We have an opportunity to take a look how Standards of Care were developed, and if this really true, we can relay on these Standards? Let us take a look at the article, and see the development of standards without Glasses.
I do have very good Medical library. Many books about diabetes, and history of diabetes, including history in diabetes treatment. I still try to find what is new in Diabetes Care, in Med Pro e-journals, or new books they publish. No one book with new ideas. All publications only, how to cure or reverse diabetes type 2 with one or another diet. There is nothing new in these ideas. They were published long time ago in one way or another.
Most famous and most successful was Dr. Allen. He developed ideas that with very severe diet diabetic's live can be prolonged. When he was asked if this treatment will safe diabetic's life he answered: "No. But we can buy the time when treatment or cure will be developed." His patient was on 400 calories diet for three years. She finally got her first Insulin shot in 1922, and then she lived for 1981. 60 years on Insulin in injections. No one diet could safe her, but Insulin done the job, and she lived, graduated form college, got married, and bring up her children.
At the time there were no types of diabetes. Regardless of any types which were identified later, all life of diagnosed diabetics lasted days or months. Less then year. All types of diabetes, obese or skinny, old or children. Children lived in wards last days of their lives, comatose. Now, almost 100 years after Insulin discovery, what Professional Practice Committee is helping to find? Do they found what they were looking for? Of cause they did. They know where to look at, in own pocket.
In contrary, committee did not contact diabetics. They studied, what they need to find, and how increase own Well Being in expense of diabetics, alive or not. They did good job.
LOL!!!!!!!!!!!
This is member of Committee who provide guidance how to treat diabetes type 2. Does this member has any idea what diabetes type 2 is? And if this member has no idea what is the subject of discussion, why this member is member of committee?
A family nurse practitioner in Philadelphia, Pennsylvania, and a member of the American Diabetes Association (ADA) Primary Care Advisory Group and Professional Practice Committee, which developed the 2018 Standards of Medical Care in DiabetesSo, at first, who they are,members of Committee and how they work to identify best treatment options for Diabetics any types.
https://www.medscape.com/viewarticle/895315?src=wnl_mdplsnews_180504_mscpedit_wir&uac=164666HZ&impID=1624313&faf=1
Feldman: The Professional Practice Committee is a multidisciplinary committee comprising clinicians throughout the spectrum of diabetes care. The committee members undertake a literature search to determine emerging research and publications and then engage in a dialogue about how best to set guidelines for clinicians involved in diabetes care.So, they read books, and ... and what? How book can show the progress in diabetes care, the effect of medicine which diabetics take, and the result of all diabetics care developed? Sorry I still not get it.
I do have very good Medical library. Many books about diabetes, and history of diabetes, including history in diabetes treatment. I still try to find what is new in Diabetes Care, in Med Pro e-journals, or new books they publish. No one book with new ideas. All publications only, how to cure or reverse diabetes type 2 with one or another diet. There is nothing new in these ideas. They were published long time ago in one way or another.
Most famous and most successful was Dr. Allen. He developed ideas that with very severe diet diabetic's live can be prolonged. When he was asked if this treatment will safe diabetic's life he answered: "No. But we can buy the time when treatment or cure will be developed." His patient was on 400 calories diet for three years. She finally got her first Insulin shot in 1922, and then she lived for 1981. 60 years on Insulin in injections. No one diet could safe her, but Insulin done the job, and she lived, graduated form college, got married, and bring up her children.
At the time there were no types of diabetes. Regardless of any types which were identified later, all life of diagnosed diabetics lasted days or months. Less then year. All types of diabetes, obese or skinny, old or children. Children lived in wards last days of their lives, comatose. Now, almost 100 years after Insulin discovery, what Professional Practice Committee is helping to find? Do they found what they were looking for? Of cause they did. They know where to look at, in own pocket.
It is a 2-year assignment. The committee rotates members off yearly. Members include anyone you would think of who would be involved in diabetes care: pediatric endocrinologists, geriatricians, obstetricians, public health professionals, nutritionists, diabetic educators, psychiatrists, psychologists, and so on.As I just said, I do have many books published in different countries. Japan for instance. They run studies how diabetes developed. They took all adults and children in some place, and collected data, who is ill, who is healthy, and so on. Then they returned to the same place to see what is different in life or health. They studies diabetes development.
In contrary, committee did not contact diabetics. They studied, what they need to find, and how increase own Well Being in expense of diabetics, alive or not. They did good job.
Writing teams comprise professionals tasked with performing a comprehensive literature search, examining new literature published within the past year, and making sense within each of the sections of the standards of care. Writing group members examine the data, the research methods (randomized controlled trials; observational trials), grade of evidence, and relevance to the population.The result of findings was ....
One of the recommendations included in the Standards is an A1c goal. This has been a hot topic right now. How did the Professional Practice Committee come up with the A1c target of less than 7%?So, if today my A1c <5.9% then what I suppose to do? Yes, increase it. Simple and brilliant. The more of us then better for them.
There was a lot of discussion among committee members about individualization, which has always been part of that target goal. The Standards include a figure by Silvio Inzucchi and his team, which emphasizes the need to look at A1c target across social determinants of health, duration of disease, comorbidities, and hypoglycemia risk.Brilliant, is not it? Well, why it is only about diabetics type 2? Let us say, that cancer patients has own goal how many infected cells must be left over in there bodies after surgery? Or if it is infection, let us be sure that it is number on thermometer that should not get lover then, 105 for instance. No one accept this individualization. Every one wish to be Healthy without any specific needs. But diabetics type 2 chose to lost limbs, vision, get stroke, be on bed, and suffer from never ending pain. Really brilliant, is not it? They created that Standards, and I have to live on these instructions, in pain, fear, and suffering. They present, it is Best For Me. Really? I do not think so. But no one ask me what goal I do have and what target I wish to meet.
I think the hardest part of practice is to avoid care fatigue. It is avoiding the [mindset] that now that my patient is at goal, I'm going to move on to something else because there will always be something else in clinical practice.Sure. As I said before, every year 80,000 diabetics type 2 lost fight with doctors and gone. These diabetics gone only because of high or low blood sugar. All Death 100% preventable. But who cares? There are all the time someone will come to clinic with high blood sugar, hoping to get help. If count all diabetics type 2 who lost life due to Medical Malpactice, then there are more then million of us every year. But there is nothing different in Standard Care published by ADA. Who cares? There are all the time some diabetics would be. So, do not worry, publish your books, and study them.
At least for me, in the practice where I work, we are never done with this. Patients who are meeting their goals, we get to cheer them on, we get to encourage them and reevaluate them, but we are not done with them and they're not done with us.Sorry, this point is not clear for me. What does it mean, 'meeting goals'? If my blood sugar under control then there is no question, I met my goals. Does it mean I am no longer diabetic type 2? Shell I stop to take medicine I need every day? Really, I do not need any cheer. I go to comedy club when I need cheer. Also what does it mean, to re-evaluate me? Is not this true that doctors must evaluate treatment and progress of treatment every time we are in clinic?
LOL!!!!!!!!!!!
This is member of Committee who provide guidance how to treat diabetes type 2. Does this member has any idea what diabetes type 2 is? And if this member has no idea what is the subject of discussion, why this member is member of committee?
It is a 2-year assignment. The committee rotates members off yearly.Sure. Every one need money. Sure they have standards in placement of into the committee. I am green with ivy. Where I can find the job where I can participate in Committee and develop Standards of Assessment for Medical Care providers, whom to rotate off diabetes care?
via Ravenvoron
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