Definition and diagnoses of Diabetes.
Diabetes is a wonderful affection , not very friquent among men, being a melting down of flesh ans limbs into urine. Its cause is of cold and humid nature, as in dropsy. The course is the collon one, namely, the kidney and bladder, for the patients never stop making water, but the few incessant, as if from the opening of aqueducts. The nature of the disease, then, is choronic, and it takes a long peiod to form; but the patient is short -lived, if the constitution of the disease be completely established; for the melting is rapid, the death speedy.
Aretaus Cappadocian, A.D. 81-138.
After insulin discovery diabetes is no longer so danger and so terrifying as it used to be before insulin era. But only if insulin treatment started on time. Unfortunately for 95% of diabetics population, the treatment with insulin come too late if ever. They are Diabetics type 2. This mysterious disease has no identification what is it, or tools how it is diagnosed. At first it is level of sugar in blood to identify diabetes. After diabetes was diagnosed there is type of diabetes must be identified. But no one diagnostic marks to identify what types of diabetes.
Someone will say, there are many marks to diagnose type of diabetes, if it is Type 1, Type 2, or LADA, or MODY. Unfortunately, no one of these mark is reliable. Even level of sugar in blood cannot be used to identify diabetes. Surprise? Not at all. If diabetic takes insulin, and with insulin diabetic control blood sugar in healthy non-diabetic range, how diabetic would be diagnosed, or confirmed, one is diabetic? Diabetic come to clinic at first time, and his/her blood sugar level is great. Even A1c is perfect. So, one is diabetic or not? Patient insist, he/she is diabetic and takes 500 units of insulin daly dose. Now he/she run out of insulin and need insulin supply. The cost of supply for so high dose of insulin would be over $3,000 monthly. But there is no one evidence that patient is diabetic. So, even screening is out of question.
This is real tragedy with diabetes. I would not say that diabetes does not have any second marks beside of level of sugar in blood. Not at all. Good endocrinologist would see these marks even without any blood sugar tests. The problem is, not so many good endocrinologists in our clinics. Every one see the obesity. No one see yellow teeth and wide gaps between teeth. No one see big size of hands and puffy feet. It is all applied to obesity, but never to diabetes.
Someone will say, there are insulin level in blood. Diabetics type 1 do not have insulin secretion in contrary with diabetics type 2 who has high level of insulin secretion.
Well, at first, insulin level never tested in diabetics blood. It is C Peptides level which usually present as level of insulin. In many cases people just misuse the level of sugar and the level of insulin.
Second, C Peptide level diabetics type 2 do have is not the level of insulin their bodies secret. Usually diabetics type 2 have treatment, Metformin and SU. SU is type of medicine which forse diabetic’s type 2 ill pancreas to secret more insulin. The result of the test for C Peptides would be wrong. It is not healthy level of insulin secretion but forced by treatment. It is usually high. With time Beta Cells distracted and there is no longer insulin secretion. If diabetic takes insulin then insulin in injections do not show up high level of C Peptides. These proteins come only with natural insulin. But for diabetic type 2 who take SU insulin is natural, so it come with C Peptides.
Third, usually it is said that diabetics type 1 do have anti-bodies in system. The question is, when they do have them? As soon as Diabetics type 1 start to take insulin in injections anti-bodies go away. But for type 2 diabetics this test never run. Diabetics type 2 stamped with first visit to clinic, type 2. So, there are no test for anti-bodies, or C Peptide level, or even A1c very often out of diagnostic need.
There are another definition to identify type of diabetes. It was recognized as ketosis-prone type 1, or ketosis-resistant type 2. What does it mean I still not get. How resistance to ketosis was identified?
via Ravenvoron
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