[Goldrun]

http://news.yahoo.com/s/hsn/20070928...nillnessitself

just wondering what folks on this forum think about this. I would not want to give up 8 of 10 years of healthy life to live without treatment (though I suppose technically I couldn't live that long without treatment).

This quote blew me away:
As reported in the October issue of Diabetes Care, some patients said the inconvenience and discomfort of having to take numerous medications each day, carefully monitoring their diet, and getting the required amounts of exercise had a major impact on their quality of life. ....what kills me, is the conclusion is that the 'inconvenience and discomfort' of treatment contributes to a poorer quality of life ?!?!?!

I'm just curious how others react to this idea? And, the notion of the potential care-giver (I suppose the partner/spouse of a diabetic) looking at treatments to staunch significant long term disabilities and care requirements versus the person with diabetes who looks at the immediate irritation/inconvenience of treatment and pretends the long term implications don't matter. Seems really adversarial to me.

[notme]

I guess I have had diabetes so long that my care and thought process is just part of me and what I have to do. If you chose to eat and not exercise and ignore diabetes, the chances are you will pay for your decision later.

I also went through a few years of whining and complaining. At the time of my diagnosis, there were no pumps available to the general public. NPH and R were the newest latest and greatest insulins and there was no such thing as carb counting. Once I got a regime that made sense (that did not include eating the same foods daily and timing peaking insulin), the whining stopped and I got a plan. Ok...I still whine sometimes. But it isn't a way of life anymore.

Nobody cares as much as you do about your health. Your doctor can give you a plan, your family can give you encouragement and DF can give you ideas. But you are the only one that can make you do what you need to do to stay healthy. At the end of the day, everyone goes home and you live with your choices.

[princesslinda]

I am stunned by this article. To think that ANYONE would willingly give up 8-10 years of life in order not to have to swallow a few pills, stick their fingers, eat healthier and move around a bit more is incomprehensible to me! I LOVE LIFE. If, in order to live, I have to adjust my lifestyle, so be it.

That being said, my mom was of that "quality over quantity" mentality. She lived her life as if she didn't have diabetes...until things caught up with her. Unfortunately for her, she didn't just die 8-10 years early...she died at 54 after about 10 years of suffering through the complications brought on by uncontrolled blood sugars...not a lot of "quality" when you can't see, can't walk, have a bad heart and failing kidneys.
Not to mention what all this does to the family who gets to watch all this happen and are helpless to stop it.

Sorry if I sound bitter...I see diabetes from the other end of the spectrum....as an opportunity to live a healthier life and take responsibility for your health. I think life is to be lived and enjoyed. I have no time for that mentality....living through it once was enough!

[Goldrun]

Linda, I definitely see your point. My mom had lung cancer..she was a chronic smoker from her teen years. And in her defense, I don't think she really got the health implications since smoking was so glamorous in the 50's 60's and 70's. But still...she disbelieved the doctors and the last year and a half was very difficult in terms of caregiving. (Mind you, I would give my eye teeth just to be able to spend another day with my mom and don't regret or begrudge the caregiving in any way)....but, having said that, I wouldn't want to knowingly ignore my diabetes and create a similar situation for my children or spouse. That just seems so tremendously selfish.

[MJB]

I think that idea is bullfeathers.

[Alice]

I think the people who whine have no idea what pain & suffering with the alternative is like. Most people who are feeling well enough to complain aren't in the bad shape they will see in the future.

Those going through dialysis (if they haven't died from a heart attack or stroke) probably wish for the simple days of "only" testing, injecting & counting carbs.

I get tired of selfish whining when many other people have it much worse. I haven't felt "inconvenienced" once in 41 years.

I was ticked off once in 4th grade, but it had nothing to do with me...my best friend's grandmother told me I couldn't spend the night with her "because I was diabetic". That's the only time I've been completely disgusted...and that wasn't at the disease...it was at the stupidity of others. I still feel the same today.

[Alice]

I also noted that this was a survey of Type II people. At least for once they clarified the difference in a survey.

Type II's spend a great deal of time on carb control, so this may sway the results. Yet, the Type I's are on injectons/pump (yes, some II's as well)...I think this is an example of how little "inconvenience" taking insulin is for more people...once you get the basics down.

You'd think it's be the other way around.

[Who?]

Stupidity is truly incurable!

If these folks think taking care of themselves it too much trouble, what will they do after a stroke, or if they go blind? How will they manage having no feet, or end-stage kidney disease with two or three dialysis sessions per week?

[shockme]

i've been taking meds for one thing or another since childhood. so- the concept of taking meds is like breathing to me....let's see-testing [owww!], insulin [owww!] ,pills,exercise,dr. visits VERSUS blindness,stroke,heart attack,amputation [MEGA OWWWWW!!!!].....gee-kinda think it's a no brainer.....i think those people were literally no brainers...... trish

[Alice]

Who writes this stuff anyway? This is why diabetics get such grief from the general public. Too me, the negative public opinions are what are the biggest pain about being diabetic. Not the disease, itself.

[parrotletzoo]

Rediculous! Sorry, if I offend but **** grow up and take your stinking medication! Popping pills, eating like a grown up and getting a little exercise can't so horrible that it ruins your quality of life. Try kidney disease, blindness,neuropathy, those will ruin quality of life and that is what you set yourself up for if you don't take care of yourself now.

Time for a reality check and maybe a slap in the face for some people if they think they're only giving up 8-10years of life because ****, whats life if you have complications years before death from being stupid?

For some people diabetes isn't the chronic illness, stupidity and the ever present "ooh poor me" attitude is.

[mho357]

Perhaps the person who wrote the piece misunderstood the study?

"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."

It almost sounds to me like the participants were asked if they would trade 8-10 years of their lives to not have diabetes. That's not the same as risking complications just so you don't have to try to manage the disease.

Regardless, the story is misleading and I hope that it isn't true as written.

Mark

[Goldrun]

Mark, I agree.....it is awkwardly worded, but this quote is pretty clear:

"Some patients, if you judge by their behavior, would rather be well on the road to future blindness, kidney failure or amputations than work hard now at their diabetes," Philipson said.

I think the people on this site by virtue of even being here, really take their health and diabetes management seriously...but we all know folks who will have a donut and not think twice (or act like they don't anyway). I have an uncle who takes meds, but never checks his bg. It's absolutely mindboggling to me.

[REDLAN]

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.

[ladytaz]

Didn't read the article, but probably don't even need to. I do whatever I can to have the quality AND quantity of life! Exercise, unfortunately, I cannot do as is necessary, BUT, I do just about every thing else possible! If it means taking yet another pill, bring it on!! When it got to the point of having to give myself multiple injections daily .... bring it on, I said!! The only thing I refuse to do, is eat stuff that I do not like. If I don't like the taste of it, if it make me feel like cr*p [can't believe I have to encrypt this word!!!], and it ain't gonna cure my diabetes, I ain't gonna eat/drink it!! Otherwise ... BRING IT ON!! I've managed to live long enough to see my kids grow up, now, I'd like to live long enough to see my grandchildren born, and live long enough for them to know their Grammie and know that she's the AWESOMEST Grammie that EVER lived!!