The object of the treatment of diabetes is to prevent the loss of sugar in the urine. (1934)It was 1934. At that time urine test was essential for diabetics. Blood sugar was not invented yet, so diabetics rely on the test sugar in urine. This is why object was to prevent sugar split into urine. Now diabetics rely of the test sugar in blood. Also in many of us who takes insulin sugar is no longer present in urine. So, this test is not so essential. Now the treatment, Invokana, very strong diuretic, is one type of the treatment for diabetic type 2.
Really, what is different today in diabetes as medical condition? Nothing. As at any time in past diabetes is the limit of insulin secretion by the diabetic's pancreas. If so then why the treatment turned un side down? If in 1934 on the rise of insulin therapy the goal of therapy was to avoid sugar in urine then why today it is the goal to increase sugar in urine? Most important, this type of therapy was not developed to treat diabetics type 1, regardless of any age and body size, and duration of diabetes, just diagnose based on nothing. For type 2 diabetic it is OK to take Invokana and pee out sugar from blood. Try to survive with this type of medicine.
Treatment with diet alone was formerly unsatisfactory, because the diet was often too strict for comfort or occasionally for life. (P19)This is another interesting point of discussion. In his manuals Dr. Joslin very often present diabetics that it is we are to blame why we are diabetics. we do not care what we do eat, get fatty, and this is why we do have diabetes. In his manuals he devoted many pages to diet, carbs counting, calorie intake. At the same time he practical do not pay too much attention to the practice, how dose of insulin was determined. He point out how diet changes according to the level of sugar in urine. But still, I did not get how the dose of insulin was proved to be right.
The patients sometimes were too weak even benefit from exercise.
The discovery of insulin is, therefore, a great boon, because with its help the patient can eat all he needs to enable him to work or play and to become a useful member of society.
No Diabetic ever expect to get gangrene or having gangrene to die of it. ....... Think of it! There are upward of 400,000 diabetics now living in the United States and of this number about 40,000 are destined to die of gangrene unless our methods are improved! Over one-half of fatal diabetic cases in four large Boston hospitals during 1923 were due to gangrene and infections. The overwhelming majority of all such deaths are needless and could be prevented by cleanliness, proper care of the feet, and early treatment of all wounds, insignificant though they are in the beginning. (Dr. Joslin. Diabetes Manual 1934. P.130)Of cause, we developed diabetes because of our overeating. We developed gangrene because of we do not wash our body, do not take shower daily. And so so on. In other words, it is all the time one who get ill to blame why one die or still ill. At the time when insulin already was available, did diabetic had treatment with insulin to avoid wounds development? Over and over, it is the same, how insulin dose was determined? And there is no one mention how Dr. Joslin Rx dose of insulin to children in his care. I read one page after another, there are all the time that patient takes .... units of insulin. Still, how these number of units was Rx? Looks like doctor distanced himself from the medicine he Rx.
When insulin supply was terminated wounds started to develop on my legs. Did I wash my foot? I do not remember. I do not wash them now. I simple cannot reach them. There are no wounds on my legs, on my feet. I do take insulin in dose I need to keep high numbers under tight control. When insulin was limited and I did not have that control wounds started to surface one over another. They never healed. Over and over there were puss running on both my legs. I had to dress them to avoid infection. Dressing fail, I cannot do it in right way. Disgusting! Shame! Pain! As soon as insulin started to be delivered all my wounds go away, and now they do not come back, even I do not take shower so often as I used before.
Dr. Joslin was wrong. There never way to have wounds insignificant and that they can be treated successfully if care started early. It is going from inside out, not from out to inside. It is not infection which bring never healing wounds on diabetic body. It is wounds, sugar, go out from inside. This wounds never would be healed if sugar in blood still high and sugar in urine is present. If doctor pretend to be specialist in diabetes care he must get better understanding why diabetics do have gangrene and die from it. Still, it looks upon reading his manual that he has another point of understanding.
No one today must have gangrene. It is avoidable with proper insulin treatment regime. No one have die today because of diabetes. And still, there are 76,000 death every year in US due to diabetes, high blood sugar level, 100% avoidable cause of death. Millions of pages in medical publications devoted to diet and exercise. Still, there is no clear definition what is difference between insulin -dependency and insulin - resistance. The same method of diagnose, right opposite regime of therapy, and so right opposite life expectancy. If diabetic treated with insulin diabetic can live with a little inconvenience for the normal old age. If diabetic treated with oral medicine such as Invokana and Actos, then within ten years diabetic would die if one will not start to take insulin on-time.
via Ravenvoron
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