Wednesday, April 18, 2012

Patient Surveys: Day 18

I surveyed Patients 47 through 50 today, all of whom are Type 2 diabetics.



Unlike yesterday, the Type 2 patients interviewed today didn't have very similar data. Patient 48's HbA1c level of 5.9% juxtaposed with that of Patient 50's of 9.8% was certainly intriguing. Both HbA1c levels are 'off the charts,' but in totally opposite respects. I found it interesting how two people who are approximately the same age and have the same type of diabetes can have such vastly different HbA1c levels. I suppose this is a good example of how medical treatment (of any kind, really) is so subjective. When you're dealing with a chronic condition that can only be treated and has not yet been cured, there really is no one-size-fits-all method of treating all of those who come in, even if they present with identical conditions. There are inumerable factors that are taken into account when devising the optimal treatment. In this facility alone, new patients are inquired about the presence of alcoholism, kidney infections, allergies, anemia, migraine, anxiety, epilepsy, multiple sclerosis, asthma, obesity, atrial fibrillation, cirrhosis, high cholesterol, hypertension, hyperthyroidism, thyroid disease, and hypothyroidism, just to name a few. Depression is merely one of these factors that are taken into account for diabetic treatment.

This also elucidates the difficulties of isolating diabetic factors as the independent variable(s). There are so many other factors (consider alcoholism or obesity, alone) that could be at work, affecting depression scores. What's worse is that it's plainly unfeasible to take the other variables into account, i.e. only surveying diabetics who have no other medical complications. Diabetes itself introduces complications across the body, from the kidneys to the eyes to the nervous system, etc. Excluding diabetics with thyroid complications alone would be ludicrous; you would be left with a minuscule sample size. Consequently, despite numerous studies having been done on the subject, the relationship between diabetes and depression is still unclear.

Lalani.

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