One size does not fit all diabetics
I've advocated for individualized treatment plans for as long as I've practiced medicine. When it comes to diabetes, one size simply does not fit all, and it doesn't make sense to try to squeeze a patient into a boxed treatment protocol.
Everyone's story is different. Some elderly patients may have recently been diagnosed with diabetes and haven't yet experienced any decline from the ravages of the disease. Others may have been working to manage their disease for years, dealing with the ups and downs that come with this system devastator.
If a patient comes to me with diabetes, I look at their individual case before I determine how best to manage the disease. Factors to consider are whether or not they've tried lifestyle changes, or did their prior doctor just plop them onto medication? And what other conditions are they trying to manage in addition to the diabetes?
One endocrinologist is advising that doctors take a look at the benefits of aggressive versus conservative treatment options, balancing the patient's overall health picture with the potential outcome of intensive blood-sugar control. According to some studies, almost half of older patients who have type-2 diabetes are also dealing with at least five (or more) serious health issues, such as heart problems and thyroid dysfunction that are challenging in their own right. If your diabetes is treated too aggressively, it could send a domino effect through your other health conditions, upsetting the apple cart, so to speak.
Work closely with your doctor, sharing with him your complete health picture— including any and all meds you may be taking. And it pays to question closely any treatment plan your doctor recommends, understanding how the treatment may affect any other diseases you have. You most certainly don't want the same treatment plan given to Jane who was in before you, and Tom who was in before her…
