The Pain in the Pills

Posted on September 27, 2007 in Sugar and Fat

A typical diabetes patient takes many medications each day, including two or three different pills to control blood sugar levels, one or two to lower cholesterol, two or more to reduce blood pressure, a daily aspirin to prevent blood clots, plus diet and exercise. As the disease progresses, the drugs increase, often including insulin shots.

“The people who care for patients with a chronic disease like diabetes think about that disease and about preventing long-term complications,” said study author Elbert Huang, MD, assistant professor of medicine at the University of Chicago. “The people who have a chronic disease think about their immediate lives, which includes the day-to-day costs and inconvenience of a multi-drug regimen. The consequences are often poor compliance, which means long-term complications, which will then require more medications.”

A neighbor who no longer lives down the street and was a social worker, once told me not to feel sorry for a diabetic man who failed to pay attention to his blood sugar levels, consequently losing a toe in the bargain. “He didn’t take his pills, so that’s what he gets” her reasoning went. The advent of pills to treat our condition hasn’t led to much understanding of what we go through. Diabetes means you are born to hardship and those who don’t have it dismiss our struggles much too lightly.

A new study finds that people like me don’t like taking their pills or going out of their way to exercise or following a diet. The results were discovered when doctors actually took the time to talk to patients and ask what annoyed them. The trouble seems to be that we diabetics don’t often make the connection between our present behavior and complications to come, for example blindness or a major stroke. (The study did not ask about the costs of being overweight and diabetic interestingly enough.) Amputations are often shrugged off. And people would rather drop dead than live with the disease:

Between 12 and 50 percent were willing to give up 8 of 10 years of life in perfect health to avoid life with complications. More surprising, between 10 and 18 percent of patients were willing to give up 8 of 10 years of healthy life to avoid life with treatments.

Now the impetus turns to find less inconviencing treatments. I don’t know how much easier mine could be unless they can produce more effective pills that cover the major medication conditions associated with my diabetes which include high blood pressure and chloresterol. I haven’t given up, but as each year passes, I look upon that former neighbor of mine — the man with the lost toe — more sympathetically. How he envied those who did not have to eat right and check their extremities every day. How I do as well.