"Marginal structural models" are not "empirically verifiable" and can be done in many different ways, so we really cannot be confident that increasing insulin doesn't increase mortality in type 2 diabetes. It is strongly associated with increased complications and mortality, and sometimes we must use it when the patient becomes a type 1.5 . Just don't feel too comfortable using it, especially at high doses.This is opinion of doctor, and what is this? He is not comfortable to use insulin. This is really what is all about. They are not comfortable to use insulin, ether dose of it, low or high. When diabetic come to clinic, diabetic diagnosed with type 2 diabetes. How they diagnosed it? Very simple. Just stamped, every one is type 2, period. This is why 95% of diabetics are diabetics type 2. Then they are very comfortable to Rx Life Style Modifications. They are very comfortable to Rx Barking Therapy for the next 10 years. And of cause, it is first line in medicine, Metformin. Does this plan work? Of cause, it is very good plan for Medical Organization. There is no one diabetic type 2 who died right after first clinical visit. It takes years when finally our blood stop to move in our blood vessels due to very high syrupy state. No one doctor can be responsible for the early Death diabetics type 2. Every year, more then 60 000 Americans die due to diabetes, high blood sugar level, 100% preventable cause of Death with right early treatment. There are no doctors in America who is comfortable to use insulin, ether dose of it.
"Our findings provide additional evidence regarding the overall and cardiovascular safety of insulin treatment in type 2 diabetes. Our study does not provide complete reassurance, as no single study can, but provides convincing evidence that confounding may be partially responsible for the observed dose-dependent association between insulin and mortality," Dr Gamble told Medscape Medical News.Show me those studies on what insulin dose dependent? Right now I do know only one way insulin dosing. Weight in pounds : 4 = daily dose of insulin. 50% is bolus short acting insulin, and 50% is basal long acting insulin. Really interesting how dose counting was found? No any idea. Do not ask them, they have no one answer. At the same time they are sure, it is dose of insulin to blame why diabetics type 2 die soon after insulin therapy started. In all this study there is no one mention how dose of insulin and level of sugar in blood related. No one word about this connection. So, studies studied what?
He added, "The findings should not change our approach to prescribing insulin but provide further evidence supporting the current clinical practice guidelines for using insulin in the management of type 2 diabetes."So simple. Let diabetics type 2 die, price for comfort of our doctors who does not want to use insulin in their practice.
Nevertheless, he cautioned, "As always, it is still important to not overtreat with insulin, given the known risks such as hypoglycemia."Really interesting point, how low blood sugar connected with high blood sugar? When diabetics type 2 die due to low blood sugar? Because of insulin use? or it is because of wrong insulin use? Or because of too late insulin use? That's right. When diabetic type 2 diagnosed with diabetes type 2, and it is 95% of American Diabetes Population, the first line treatment is Life Style Modifications, no insulin. Then it is first line add-on, Metformin. Good for doctors. No low blood sugar. Cost effective regime. No problem to pay for treatment. It is only $4 for month supply of medicine. Still numbers do not drop. SU is number 2 add-on. Very danger type of medicine. At first it is very high low blood sugar. Then sugar in blood drops very low. No any control possible. Second, it is speedy way to progress to Beta Cells depletion, so next add-on such as Invokana would be part of treatmnt regime. Diabetic type 2 lost weight dramatically. Infections, increased blood sugar, and so on. Finally, when all add-on were already on table, insulin, low dose would be added. This is when we start to die. They said it is because of insulin to blame. Really? Who is insulin resistant? Diabetics type 2? Medical Care Providers? WHO? ADA?
In the current study, both raw and adjusted data did suggest an increase in death and MACE with increasing insulin doses in type 2 diabetes patients. However, that association disappeared after Dr Gamble and colleagues applied a statistical approach called "marginal structural models," which adjusts for factors that change over time and that are affected by insulin dosage — such as number of hypoglycemic events, body weight, and glycemic control.Interesting, how body weight effect glycemic control? Level of sugar is different every day, every hour, every moment. To control those numbers we have to adjust insulin injections with every shot we take. How speedy weight changes? How weight in the 6 am different with weight at 12 pm? And if so then it must be very fine table to help diabetic type 2 find the dose of insulin to inject depending on body weight. There is no one table like that. No one. So, how they adjusted insulin dose? If this is so important how weight effect dose of insulin, there are must be table, and we all, diabetics type 2 have to have it with first visits after we diagnosed with diabetes type 2. This table simple has no place to be. We have to adjust dose of insulin every time we inject insulin in our bellies.
Those same factors also in turn influence insulin dosage and are related to the outcomes of interest — in this case, death — and therefore may be responsible for a spurious association between insulin dosage and death, Dr Gamble explained.Sorry doctor Gamble. You are barking on wrong tree. Dose of insulin does not effect mortality. It is only WRONG dose of insulin which kill diabetic type 2. Also it is wrong Type of Insulin, and Wrong Regime of Insulin Therapy. It is big difference from what you just said. If it is dose of insulin when it is high (any why how high is high?) then why MD Rx this dose? Over and over and over we come back to the mechanism of Insulin Dosing. Because of dose of insulin determined by body weight, and dose of insulin responsible for the mortality of diabetics type 2, it is time to adjust insulin dosing instead to blame insulin in our mortality.
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 faultNumbers are tricky. Take a look at the sample:
1 apple + 2+ 5 + 3= ? How many apples in the basket?
It is easy to say, it is only one. Still no one number can be put into basket. So, what is in basket? Why there is not possible to be 5 apples and 3 mushrooms, and 2 potatoes? So, how many apples in the basket?
It is easy to see with apples and basket. The question is, why it is not possible to see with dose of insulin in injection, blood sugar control, and mortality diabetics type 2? People with diabetes type 2 do not die because of we are diabetics type 2. We die because of very high blood sugar, very low insulin secretion. If insulin added in blood stream, our numbers start to drop, our lives would be safe. But our medical care providers are very uncomfortable to use insulin. They prefer to provide us with very high loud Barking Therapy that we do not control our high blood sugar numbers. This is why we die sooner then diabetics type 1, who take low dose of insulin since childhood, and live long and very comfortable, walking on both legs, no rush on the body, no never healing wounds.
Can This Be Proved Definitively: Why Doesn't Insulin Prolong Life?Because of Medical Care Providers are not comfortable to use insulin. They are Insulin Resistant. They have no one idea how to use it safely. They do not know what dose of insulin diabetic must stake, how to adjust dose of insulin according to the number on diabetic's glucose meter right now. They have no one idea what regime of insulin therapy to Rx. They do not know difference between types of insulin, which one to Rx and how.
Every one of them very comfortable to ask, if diabetic type 2 control blood sugar or not. But no one even take into consideration that if one control blood sugar one is not diabetic at all. So, why this diabetic diagnosed as diabetic type 2?
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New Insight Into Insulin Dose and Mortality in Type 2 Diabetes
via Ravenvoron
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