The Potential Perils of Over-Treating DiabetesElizabeth Nelson
Treating your diabetes is, of course, very important for a long healthy life. But in our efforts to do something good for our bodies, have we actually gotten into the habit of over-treating diabetes and causing more harm than good?
A recent study of 31,000 adults with type 2 diabetes examined the risk of overdoing diabetes treatments, defining “intensive treatment” as “use of more glucose-lowering medications than recommended by practice guidelines per glycated hemoglobin level.” They found that intensive use of glucose-lowering treatments among adults with type 2 diabetes who did not require insulin to maintain a hemoglobin A1C level below 7% significantly increased their risk of hypoglycemia.
The study was conducted by Rozalina G. McCoy, MD, an assistant professor of medicine at the Mayo Clinic in Rochester, MN, and her colleagues. JAMA Internal Medicine published their findings on June 6, 2016. The study estimates that roughly 20% of type 2 diabetes patients receive more intensive care than necessary, nearly doubling the risk that clinically complex patients would encounter severe hypoglycemia. Clinically complex patients, as defined by the American Geriatrics Society, are those over age 75, those with end-stage kidney disease or dementia, and those with more than two serious chronic conditions.
McCoy says the findings concern her and her colleagues for many reasons:
Overtreatment results in greater patient burden, higher risk of medication side effects, and more severe hypoglycemia, which can lead to serious injury and even death. It adds more unnecessary costs for patients and the health care system. And, at the same time, there is often little or no benefit from such intensive treatment — not in the long term and certainly not in the short term.
In our healthcare culture, more is better. If you’ve got a medical problem, doctors will throw everything at it–shots, pills, surgeries. But we’re learning lately that extra treatment may actually hinder us more than it helps us (and it certainly harms our wallets if nothing else). It’s time to reexamine our treatments for all sorts of diseases and ask ourselves whether or not we’re overdoing it and what the unintended consequences could be.
In the end, balance is key. People with diabetes and their care providers should be carefully monitoring their condition, but an effort should be made to avoid both hyperglycemia and hypoglycemia. It’s time to stop avoiding one medical problem so vehemently that we drive ourselves to the other end of the spectrum.
If you’re concerned that your diabetes is being over-treated, talk to your doctor to see what your options are. To learn about how too much testing could also negatively impact your health and to find out how much testing is too much, click here.