Diabetes medication or lifestyle changes?

elljay

Hopefully this question doesn't count as a medical advice request but a friend of mine's husband has just been diagnosed with type 2 diabetes and has been put onto medication.(metformin?). My friend was really worried at first about things like foot amputation and other diabetes-related conditions but she then spoke to a work colleague who said she'd had it for years but as long as she kept taking the tablets she could eat anything and didn't have to worry. Their GP seems to have the same opinion.

My friend's husband is a coach driver, very overweight, pasty and unhealthy looking, in his 50s, lives off chips and mash with everything (often together) plus all the fast food you can buy.

If it was me I'd want to do what I could lifestyle-wise and try to keep off the medication but their attitude is what's the point when the medication will deal with the sugar levels and consequently the risks of diabetes related illnesses.

I just wondered what other people thought and what you'd do?

lessonlearned

Lifestyle changes are the way forward. Meds are not the answer.

Tell your friend to look at the Blood Sugar Diet book. He needs to shift the weight and get active. The sooner the better.

pogofish

In the vast majority of cases medics will try to encourage a sufferer to make diet/lifestyle changes before starting/along with any oral medication.

And in a many of these cases, a few simple changes and a 10-15% weight loss can often return blood sugar levels to a state which will stave-off the need for medication for a very long time - although it is probably in the nature of diabetes that he will eventually need to move-on to something. In my case, I managed to keep off medication altogether for over five years and it was over fifteen more years before I needed to start insulin. A very good innings according to my medics.

But this all depends on his individual readings and the exact state of his symptoms/condition and keeping on top of any potential secondary/complicating conditions - and that's where the advice and involvement of medics is essential.

So he needs proper medical oversight and to start taking and logging his own blood sugar readingsfor a while. In that period he should also make some effort to educate himself (and his partner) about the condition and the range of options for managing it (incl but not exclusively reading the book mentioned above). Being and keeping yourself informed is also a big part of managing diabetes. If he is not already referred to a proper diabetes clinic, he needs to get referred - they tend to be much more up to date with the latest treatment ideas and methods and most willing to work with the patient than GP-based treatment, which can be dogmatic and sometimes woefully behind the times.

But saying all that, its probably not rocket science to suggest that he needs to cut down on the carbs/junk and shed a few pounds - which will help him feel better/manage things in the short term and then concentrate on finding something he can live with long term, which can take a while and there is no quick fix.

elljay

Thank you lessonlearned, yes my view too. My ex has diabetes but has very nearly clobbered it by a programme of healthy eating, walking and no caffeine. But he has read a lot of research and puts it into practice. Certainly lost lots of weight and looks and feels really healthy.

I don't think her husband is the type to really bother reading up on the subject and though she's tried to lower his carb intake, he only knows sugar as sugar, doesn't realise that carbs are sugar too. This view seems to be perpetuated by the medical people he's seen.

My friend has actually bought the book you mention, but the question still remains, why bother with all that if the medication will keep it in check anyway? Meds do seem to be the answer - I'd just love to persuade them otherwise.

pogofish

An on a more practical note - if he gets wobbly guts from the Metformin, he should ask for the slow release version, which may be much more suited to his job!

The medication may only keep things in check for a while - If he won't make more permanent changes, it too will become ineffective, or lead to an ever-increasing spiral of more and more medication.

lessonlearned

Meds alone won't be enough. It needs a several pronged attack and as pogofish points out he will need careful monitoring.

You can't just take the meds and eat what you want.

sheramber

Is he aware that as a coach driver he must notify DVLA that he has diabetes?

Tablets will only work to a certain extent. It will depend on what his diet is as to whether the tablets can control his blood sugar level.

I could say I can eat what I like but I would not be eating what your friend's husband is eating.

donnac2558

Yes right just eat anything and take the tablets.:rotfl::rotfl: A friend has done that, now she has to inject everyday. He will have to check his bloods every day to see what is happening. Oh and she always had the sh*ts from the tablets too.

I have type 2 but controlled by diet only, I loss 5 stone and watch what I eat. Yes you can have treats but that is what they are treats. You don't have to live on salads either. I cannot take statins as they damaged my liver, so it was up to be to get my cholesterol down and I did.

teddysmum

The three levels of management for diabetes (it is not curable)are diet and exercise, tablets , then insulin.


My doctor's practice has a diabetes specialist nurse and she started me on the first and I'm still there, 7 years later (with one naughty patch, but I knew that I had to get back on track).


An aquaintance's GP has no specialist nurse and his knowledge seems limited, as he also gave her little advice and put her straight onto tablets.


Tablets do not allow you to eat what you like. They are a supplement to help the diet and exercise; the attitude of eating what you please often leading to insulin being needed.


You don't have to cut out everything completely and the odd treat is allowable, in moderation, but a diet of mainly carbohydrates (potatoes, pasta , bread) is not good, as these are turned into sugars by the body.


If you are sensible and take care of yourself (My husband's friend landed in hospital because he neglected a foot ulcer), then you are very unlikely to lose a limb or experience some of the other horrific results of diabetes.


For beginners and comforting for 'long termers' who struggle, Diabetes UK has local groups that hold monthly free meetings, where talks are given by experts, such as doctors, specialist nurses, dieticians, vascular surgeons and dentists. They also hand out expensive to buy literature, give advice and support, besides raising funds to further research and keep people informed. (details here https://www.diabetes.org.uk/?gclid=CIzs7rDB6c4CFcFsGwod5lII9A)

teddysmum

sheramber wrote: »

Is he aware that as a coach driver he must notify DVLA that he has diabetes?

If he ignores the diet and exercise advise and ends up on insulin, his licence could be revoked, because of the danger of passing out during a hypo.


If you use any vehicle (including a motorbike) , you have to tell the DVLA if you are on diabetes tablets or insulin and failure to do so can mean a £1000 fine, with insurance after an accident being invalid and resulting in prosecution.


There is no need to inform them if well controlled on diet and exercise.

elljay

Thank you to everyone, this is really interesting. I'm seeing her on Thurs so will find out the latest. I assume he has told DVLA, as his boss knows.

Depressing to hear about the varying types of advice from doctors considering we are supposed to be in a diabetes epidemic. She's never mentioned he's seen a specialist nurse, just the GP. He was put on tablets as soon as diagnosed and that seems to be that. Although I know he's cut down some sugar in his tea I don't think the link with carbs has been explained to him at all, just sugar as it's commonly known. Even I remember my science lessons (and even the formulas!) from all those years ago.

All the family are hugely overweight, even the teenage sons and I feel my friend is a bit of a 'feeder' - and all could easily follow their dad.

Thanks again