Diabetes affects more than 9% of the U.S. population. Treatment can be a difficult balancing act, with about 25% of diabetes patients failing to keep their blood sugar within manageable levels. Undertreatment can be serious, creating blood sugar spikes that increase the risks for numerous health problems — but the health effects of overtreatment can be dangerous, too. The key is knowing how to strike a balance.
Diabetes treatment is a delicate balancing act. Many sufferers unwittingly over-manage their condition, which can put them at serious risk. Efforts to avoid high blood sugar can lead to hypoglycemia, which can cause disorientation, unconsciousness and sometimes death. Emergency room visits for hypoglycemia can be costly, as can costs of excessive testing. Treatment for prediabetic conditions may also be excessive, with patients spending money on medications and testing devices they may not need. Details on over-managing diabetes are in the story below.
A Balancing Act
Diabetes can feel like a blood sugar yo-yo. How much insulin a person takes is only one factor in how meals will affect their blood sugar levels. Exercise, stress and even a woman’s menstrual cycle can determine whether blood sugar will unexpectedly spike.
High blood sugar levels can lead to serious issues, including renal failure and damage to the eyes and peripheral nerves, so proper management is crucial. Because diabetes can be so difficult to control, many people end up over-managing their illness in an attempt to keep blood sugar levels from spiking. This invites a whole new set of dangers, with the most serious being extreme hypoglycemia.
Effects of Hypoglycemia
Believe it or not, low blood sugar sends more people to the emergency room each year than high blood sugar. In people with diabetes, hypoglycemia can result when too much insulin is taken for a given meal.
Initial signs of hypoglycemia include irritability, shakiness, anxiety, sweating, fatigue and irregular heartbeat. When blood sugar falls to dangerous lows, it can lead to confusion, blurry vision, unconsciousness and even death. A person suffering from extremely low blood sugar may initially appear drunk.
A person’s risk of experiencing diabetes-related hypoglycemia increases with age. Diabetes management can become less effective in older adults, with A1C goals — or overall blood sugar levels — becoming harder to maintain. Efforts to lower A1C levels to optimum range in these people can easily backfire, leading to deadly drops in blood sugar.
Over-management may also add undue financial strain to diabetes patients. One study found that doctors ordered A1C testing far too frequently, costing patients and insurance companies unnecessary money in lab fees. Hypoglycemia-related emergency room visits can also be costly.
The market for “prediabetes” treatments is also on the rise, which has some doctors concerned. Only 2% of “prediabetics” become actual diabetics each year, yet authorities are butting heads over whether pharmaceutical intervention is necessary. In the meantime, the “prediabetic” plight opens a whole new demographic to sales of expensive diabetic supplies, such as glucose monitors and test strips.
Diabetes treatment is a delicate balancing act, for sure. But if this is only an approaching condition and not a true problem yet, then overreacting can cause just as many problems as underreacting. Many sufferers unwittingly over-manage their condition and end up being put at risk as a result. Emergency room visits for hypoglycemia can be costly, as can costs of excessive testing — so patients would do well to consider carefully before overmedicating or subjecting themselves to repeat testing.