Higher insulin doses do not raise the risks for mortality or major adverse cardiovascular events (MACE) in patients with type 2 diabetes, new research indicates, after careful adjustment for potential confounders.How there are a few questions.
New Insight Into Insulin Dose and Mortality in Type 2 Diabetes
First one: Why diabetics type 2 need high dose of insulin in first palace?
In 1980 diabetes type 2 was defined as Insulin-Independent type 2 Diabetes, in contrary with Insulin-Dependent type 1 diabetes. In some countries it is even named as non-sugary diabetes, the hell do know what does it mean. Diabetes type 1 when pancreas does not secret insulin, so diabetics type 1 need insulin injections, and if they skip dose of insulin they even may die. In contrary, diabetics type 2, according to ADA definition, resulted by high body mass, and it can be prevented, or delayed in diagnose, or reset with low carb diet. Now, after almost 40 years treatment with Life Style Modifications our medical care present that high dose of insulin do not rise risk for mortality of diabetics type 2, why?
So, why Mortality of Diabetics type 2 is so high? Probably because of Healthy Life style is so danger that no one of us is capable to flee of Graves. Difference with type 1 diabetics, who may die because of pancreas does not secret insulin, still they live very long, on pretty low dose of insulin.
Another point is, why high dose of insulin does not increase risk of high mortality diabetics type 2? Probably it is because of we are in such high risk that there is not possible to be higher? Remember, diabetes type 2 is number 7 cause of death, 100% preventable cause of death. But still, it is not the rate of mortality diabetics type 2. More then high blood sugar we die because of heart failure, kidney failure, and all other causes of mortality, no one ever counted.
Second one, what dose of insulin was taken into consideration which does not increase the rate of mortality diabetics type 2?
In an accompanying editorial, Amanda Adler, MD, PhD, of the Wolfson Diabetes and Endocrine Clinic at Addenbrooke's Hospital, Cambridge, United Kingdom, points out: "People with type 2 diabetes who take insulin die sooner than people with type 2 diabetes who do not take insulin. This is accepted. What is not accepted is whether insulin is at fault."I tried to read all article, it is very specific, and really it is not so informative for me. I tied to find out how dose of insulin was found, how to count dose of insulin? I did not find any answer. What I found regarding dose of insulin was that
Crude mortality rates by daily insulin dose per 1000 person-days were 46 for less than 25 units per day, 39 for 25 to 49 units, 27 for 50 to 74 units, 34 for 75 to 99 units, and 32 for 100 or more units. The overall crude mortality rate during follow-up was 31 deaths per 1000 person-years.And so what? Really studies were what about? The result is pretty not clear, why diabetics type 2 who take insulin die sooner then diabetics type 2 who do not take insulin? And really the expression: "take insulin - do not take insulin" is pretty meaningless. If I will take 25 units of insulin daily definitely I will not safe with insulin. Nether I will safe with insulin + metformin. The same as there is no any safety to take insulin + Invokana, and so on. 300 units of insulin daily dose keep me alive, and really not very good but still functional. It is 300 units of insulin daily dose. No Metformin. No Invokana. No any Trash Medicine in my medicine box.
When studies were done, what they really studied? What they took into consideration?
After adjustment for baseline covariates, including age at insulin initiation, sex, smoking, HbA1c, body-mass index, blood pressure, number of physician visits in the year before insulin initiation, medication use, and comorbidities, higher insulin doses were still significantly associated with increased mortality (P for trend = .006). Sensitivity analyses produced consistent results.I do not want to speculate. Really, how weight effect HbA1c? Did they found this connection? I did not. My weight is stable day after day. It does not go up and down every day, or even every hour. Still, the level of sugar in blood dramatically different depending of weather outside, my other health conditions, season time, and so many other things. So how it is possible, really how it is logical to count dose of insulin according to body weight? smoking statue? sex? level of education? and so on? In all that considerations I do not see any connection with blood sugar level. No one word about ability of diabetics type 2 pancreas health condition? Is Pancreas still capable to secret insulin? Because of, if it does not work, then there does not matter how small or tall diabetic is, how one smoke or what sex do one, the insulin secretion would be '0' so all insulin must be added in injections.
This is reality of any studies. They study how sex effect their lives, or how many glasses of red wine will set diabetic type 2 diabetes-free, or what movie to watch to reduce level of sugar in blood, and so so on and on and on... . What they never study, how level of sugar connected with insulin dose injected. How many units of insulin to inject to escape low blood sugar and at the same time reduce high blood sugar numbers, and still alive and functional.
Dr Adler concludes her editorial with a different thought — should there ever be data to definitively prove the safety of insulin in type 2 diabetes patients, "one could also wonder why more insulin does not make people with type 2 diabetes live any longer."I am ready to answer to your question.
"more insulin" has no one meaning. The dose of insulin should not be "more' or " a little bit" or any "Tiny". It must be simple "RIGHT", different for any and every one and all diabetics type 2, regardless of body mass or body shape, eyes color or amount of fingers on right hand. So simple. There are a lot of Studies which cut our lives. There is no one right study how to stop killing, and start healing 95% of American Diabetics Population.
"Study subjects were 6072 new users of insulin added to existing metformin therapy during 2001–2012, divided into four groups based on the mean daily insulin dose during follow-up.12 years they studied how to teach Donkey to speak. Half of their Rats died withing 3.1 years of study. They still study, and study, how diabetics type 2 die, with insulin, without insulin, insulin + metformin, insulin + invokana, Insulin + ..... . Now the time to present results. From 6072 subjects of study 3599 died.Is this because of at the end of the life diabetic type 2 was injected insulin, finally, and died because of low blood sugar? Because of ignorance and malpractice Medical Care Providers?
Relative differences in mortality and MACE (nonfatal myocardial infarction, nonfatal stroke, cardiovascular-related mortality) were assessed. A subgroup of 3599 patients had linked hospital and death-certificate data. Median follow-up time was 3.1 years."
Really, what increase Mortality Diabetics type 2? Why our life is so short and so painfull and miserable?
via Ravenvoron
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