Jewels Doskicz is a registered nurse, freelance writer, patient advocate, health coach, and long-distance cyclist. Jewels is the moderator of Diabetic Connect’s weekly #DCDE Twitter chat, and she and her daughter both live healthfully with type 1 diabetes.
There have been a number of studies over the years in which quality of life has gone under the microscope for those living with type 2 diabetes.
Diabetes is a balancing act; it’s not a freestanding disease. Rather, it’s impacted by most everything one does in their daily life, affecting both mental and physical health. Finding a balance between "becoming your disease" and "living with one" isn’t over-rated. This fluid line is an important one to draw in the sand—and it's remarkably different person to person.
Quality of life research
Sandeep Vijan, lead researcher at the University of Michigan Medical School, assessed more than 5,000 people living with type 2 diabetes with insulin and/or oral diabetes medication.
At 20 years, study participants were engaged once again to follow how their diabetes treatments affected their quality of life and their long-term disease health.
Most interestingly, according to Diabetes in Control, the research team found that “the benefits of insulin therapy for patients with type 2 diabetes are dependent on their age at treatment initiation and the potential side effects, rather than their blood sugar levels.”
Researchers have determined that using a single number (A1c) to guide an individual and their medication management of type 2 diabetes is a "fundamentally flawed strategy."
Clearly, a person's subjective response to the burdens associated with disease management shouldn’t be discounted.
It's important to note that this research is applicable for adults with A1c levels below 8.5 percent. With A1c levels above 8.5 percent, insulin therapy is usually suggested to prevent disease complications.
The need to be listened to
Your voice can have a way of being drowned out once a practitioner gets on a roll with "their plan." But when it comes to treatment decisions, it isn’t always “doctor knows best.” You inherently know what treatment regime is most suitable for you as an individual. Unfortunately, you’re just not asked for your input often enough.
In fact, study co-author John S. Yudkin states that insulin treatment may not have positive impacts on a person’s quality of life. According to Diabetes in Control: "If people feel that insulin therapy reduces their quality of life by anything more than around three to four percent, this will outweigh any potential benefits gained by treatment in almost anyone with type 2 diabetes over around 50 years old."
This study finds:
• A person with type 2 diabetes starting insulin therapy at age 45 who decreases their A1c levels by one percent may glean an extra 10 months of healthy living.
• In contrast, a person starting insulin at age 75 may only glean an extra three weeks of healthy living.
Whether the potential side effects of medications are worth the risk of taking them versus the uncertain risks of not, it’s a very personal decision—but being part of the decision-making process is certainly priceless.