Type 2 Diabetes and Quality of Life Choices
What works for my type 2 diabetes and associated health risks may not work for everybody. What works for your type 2 diabetes and associated health risks may not work for everybody. And as we assess the things that work for our type 2 diabetes and associated health risks, we hope to make choices that improve our quality of life, even if our physicians give us different advice for quantity of life.
The first time I was prescribed metformin, the gastrointestinal side effects were disrupting my work day and making planning for social events difficult. Luckily at the time, A1c levels and blood glucose trends were indicative that I could go back to managing type 2 diabetes with diet and exercise alone, so quality of life easily won out in that situation.
A few years later, as numbers started creeping up again, I made another attempt and this time had no problem with side effects. I was relieved to discover that the medication no longer interfered with daily activities while improved fasting blood glucose. Better yet, it may protect against cardiovascular disease, something that runs in my family.
Now that I am over forty (40!) and type 2 diabetes has been around for thirteen years, and because there is a significant family history of heart disease, there are more choices that I am needing to make regarding treatments. Before leaving Colorado last year, the endocrinologist who had seen me through so many years indicated that perhaps a full cardiac workup to get a baseline of where I am at compared to other women my age would be best before starting a statin medication. He weighed the consistent excellent cholesterol levels with the fact I was still pre-menopausal, and had I continued in his care, the more evidence that it would be necessary to start at my age.
Should I take medication that will impact my quality of life?
Arriving in Minnesota, the primary care physician I found prescribed me a statin without much thought to continued decent cholesterol levels. It is her belief that anyone over forty with diabetes should be on a statin, indicating that a cardiac workup would not be worth pursuing given the strong family history component.
Muscle weakness is a known side effect of statins, which is worrisome. I like exercising to improve blood glucose, blood pressure, and decrease heart disease risk, not to mention what it does for mental health. I have been hindered a couple of times by muscular injuries that limited exercise, and the lack of exercise while recovering showed a huge difference in being able to manage blood glucose levels. To me, the question that I needed to answer was whether I should take a drug known to cause issues that would interfere with the quality of life I currently enjoy leading a fairly active lifestyle.
For now, it is a no-brainer for me. I am choosing not to take a statin at this point in my life. In my case, it is likely only a delay in the start of medication that will increase quantity of life once my known heart risk goes up further during and after menopause, and when I may not be as physically active as I am now. It may be an unpopular opinion amongst physicians and patients alike to not start a statin now, but one I am choosing with all known factors in play, and with careful consideration of quality of life at this moment in time.