Diabetes type 2 first line treatment is Life style modification, diet and exercise and if it is not enough then metformin added. Does it work? Of cause not. Every med pro do know it very well. Then why it is first line in treatment of medical condition such as diabetes? Because of without first line there is not second line. So, after first visit to clinic two weeks later there is another medicine would be added, SU. Now for a few years doctor charge health plan for every month victim visit to the clinic. There are ECG and blood works, different types of therapy, which is usually in the same clinic under supervision of the same doctor, or closer MD friend. It is almost ten years in front to treat diabetic in this way till diabetes take full power. Then there are a few years of incentive therapy with amputations, pacemakers, home aids, nurse visits, and so on. They are 'add-on' to medical money pool. And finally, it is hospital, death, and organ and tissue to transplant. Final harvest.
Every one count how much diabetes care cost to society. No one count how much diabetics type 2 pay for own life. Where all those money go? In private pocket of Con MD. Is this really possible to get rid of diabetes type 2 with any treatment, first line or any add-ons, newly medicine or old one? I do not think so. This is why year after year there are more and more diabetics type 2. Today it is even not epidemic but pandemic. Say me, why Zika virus did not became pandemic? Why many other epidemic stopped before these epidemic claim millions of lives? Because of they are not so profitable. Or they can take lives regardless of income of victim. Diabetics type 2 are low income low level of American Society. This is why they must control Diabetes type 2 with life style modifications. High society does not need this sufferings. They take Insulin, and live with small inconvenience of daily insulin injections.
Co-pays payment that patient cannot afford is really another myth. If one work then family can afford to pay co-pays. If there is low income family then there is no any co-pays, high or low. Simple, diabetic cannot afford visit to medical clinic and pay to MD. So, it is really trick that insurance companies does not pay, and co-pays so high, diabetics cannot afford to pay it. If there is no co-pays as it is with Medicaid for low income families, then MD give Rx to medicine to any patient who really does not need it. Check up for this practice.
Insulin such as NPH, Novolin or Humalin is really in very reduced price. The problem is, it does not work very well. It is regular type of insulin. The basal insulin such as Lantus Solo Star, in pen, or Lantus actually can be the same price because of it is high quality and effect of this type of insulin. With time or when this insulin started to be taken early it is the same price, and even lower. With time dose of Lantus Solo Star dropping, so the price of therapy go down.
It is Myth that properties of insulin are the same and it is only the price what is matter. Insulin has different properties, and it is not exchangeable. Some insulin work perfectly well. Other types work less effectively, and some does not work in positive way.
Every one count how much diabetes care cost to society. No one count how much diabetics type 2 pay for own life. Where all those money go? In private pocket of Con MD. Is this really possible to get rid of diabetes type 2 with any treatment, first line or any add-ons, newly medicine or old one? I do not think so. This is why year after year there are more and more diabetics type 2. Today it is even not epidemic but pandemic. Say me, why Zika virus did not became pandemic? Why many other epidemic stopped before these epidemic claim millions of lives? Because of they are not so profitable. Or they can take lives regardless of income of victim. Diabetics type 2 are low income low level of American Society. This is why they must control Diabetes type 2 with life style modifications. High society does not need this sufferings. They take Insulin, and live with small inconvenience of daily insulin injections.
I don't necessarily agree with your statement about pharmaceutical firms but I will say this. I practice in a large metropolitan outpatient hospital clinic. I regularly have patients who cant afford the basal insulin products prescribed because of copays and insurance restrictions. Many times these patients can be switch to NPH insulin (Novolin or Humulin) and there copays and price to the insurance carriers are greatly reduced. It has the same glucose lowering properties except its given twice daily. Why are many physicians not making this change?Now so true. Usually insurance company ask if there is some reason that more expensive medicine must be taken. It is not that they do not pay for this medicine, they just make sure, this medicine and spending necessary. There is no need to switch from one medicine to another. Also it is practice that before patient get different medicine pharmacy contact doctor if switch is acceptable. If doctor insist, there are no another medicine but this one, then insurance will pay.
Co-pays payment that patient cannot afford is really another myth. If one work then family can afford to pay co-pays. If there is low income family then there is no any co-pays, high or low. Simple, diabetic cannot afford visit to medical clinic and pay to MD. So, it is really trick that insurance companies does not pay, and co-pays so high, diabetics cannot afford to pay it. If there is no co-pays as it is with Medicaid for low income families, then MD give Rx to medicine to any patient who really does not need it. Check up for this practice.
Insulin such as NPH, Novolin or Humalin is really in very reduced price. The problem is, it does not work very well. It is regular type of insulin. The basal insulin such as Lantus Solo Star, in pen, or Lantus actually can be the same price because of it is high quality and effect of this type of insulin. With time or when this insulin started to be taken early it is the same price, and even lower. With time dose of Lantus Solo Star dropping, so the price of therapy go down.
It is Myth that properties of insulin are the same and it is only the price what is matter. Insulin has different properties, and it is not exchangeable. Some insulin work perfectly well. Other types work less effectively, and some does not work in positive way.
Also, please explain to me why we have such obese patients who are diabetic and we do not rigorously pursue the treatments that work, weight loss and exercise and diet. It seems to me we are treating after the fact since its easy and does not require much effort. Throw meds at them. I know there are some patients the easy may not work, but there are many who would benefit.I tried to answer to this question in all above. If question still not answered then please continue reading. There is one one way to find out obesity, bathroom scale. Still, bathroom scale does not show the difference between fat and edema, water retention. Severe edema lead to the condition when water go through the skin, skin get infected, amputations which really does not solve the problem. The idea of weight loss really has no any meaning. For what degree weight can be lost? I really do not want to discuss this absurd such as weight loss. This 'therapy' work for no one. This is why it is 'first line' which mean, there are second line will follow, and then add-ons one after another.
New paper shows how to treat type 2 diabetes. All based on just discovered new pathway of glucose metabolism. http://ift.tt/2kciL6XThere is another trick. Diabetes is not metabolism. It is endocrine system disorder. There are now type 2 diabetes. There are chronicle poorly treated or never treated medical condition, usually infection which lead to the pancreas disability. Disable pancreas cannot work correctly and cannot support healthy living. This is with time diabetes progress and finally it is fatal. Insulin in injections can not only safe diabetics lives but also cure diabetes in incoming generations, decrease epidemic and prolong life span.
SULPHONYL UREAS ARE NOT COMPLETELY BAD ACTORS THEY ARE GENERIC AND REDUCE HBA1C IT IS TRUE OF HYPOGLYCEMIA BUT PT IS AWARE OF IT AND THEY ARE CHEAP AND IMPROVE HBA1C.It is not my style to type in this way. I just copied the comment. Now, SU is cheap, this is true. And it is all what is True in this statement. SU lead to very low blood sugar, absolutely not controllable. Also it lead to the pancreas disability, to kill insulin producing beta-cells. Of cause if high sugar 400 mg/dl combined with low sugar 40 mg/dl. the A1c is almost perfect, 220 mg/dl. Still, to flog disable horse never lead to get closer to destination.
THE POST MARKETING TRIALS ARE SCARY AS THEY SHOULD HAVE BEEN DONE FIRST BEFORE RELEASE.Really, why people so love to yelling? Just think about, what this MD doing in his clinic where patient is 100% helpless. Now about those trails. Really, why MD does not run his trails? He must. He is responsible if medicine he Rx work for this patient or not. But no one of them do control Rx they provide to victims. This is why today at first it is Rx, and then it is De-Rx. So funny! They really does not understand how ridiculous they are in all comments and articles they publish.
via Ravenvoron
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