What Comes After Metformin in Type 2 Diabetes? january 31, 2018

Until 2012, the American Diabetes Association (ADA) recommended lifestyle and metformin as first-line therapy for glycemic management in type 2 diabetes, followed by a sulfonylurea (SU) or insulin for additional A1c reduction.

 What Comes After Metformin in Type 2 Diabetes? by Gregory A. Nichols, PhD

 https://www.medscape.com/viewarticle/891625?nlid=120428_1521&src=WNL_mdplsfeat_180130_mscpedit_wir&uac=164666HZ&spon=17&impID=1546694&faf=1

      What is now, after 2012?  If that therapy back to before 2012 worked that why it must be changed? If that therapy did not work then then why it still in ADA recommendations 2018? There are thousands book and publications how diet worked out and  diabetic type 2 reversed diabetes type 2. Many of those publications officially published. There is only one problem with diabetes type 2 reverse. How to confirm one is not longer has diabetes, meaning that pancreas healthy, amount of beta-cells sufficient, and insulin secretion is not limited? Not to test that there is no diabetes type 2 any-longer? There is no test like that. All test to diagnose diabetes ether type of it just level of sugar. The same test to diagnose diabetes, or if diabetes under control, or if diabetes reversed.
       To be clear in my point, at first diagnose of diabetes must be based on data other then level of sugar in blood. ECG show not only present MI but all MI in past, reversed or active. MRI show all black spots in brain, past or present strokes. Level of sugar in blood does not show if there was diabetes in past and reversed, or it is present active diabetes right now. Blood is in constant change. This test cannot be reliable to diagnose that one is diabetes  free. The level of sugar in blood is only test for active medical condition and for control of diabetes. The same as the temperature of the body. Today we are flu - free and tomorrow we got it.
      So, how it is possible that life style and metformin can be first line in treatment of diabetes? It is possible only in one case, pancreas solved the problem and for some time body able to function normally.  At that time we try to be active as much as we can, big mistake I can say. Also at that time we are able to pay for diets and force ourselves to follow them. Another big mistake. In addition to these two MD Rx Metformin to kill healthy well working liver and destroy healthy muscles. When we are not so ill, just in first stage, we follow doctor's order, and we trust in doctor. Plus there is aggressive propaganda that we are all fat, regardless the body size and shape. It works perfectly. The treatment of diabetes moves to the next stage, second line.
      SU or insulin? What to chose? There is the problem. The problem is cost. Insulin is expensive. SU is cheap.What is doctor's choice? SU. In addition to that MD Rx cost effective therapy, MD secure future business development. With SU no one diabetic ever would be able to reverse diabetes, to get healthy, to get off the medical hook. We are hooked for the next ten years, getting fatty, ill, and finally die in pain and suffering.

Today, with many more second-line options available, the ADA's new guidelines open the door to whichever therapy is best for the individual patient. But what exactly does that mean?

       Free pie for all medical industry. Nutritionists and Surgens to cut our legs, pain management and depression therapy, you name it, all follow up with Metformin, SU and life style modifications. All pain can be eased with insulin. But insulin is not the choice for diabetics type 2. The same as many other active and effective medicine.We may not have it, why? Life-stock must be kept in the barn available to be used at any time.
      Before 2012 there are only SU and Metformin were avalable to kill diabetics. Now there are much more. Try it. If one does not work then try another medicine. Take Avandia or Invokana, oral tablets or injectable if one wish. The result is the same. Less then ten years after being diagnosed with diabetes type 2 diabetic type 2 would die.

 Most patients added a therapy to metformin, the most common of which was SU (41%) followed by DPP-4 inhibitor (31%). Baseline A1c was 8.7% overall and 9.2% and 8.4% for SU and DPP-4 inhibitor combined with metformin, respectively. Patients initiating insulin experienced the largest absolute 6-month change in A1c (-2.1%), followed by those adding SU to metformin (-1.7%).

As it is said, insulin provided greatest improvement in diabetes control. SU can reduse A1c but only temporally. With time pancreas lost ability to secret insulin and insulin secretion drops below any ability to survive. Even in this stage insulin can support life. But there is no recommendations or protocol that insulin must be first in line. Diabetic die due to diabetes, high blood sugar  level, 100% preventable death, or MI, heart arrest due to spasm of heart muscles, or stroke due to blood is so dense it rupture blood vessel. Insulin could prevent any of these conditions. There uis no insulin for diabetic type 2. Diabetics type 2 practice to try one medicine after another. Perfect Human Ginea Pigs for medical experiments.

via Ravenvoron