Monday, March 16, 2009
Diabetes: Excercise & Diet versus Pills
I've seen this bit of news and I'm honestly not that surprised. A GP with a lot of experience will know that lifestyle changes are something very unlikely to occur. If they do occur successfully, they have to take the form of a perscription.
Basically, it is unlikely for a human being to go off and do more exercise unless I as the GP -- after discussion with them -- tell them they have to go to the following so and so classes or see the practice's exercise/diet specialists (ah, the ideal multidisciplinary team, such a beautiful dream) and bring evidence of this, lose some weight and produce a satisfactory diet diary otherwise I won't put them on the drugs.
According to this, there seems to be agreement with the idea that there should be some sort of structure to the throwaway advice 'get more exercise' with an actual practical, individualised approach e.g. taking into account the back and knee problems people may have.
I suspect part of the grumbling may be due to diabetes patients getting their medication for free. Let's assume the Department of Health doesn't hold this as its primary concern.
Obesity's sending everyone into a panic. It's hard to differentiate the beneficial thing to do from being a nanny state but I know when the 'too far' line has been crossed and thank God, so do most GPs at the moment. Some blasphemous ideas have been circulating. It's not that I have a conflict of interest except for my intractable addiction to the little tastes of heaven that go by the mundane name of chocolates, of which it would be a crime surely not to have at least one a day.