Sometimes It Takes a Disaster to Prevent a Bigger Disaster

This is a follow-up from the Disaster Averted: When Changing to Combo Pill, Know the Dosages You are Changing

This patient was newly diagnosed, but I did not really think she believed she had diabetes. In other words, she was in denial. Once she saw the results of her labs, I could see things changed in her. She “got it.”

She did resume her Victoza and followed a low carb meal plan. She did start to check her glucose levels, which were in the high 200s, whether fasting or not. As with many patients I’ve met, I realized she may have not even known the targets she was “shooting” for. I told her. I also told her that with doing all she was doing, I thought she was going to still need to take the extra 1,000mg of metformin along with the 1,000mg she was getting with her Xigduo daily. Once she realized how far off her glucose levels were, she did resume the metformin and her glucose levels are now in the 130 range and she is feeling better…much better.

We’ll see in 3 months what her A1C shows, but I can’t help but think there will be an improvement.

Lessons Learned:

• Because type 2 diabetes does not always have “blaring” symptoms, a patient may not feel or think they feel the complications of diabetes, and they may deny the fact they have diabetes. Numbers don’t lie though.
• Teach your patients the numbers they need to know –  the numbers to diagnose diabetes and the numbers recommended to manage diabetes. Sounds so simple, and actually teaching numbers is simple.
• When patients don’t understand or are in denial, sometimes it takes a “disaster” to help get one to understand and accept the fact that, “Yes, I do have diabetes,” and be more open to making the changes needed to manage diabetes.
• Accepting the fact that one has diabetes and following a personalized plan has been shown to help prevent complications of diabetes.

Anonymous

Editor’s Note: March 28, 2017 is American Diabetes Association Alert Day®, the annual opportunity to sound the alarm about the prevalence of type 2 diabetes risk in America. An estimated 86 million American adults—about one in three—are at risk for type 2 diabetes, but 90% of them don’t know it. You can help raise awareness of the risk by sharing the link to the one-minute Type 2 Diabetes Risk Test (you can also download a printable version to share in your office), or share about Alert Day online using #DiabetesAlertDay.