Diagnosed but never treated with meds. Is this common?

Drew · #1 (**permalink**) 10-23-2008, 02:39 PM

How common is it for a physician to diagnose someone with Type 2 diabetes and not prescibe medication to the patient?

princesslinda · #2 (**permalink**) 10-23-2008, 02:44 PM

If the blood sugar isn't sky-high at diagnosis, some doctors will try and let the patient learn to control blood sugars through diet modification and exercise alone. If this isn't successful in lowering the blood sugar, then they will usually start on metformin. I guess a lot would depend on the doctor, as well as patient's family history, weight and other health factors.

Some individuals start immediately on medication, then as they improve their lifestyles, they can go off medicine and successfully manage w/o for a long time.

Keep in mind that diabetes is progressive, so most of us will at some point end up on medication. The goal is good blood sugar control, by whatever means works.

Welcome to the forums!

Drew · #3 (**permalink**) 10-23-2008, 03:00 PM

Thanks!

So just to clarify, would this still be the case if the patient was offically diagnosed with Type 2? Or would these people who are put on a diet and exercise program simply be at risk but not actually diagnosed with Type 2?

Thanks again.

adiantum · #4 (**permalink**) 10-23-2008, 03:13 PM

G'day Drew, I was diagnosed with T2 almost a year ago & so far am controlling it with diet & exercise.
A friend has controlled his for 15yrs this way but stays on a strict diet & execise program.

volleyball · #5 (**permalink**) 10-23-2008, 03:13 PM

There is no universal answer. Your health, you and the doctor make up the answer. If you have another condition, the doc may want to focus on that and not add another med. Maybe he feels the diet and exercise is the first step. Maybe the doc feels you won't diet and exercise if you get meds. Lots of other reasons. If you got no initial meds, most likely your numbers were not too far out of range.
Diabetes may progress, may not. The better you take care of yourself, the less likely that is to happen. Ignore it and eat poorly and you most likely will progress. Even if you change your ways and do better later, if it is progressing, it most likely will progress further.

EeyoreButterfly · #6 (**permalink**) 10-23-2008, 03:49 PM

My understanding is that once diabetic always diabetic, but you may experience an absence of symptoms for a very long time if you make the necessary lifestyle changes early enough. Not sure how often this happens though.

Evermont · #7 (**permalink**) 10-23-2008, 03:54 PM

I have no idea how common it is but sometimes I think it should be more common.

Unless a patient starts out trying to get control with just lifestyle modification and no meds, they can't get a baseline for how much improvement is possible.

Some people are severe at Dx, some are not. Some are more likely to actualize lifestyle changes than others. Some have more weight to lose than others and so more room for improvement. Some patients are quite advanced in age at Dx, so there may not be a lot of concern about long term complications. If lifestyle is already good/excellent at Dx then there's less room for improvement.

Many factors to consider so case by case basis for the decision. I think it best for doc and patient to discuss all this and decide if meds are warranted at Dx, or if the lifestyle change experiment makes sense.

Either way I don't think the decision is critical. If whichever approach is taken appears not to be working then simply go the other way.

Nita · #8 (**permalink**) 10-23-2008, 04:03 PM

When I was diagnosed with Type 2 20 years ago that is exactly what my PCP did.....diet and exercise. It was poorly done I can see now as there was no direction. Going to a dietician should have been prescribed. Actually the nurse told me to just eat 1200 calories a day.

I then progressed with time to oral meds for many years until they were no longer effective. I have been to dieticians a couple of times since. Doing just the diet thing you are much more restricted in my opinion. I use insulin now. BUT DO IT if you can !!! I am sure your dr. will prescribe meds when and if the time comes.

Good luck,
Nita

matingara · #9 (**permalink**) 10-23-2008, 05:26 PM

Quote:

Originally Posted by EeyoreButterfly

My understanding is that once diabetic always diabetic, but you may experience an absence of symptoms for a very long time if you make the necessary lifestyle changes early enough. Not sure how often this happens though.

diabetes, per se, does not have any symptoms.

shutterbug · #10 (**permalink**) 10-23-2008, 05:52 PM

Yeah.. many times docs don't even call patients to let them know about their diagnosis. They wait till the appoinment date. Many docs don't take it seriously unless the a1c or fasting results are sky high.

EeyoreButterfly · #11 (**permalink**) 10-23-2008, 08:20 PM

Quote:

Originally Posted by matingara

diabetes, per se, does not have any symptoms.

All diseases have symptoms. High blood sugar and its accompanying symptoms are one symptom of the larger diagnosis of diabetes, as is impaired glucose tolerance and impaired fasting tolerance. By absence of symptoms I mean the high blood sugar and the complications that go with it.

Patient254 · #12 (**permalink**) 10-23-2008, 10:49 PM

I was put on insulin immediately upon diagnosis (in the hospital) and then metformin 2 weeks later.

EeyoreButterfly · #13 (**permalink**) 10-23-2008, 11:03 PM

Do you mind if I ask what your levels were at diagnosis?

ErikaA · #14 (**permalink**) 10-24-2008, 01:24 AM

I gain the impression that your management program varies from person to person...

My diet and weight are already rigidly controlled as an athlete so neither are a means to lower my sugar levels any further. I already exercise 40hrs a week... they can't really expect anyone to do more. So they started me on meds right away. If I ate junk and didn't exercise, I'm told my condition would be more serious... but it also means there's no where to go but meds.
My day to day sugar levels are no where near as high as some people i've come across who are on no meds.... but I also cannot get the improvement that they will get as their weight drops and diet improves.

My dad did the diet and exercise thing with tablets for a few years and they worked out that the only way to keep his sugars down was if he ate while on the exercise bike.... lazy man didn't think that was reasonable

..... so they put him on insulin.

Another member of my family was put on diet and exercise and just never bothered with either. So he is now on insulin too and starting to experience complications.

Another friend is on just diet and exercise and is doing nicely...i think getting diabetes may have actually improved his life expectancy just by making him drop those excess kilos and improving his diet. He's feeling like a new man.

Kanga · #15 (**permalink**) 10-24-2008, 01:51 AM

I wanted to control my Bg levels with low carb diet and increasing my exercise, but my levels were very high at dx so I am on Metaformin but plan very, very, soon to come off it. I have brought my Bg down to within the almost normal range in 4 weeks. Without any help from dieticians etc as I am still waiting to see them.

I think if you can do it without meds all the better....... as it shows determination and commitment to control this beast called Diabetes. Also, as no two people are the same it goes to show that treatment will also differ from one person to another.