"So what should be the goals of therapy? Many groups have their own perspectives on this question"Well, what is the goal for open heart surgery? To improve heart health and make it work as well as it is possible. What is the goal of antibiotic therapy? To kill virus coursed inflammation, so human can live. What is the goal when we go to dental office? To fix our teeth and be pain-free. So, what is the goal for Diabetes type 2 treatment? Interesting, is not it? Why so many groups have so different goals how I have be treated? Ask me, and I will answer: My goal is to have blood sugar level as close to the normal healthy level of non-diabetic as I can. Simple. This is goal of every one who is ill, just get as healthy as we can. Do I wish to be diabetic type 2? Do I like to swing on high - low blood sugar swings? Do I like to carry on all water I collected in my heart, lungs, liver, to walk on watered legs, or I do like pain in my hands, that I am not capable even open a door? What is goal of therapy for me?
by Beaser M D, Richard S
It is really very shameless to even ask the question like that. But it is a guide for primary care providers by Richard S. Beaser, MD, Joslin Diabetes Center. They ask this question seriously, and they answer to this question with all professional knowledge. ADA published recommendations different for over the time. Why there are so many variations? Why do not make it much easy? In stead to set up the goal according to the individual needs, absurd in first place of the nature of this expression, why do not set up the goal to have blood sugar level just normal as every one non diabetic do have? Just to be diabetes type 2 free? Why not?
It is easy to set up goal. It is ADA who recommend how to treat diabetics type 2 with life style modifications, but it is diabetic type 2 who must control blood sugar level, and reach the goal ADA and primary care set up for us. In all book, and in any ADA recommendations there is no one instructions how to get from A1c>12.2 % back to A1c < 7%. So easy to print on paper, the goal is ..... . But is is very different to get from 599 mg/dl blood sugar level down to the 120 mg/dl. No one guidance in what direction to go.
Now after goal was set up, what is the next? Lose weight. But there is no one evidence that weight effect blood sugar level. There is only Medical Organization Bathroom Scale Bulling Therapy that it is obesity caused diabetes. Diabetes is elevated level of sugar, according to ADA. So, if obesity leads to diabetes then every one obese person would be diabetic type 2. It is not the case. And as it is mentioned by Beaser M D, Richard S. the amount of meal, or size of portion do not lead to diabetes. This is right in the book I read right now, professional very well done book published as reference for primary care providers. Then why it is life style modifications, diet, carbs and calories counting taken as prime goal to treat diabetes type 2, cost effective therapy? Diet cannot reduce level of sugar in long term.
It is another very interesting statement that diabetes type 2 which, according to ADA and Medical Organization statements caused by obesity, can be treated with starvation, simple to avoiding eating, but flu cannot be treated with therapy to put on worm jacket? Not at all. Flu will be treated with antibiotic therapy. In contrary, diabetes type 2 treatment based on food restrictions, most cost effective type of medical care. The consequences of this therapy, mortality of diabetics type 2 is number one in America, if taken into account all diabetics type 2 deaths.
Stroke and heart attacks, the cloths in blood, very high syrupy blood with is highly coagulated.
Low respiratory complications, show me one diabetic type 2 who is Operatic Soprano of high level. Just take a look at Operatic Sopranos, they have very huge frame. But no one of them is diabetic type 2. We simple cannot hold our breath, we cannot sing on high stage. Diabetics type 1 can be athletes. Diabetics type 2 cannot, why? Because of insulin give energy to be good athlete. Metformin and diet, most cost effective treatment for diabetics type 2, lead to death just withing less then 10 years.
Really, what is the goal for diabetics type 2 treatment? Do the goal is to speed up gap between diagnose of diabetes type 2 and funeral? This is only one way to go. Without insulin no one of us survive. We all collect pounds, and finally became highly obese. But no one type of diet ever lead to diabetes type 2 cure or reverse, or resolution, so many baby toys in dictionary Medical Care Providers, colorful and loud, still no one of this toy can be used as cure.
Why Medical Organization or ADA or WHO do not set up the goal to reduce mortality of diabetics type 2? Not good for business. In contrary, Medical Organization promises that in incoming future they will increase diabetic type 2 population up to the level when every one out of three would be diabetic type 2.
via Ravenvoron
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