to mention some rather important facts like...
1) tight blood glucose control had no effect on diabetes related or overall mortality - yep that's right, you won't live any longer if you have good blood sugar control.
2) diabetic patients with hypertension benefit more from good blood pressure control than good blood glucose control.
Hmmm, it's food for thought isn't it...
drug side effects may be worse then the effect of complications, good blood sugar control won't make you live any longer but may delay the onset of complications, so you could get drug side effects AND complications...
seems to me that there is a sizeable number of people who want to avoid complications, and there is also a small but significant number of people who don't like the treatments that diabetes entails.
I would suggest that we need
a) better treatments, with fewer more manageable side effects
b) treatments that are actually evidenced rather than myth/opinion base.
