Objective: More than half of African Americans (AA) with a new diagnosis of diabetic ketoacidosis have clinical and metabolic features of type 2 diabetes during follow-up. This particular presentation of diabetes has been termed as ketosis-prone type 2 diabetes (KPDM) or atypical diabetes.Interesting, how many types of diabetes do MD diagnosis? As many as they wont. Types of diabetes right now as types of Vtamines. Vitamines were named in alphabetical range. Types of diabetes names in numerical range. So, for types of diabetes there is no limits.
Diabetic Ketoacidosis: A Common Debut of Diabetes Among African Americans With Type 2 Diabetes
by Priyathama Vellanki, MD; Guillermo E. Umpierrez, MD
http://ift.tt/2j1VOmr
type 1 diabetes in children
type 2 diabetes in adults
type 3 diabetes
LADA
MODY
Diabetes type 2 in AA (African American)
Diabetes type 2 in AA who are not Americans
type 2 diabetes as ketosis-prone
type 2 diabetes as non-ketosis-prone
Insulin dependent diabetes type 1
insuln dependent type 2 diabetes
insulin resistant type 1 diabetes
insulin resistant type 2 diabetes
insulin resistant ketosis prone type 2 diabetes
insulin independent ketosis prone type 2 diabetes in AA (African American) in AA( Asian American) in WA (Wight American) in ...... you name the rest if you can find the end of the story.
But let us take another look at all these names and stories.
At first, diagnosis. How diabetes diagnosed in AA or AM? The same If diagnostic mark the same then why names for medical conditions so different? We do not fave AA Flu, or AA cold. Regardless color of skin or birth place we all do have the same flu and the same treatment for flu, antibiotics. Yes, someone respond on therapy faster and better, other have long way to recovery, still we all have the same diagnose and the same treatment. It is diagnose for flu.
It is different in diagnose for diabetes. We diagnosed according to body weight or color or skin, age or occupation, and we diagnosed according to our treatment. That's right, treatment come first, Oral Medicine. so we diagnosed as insulin independent diabetics type 2. Then insulin added to our regime, so diagnose now diabetes type 2 insulin resistant on insulin, and so so on. To bore to name all the types or names we got. Now it is official,
African Americans (AA) with diabetic ketoacidosis diabetics type 2.
Is name changed anything? Not too much.In contrast to the long-term insulin requirement of auto-immune type 1 diabetes, patients with KPDM are able to discontinue insulin after a few months of therapy and maintain acceptable glycemic control for many years on either diet or oral agents.Really? The question is, what does it mean, 'acceptable glycemic control'? This expression come from where? Is this blood sugar control, or it is not control? Is this diabetes cure, or it is not cure? Is this really true that type 1 diabetics need long-term insulin therapy, and African American people with black skin do not need this long tearm therapy?
Patients with KPDM have significant impairment of both insulin secretion and insulin action at presentation; however, at the time of near-normoglycemia remission, insulin secretion and action improve to levels similar to hyperglycemic patients with ketosis-resistant type 2 diabetes.Is there are another name for us, type 2 diabetics? I do not remember when how I was diagnosed do I have ketosis - resistant diabetes type 2 or it is ketosis- dependent diabetes type 2? or it is ketosis prone diabetes type 2? BTW, type 1 diabetics are they ketosis resistant or ketosis dependent diabetics? See, how easy to put types of diabetes, and be lost in all that resistance-dependent-pron's. But the point is only one, and it is right here in this article.
In the long term, however, patients with KPDM have a decline in β-cell function similar to patients with type 2 diabetes.Why treatment with insulin was stopped? Why that unknown expression such as 'acceptable glycemic control' take place in therapy of diabetic who responded very well on insulin therapy?
In the long term, however, patients with KPDM have a decline in β-cell function similar to patients with type 2 diabetes.Why it is so? Why B-cells statrted to decline if diabetes is under control? Or there is no blood sugar control with "acceptable glycimeic" level? With time this level became nor acceptable, but it will be later, and diabetic will not respond so nicely to the next team of insulin therapy.
Recent studies indicate that treatment with metformin and dipeptidyl peptidase-4 inhibitors can prolong the period of near-normoglycemia remission for several years compared to placebo therapy.This is most interesting point. Why these treatment compared with placebo therapy? Why do not compare these two options with Insulin Therapy? That's right, let it be three groups for study:
- Metformin and DPP-4 inhubitors;
- Placebo;
- Insulin Therapy.
There are no tables to compare DPP-4 with Insulin, Metformin and Insulin, or Invokana and Weight loss surgery compare with insulin. What keep blood sugar longer under control, and for how long diabetic still alive and functional.
Good article to read. But it must be read with opened mind and with opened eyes. Do not take it for granted that authors jump to conclusion and this conclusion is right for you. Read it with eyes opened, and see it with critical mind. The conclusion I come to after reading is so simple: There is no types of diabetes but stages of blood sugar level, and this level of sugar in blood depend on the level of insulin our ill pancread capable to secret. If pancreas get help on - time with outside insulin injection, diabetic any tipe get better and with time and proper treatmnt will get rid of diabetes any type.
This is my conclusion after reading this article., I see the prove of all my points in this official publication.
via Ravenvoron
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