Non-compliance from the Pediatric and Adolescent Medicine Perspective

Dr. Fran Cogen Caregiver Director, Child/Adolescent Diabetes Program at Children's Nat'l Fran R. Cogen, MD, CDE, originally from New York, has resided in San... Send Message Subscribe: Dr. Fran Cogen

Wednesday, October 07, 2009
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Not only do I have the opportunity to participate and write blogs for this site; but I also peruse the diabetes site and learn from my co-bloggers. Today I read a blog written by one of our colleagues discussing "non-compliance" in terms of the doctor-patient relationship. I am aware that this ...

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I am as non compliant as they come
Neil
Wednesday, October 07, 2009 at 11:44 AM

I refuse cholesterol drug, high blood pressure drugs and use only humalog insulin injected every two hours or so. I exercise up to three hours non stop on some days and don't even count my food exchanges. I know exactly what to do and when to do it. Exercise will lower blood sugars only if you have adequate insulin. However, you will need less. My doctor one days asked about injecting every two hour: Are you still doing that. Of course because I want to live in perfect health. I also refused long acting insulin because it makes no difference anyway I have the same A1c with or without it so why spend the money?

Has any ever considered the dangers of weigh loss surgery
Neil
Wednesday, October 07, 2009 at 03:33 PM

So much about diabetes care is altering the body's function, which weigh loss sugery is one. Diabetic pills often alter the liver function. Why would the medical even suggest altering the body's function when other very effective methods of treating diabetes exists?

re: I am as non compliant as they come
MaryHH
Friday, October 09, 2009 at 01:39 PM

Neil, I too have noticed that no matter what I do my A1C's don't change much! My approach is different than yours. Tell me what range are your A1C's? Mine are 8.0-9.0. I am being pointed at by my dr.s as someone who is at risk of course but also as either non compliant or sloppy in my approach. Poor ignorant diabetic I am! I have a bit of attitude today but basically have had nothing close to success in 34yesrs in handling brittle diabetes-that's where the attitude comes from. Maybe if I had more time and money I'd do better. I think Diabetes is a disease that only the rich and iddle should have. (haha)

compliance
Mary Haas-Hackett
Friday, October 09, 2009 at 01:25 PM

Non-compliance vs non adherance is an astute observation. I've had diabetes for 34 years. I know more than many of my doctors know from what I've seen. During my appointment, time is not spent with me to ever get beyond the initial superficial stuff. This disease requires more than looking at an A1C and jumping to uninformed conclusions! Even having insurance doesn't mean that a patient has a lot of time,and money to spend running to more appointments that are costly and not helpful, that is my experience. When a see an endocrinologist, whom I've screen prior to seeing-to see if they work with my particular pump, I get there and the dr. nor staff even looks at my pump nor downloads the wonderful useful info from the pump. Instead, at times they hand me a bundle of papers to fill in charts to test my BG 12 times per day before/after meals and other times that means for at least one whole day I can not doing anything but fill in these logs while testing! They completely ignore what info is integrated into the pumps programs. I call that NONCOMPLIANCE. They get paid to help me manage my diabetes yet don't work in a logical practical path to gets good results! It's frustrating and dangerous. I am about to lose my health insurance and other than supplies I won't miss these depressingly inaffective appoinments. I will miss seeing my A1c's as I am very motivated and test 6-10 times per day to try to control my BRITTLE DIABETES.

re: compliance
Archie
Tuesday, October 20, 2009 at 05:24 PM

First of all, you only need your doctor to prescribe insulin. The rest is entirely up to you. I have been a diabetic longer than most diabetics I know have even been alive. That is right, I am an old guy who did not get diagnosed until I was in my early 20s but I am quite sure I had it several years before my body all but failed. That is right -- I was pissing myself to death and pooping myself to death. On top of that, I was puking myself to death. Once given insulin, I soon learned that I could live in perfect health by exercising lots and lots, and I still do. I also found out checking my blood sugar every two hours and if I am having an issue check every hour is quite wise. Lay off the corn syrup, read all labels get rid of the vegetable oil, make your own bread and tell the doctors to stick in their ear. At least that is what I did. My doctor knows I am a lunatic and he no longer bothers me about all the BS about statin drugs since my cholesterol is better than 95 percent of the men my age. I can out run and out perform most youths in their 20s. However, I do recognize I have a unique set of genetics. I did not even fully pass through puberty until age 25 and did not have facial hair, leg hair or chest hair at all until that age. In fact, I still had blonde hair until the age I reached full manhood.

I had to watch my mother, my cousin and my niece die of diabetes. I can assure you I will not die of diabetes. I might die of something else like a bullet in the head because I piss off so money people though.