The cost of Diabetes type 2 treatemnt. November 30, 2018

Diabetologia. "25-year study shows that incidence of type 1 diabetes is increasing by more than 3 percent per year in Europe." ScienceDaily. ScienceDaily, 28 November 2018. <www.sciencedaily.com/releases/2018/11/181128182132.htm>.

The study concentrated on diagnose of diabetes type 1 in children in Europe.It  is very special studies, and I am not fancy ether try to understand how they were conducted nether interpreter them. Be free to read and get all info you wish. My point is another.
      According to US Public Health Service in year between 1950 and 1965 there were 4.4 million diabetics, 1.6 million of them undiagnosed.
      In 1973 Report of thr National Diabetes Commission to the Congress there were 4,191,000 diabetics in America. 3,570,000 of them Caucasian and 622,000 of other race and ethnicity. Today according to American Diabetes Assosiation there are 30.3 million of Ameriicans with diabetes. It is 9.4% of all American population. 1.25 million are children and adults with diabetes type 1.

Diabetes was the seventh leading cause of death in the United States in 2015 based on the 79,535 death certificates in which diabetes was listed as the underlying cause of death. In 2015, diabetes was mentioned as a cause of death in a total of 252,806 certificates. (ADA Statistic)

       More then 200,000 diabetics die of all cause only in 2015. Looks like no one really care, why all those Death happened. Obesity? Why not? According to ADA diabetes type 2, and this is leading cause of Death, whay is it? What is definition of this medical condition which leads to so high fatality? There is no definition which can be clear and understandable.
    In medical education diabetes type 2 presented that it is when body cannot use insulin properly. OK, I take it. What is the treatment for this condition if any? Oral medicine. Most effective is SU, type of medicine which force diabetic type 2 secret more insulin. ???? How this medicine can possible cure or treat diabetes type 2 if it is as it was said, when insulin used wrongly? There is no one way that SU can be used to treat diabetes type 2.
     SU is oral medicine which is cheap. To compare with Insulin which is very expensive. At the same time ADA published the cost of diabetes

• $327 billion: Total costs of diagnosed diabetes in the United States in 2017
• $237 billion for direct medical costs
• $90 billion in reduced productivity

        It is not cost of insulin, it is all cost of direct medical spending, medical visits including. The cost of visit will be the same if MD Rx Insulin or SU. The amount of medical visits will be different. With insulin there is less and less medical visits, less complications. With SU for 10 years cost of diabetic treatment skyrocket.  There are amputations, heart surgeries, expensive cost of medicine for Asthma and Sleep Aphnea, medical supply to treat never healing wounds, and you add to list the rest.
       Now there is the question, what is more expensive, to treat diabetics of all types with Insulin or with all oral medicine which already developed and in the way to be pushed to market?

via Ravenvoron

#SafetyIsThePoint: How to Safely Dispose of Used Sharps (Safe Needle Disposal)

It’s a fact, if you or someone you love lives with diabetes, you use a never ending amount of sharps. 

Sharps include: Needles, lancets, auto injectors for cgms, and tubing/infusion sets, connection needle sets on a daily basis. 

Over 9 million people with diabetes and other chronic conditions dispose of 3 billion sharps a year!  

A. That’s a hell of a lot of sharps

B. How the heck do we dispose of them safely and properly? 

 First: All used sharps must be placed in an FDA cleared sharps disposal container found via pharmacies, medical supply companies, or online. 

Luckily, most of us already have everything we need at home to dispose of sharps safely and in the form of a strong plastic container - either and empty laundry detergent or bleach bottle.

My Current Sharps Container & not filled up yet!

Bottles must be leak-resistant, remain upright, and have a tight-fitting, puncture-resistant lid. 

When the container is about 3/4 full, seal the lid closed and label the bottle, then follow guidelines for proper disposal at SafeNeedleDisposal.org. 

FTR: Some cities allow in-home trash disposal others require used sharps to be taken to drop-off locations. 

Sidebar: After I entered my zip on safeneedledisposal.com in the field to find local safe disposal options, I was shocked to discover that I had 3 needle disposal locations within a 12 mile radius - and the closest was 1 mile away! I HAD NO IDEA. 

No matter what, sharps should NEVER be put in the recyclables, thrown in the trash or down the toilet! 

If your state allows for home disposal, seal and label your strong container, seal the lid and discard with trash. DO NOT RECYCLE. 

Click HERE to find a list of companies offering mail back and container programs.

Checkout other disposal options, HERE. 

The video below is 60 seconds long and shows you how to safely dispose of used sharps.

Because #safetyisthepoint

This post is sponsored by SafeNeedleDisposal.Org, run by NeedyMeds, a 501(c)(3) national non profit. Read more about them by clicking on the following link: https://safeneedledisposal.org/about-2/about/

As always: These thoughts are mine and if I didn’t think sharps disposal was important in our lives with diabetes and our planet - I wouldn’t post about it! 

via Diabetesaliciousness

Suzanne Valadon - Bo

Suzanne Valadon - Bouquet of Parma Violets

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Fredrik Marinus Krus

Fredrik Marinus Kruseman "Winter landscape with skaters near a castle" (detail modified) c.1857

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G6

The Dexcom G6 is up and running, and it's keeping us running.

Technologically we're totally impressed. It's accurate. The readings flow seamlessly from the transmitter to my daughter's iPhone and the Dexcom receiver, and then on to my phone and the Dexcom Clarity page online. And no fingersticks? Amazing.

We used our previous CGM, the G4, only as a general guide. Heading up or down? Always alarms between 2-3 a.m.? Should she do anything before changing for gym? It was less accurate and had crapped out months ago on sharing numbers to anybody's phone, so unless it was alarming with an urgent low, it was mostly background noise to be addressed eventually.

The G6 feels less like a lowly assistant making suggestions from the corner of the conference room and more like the boss. What it says goes. Low predicted in 15 minutes? Eat something. Now! Suddenly skyrocketing? Drop your pants and check that site! Clarity shows you've gone over 220 after lunch five of the past seven days? Fix something!

Some of that is good for us. Most of us get lazy with diabetes at one time or another, and of late, we have. Having the G6 looking over our shoulders and nudging us at every turn is causing more action than had been happening here, at least in terms of more minor excursions from a target blood sugar range.

Some of it, though, is wearing. Already. After 12 days. (But who's counting?)

The alarms are driving us nuts. Starting it up over a busy school play weekend followed by a Thanksgiving week full of family and food certainly didn't help. Diner pancakes at 10 p.m., daily servings of stuffing, and pecan pie two nights in a row are rare treats, and as the schedule goes back to normal, alarms are settling down. We learned quickly not to have both the Dexcom receiver, and all of our phones set to alarm when all of them are in the same house. The cacophony and the subsequent process of silencing them all would jar anybody's nerves.

We're also struggling with information overload. The numbers are in our faces all the time. Because the previous system's data went only to its own receiver, my daughter would look at it at mealtime, before bed, and when it alarmed. Now can see numbers whenever she opens her phone. And with share operational again, I too can see numbers anytime I want instead of looking at the receiver once a day- or less. A diabetes-life balance is, in my opinion, a very important aspect of living sanely. It will take some time to figure out how to compartmentalize the extra information so that it does not overwhelm.

Was it worth waiting for? Absolutely. The steady stream of accurate data is incredibly useful. It helps with hour to hour decision-making. Once the bulk of the data isn't skewed by Thanksgiving food, the long-term graphs will be incredibly valuable in adjusting basal rates and bolus ratios. And maybe when the data settles down into a more predictable range we won't mind seeing it so often.




via Adventures in Diabetes Parenting

Diabetes Diagnose. November 29, 2018

Diagnose of diabetes is complicated. There are a few test must be taken, and no one of them would be complete to diagnose diabetes.
       CTT Test - is Carbohudrates Tolerance test.
 Fasting sugar level, then two hours  after meal contaning 100 gm carbohydrates. In non diabetic level of sugar retutns back to normal level after two hours. If sugar is  still abnormally high then diabetes must be considered.
      SGTT test - is Standart Glucose Tolerance Test.
This test is given to see how blood sugar going after carbohydrates intake
30 min, 60 min, 90 min, 120 min, and if it is necessary up to 6 hours. This test is more expensive, and usually only one test used, CTT to diagnose diabetes. At the same time this test is more acceptable to diagnose mild diabetes.
      Nether one of those test is complete and accurate. There are different factors must be considered to interpreter the results of the test.
1st factor is the difference in testing from one author to another. 
2nd factor is age. In spite of the fact that in aged population level of sugar is higher after 2 hours after meal. still it is not diabetes, but some other problem. Insulin is not in deficit but rather delayed to be used.
3rd factor is fluctuation in glucose level. One time this can be normal, in another time is may be abnormal. In extreme situation the total remission of diabetes observed after being normal with some treatments such as diet and work outs.
4th factor is souse of blood sample, if it is capillarity test or venous test.
      There are just a few factors to lead to different interpretation of test in diagnose of diabetes. In other words, diagnose of diabetes is very liberal. In one patient very high level of sugar would be diagnosed as normal, no diabetes, and in other clinic the normal non diabetic level of sugar will be diagnosed as patient being diabetic.  There are no standard criteria to diagnose diabetes. The blood  is different at every moment and there is no way to say if today it is diabetes or not when doctor insist, there is no diabetes according to the blood work.
     The problem with diagnostic lead to the fact that in America today out of the 30.3 million adults with diabetes, 23.1 million were diagnosed, and 7.2 million were undiagnosed., according to ADA statistic.

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Use Cook'n consecuti

Use Cook'n consecutively for 21 days and win a prize!

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Fight Low Blood Sugar. November 28, 2018

      To fight low blood sugar officially doctors suggest to take two spoons of sugar, have hart candy everywhere you go. Does it works? Not really. I do have low sugar is as part of my daily life. Not the case it is all the time low sugar every day. But when sugar is low, even it is not so low as it is 40 mg/dl. With 70 mg/dl I can feel low sugar. In case like that every step is problem for me. I have no energy to walk, to get some place to sit. I need to eat something right away, and candy is not the solution.
      This is why I try to have some meal for myself in my handbag. It is easy to put on bottle of coffee. Also is very effective bottle of OJ. Not big one, or large, just small one, or two if one will not reduce hunger. It is temporary solution. But it is easy to carry on and to have it handy at any place. Also it does not need to be replaced because of it is spoiled. It can be store in room for long period of time. It is also very important in our routine. Just think about, you have to care if emergency kit good to take, or you have to replace it every day or hour.
     Also I do carry on in my bag Protein bar I buy in Costco. It is very convenient. It can be stored for month in hand bag, if it is not Summer. Also it is easy to eat at anytime everywhere. I even eat bar in Met Opera House if I am too low as I do feel. I avoid this as much as I can. I ate this bar only once in all my seasons. But as I said, it is easy and very convenient. Protein bar keep me good for the time I get home.
     Every time when we go out, go camping, or go to Lincoln Center I try to have sandwiches. It is very good to have sandwich when I am outdoor. Sandwich works very well in case of low sugar, in case we have to eat something. Everyone do sandwiches. The question is, why it is not presented in routine care for diabetics? Two spoons of sugar is not easy to have. Most important, it never works.
     Really, does those who created guidance or recommendations do know anything about condition they recommend to fight? I really do not see they do. Two spoon of sugar is not meal. When we are hungry, no one of us eat two spoons of sugar. Every one prefer to eat sandwich. What is difference when one is diabetic? Well, diabetic's body does not metabolize carbs. So, added two spoons will not be used as source for energy. If so then why it is recommended as effective part of treatment? It never was, it never will.
     At the same time when I eat my sandwich, and I am 380 pounds, what people see? I do have diabetes because of I cannot stop to eat. They see, I eat so much that I eat everywhere I go. It is not the case. No one do know me. Every one judge me. They see. At the same time if someone try to push into my mouth sugar, they understand, it is emergency, and they will try to help.  This practice is so widely used that if I am in ED with low blood sugar they do IV with glucose. Sugar going above the sky.
     I do not know why after low blood sugar episode sugar is all the time go up and very high, regardless what was put into my body.  Even if I was at home and ate soup, I will have higher level of sugar then I usually do have. I do not have study or understanding of this, it is just how I do see it on my meter. But after shot of insulin sugar going down withing a few hours. It does not effect any next readings.

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Blood Sugar level A1c in % or mg/dl. November 27, 2018

   A1c is the average level of sugar in blood withing three month. It is taken in % and diabetics do not check up this level. It is lab test which can be ordered by doctor.
    In contrary with A1c level of sugar in mg/dl taken by diabetic or in clinic. It is almost the same level when blood taken from drop of blood from finger or from vainm plasma level. There are some differences, but not so big.
     There are some table to compare A1c in % and blood sugar in mg/dl. Some diabetics or doctors use this table reversible. It is wrong. At home we do not have ability to see the average of blood sugar withing day or week or month. We do have test just for particular moment, when blood drop was taken. In contrary, level of sugar in % estimates all the levels of sugar during the day, week, month, and so on.
     So, when table said that A1c=6%  is estimated 126 mg/dl. it is not the same when we see 126 mg/dl on our metes and this mean that A1c = 6%. This is greatest mistake some people use to post on there blogs, or posts. When they take level of sugar and it is 270 mg/dl they pretend they do have A1c = 11%. Reading of 198 mg/dl is just the normal random level of sugar. In contrary A1c=11% is fatally danger and must be treated in hospital. This mean that the level of sugar is fatally high, and average blood sugar level is always too high.
A1c %   4 %          72mg/dl
              5%           90 mg/dl
             6%           108 mg/dl
             7%           126 mg/dl
            8 %           144 mg/dl
            9 %            162 mg/dl
            10%           180 mg/dl
            11%            198 mg/dl
             12%           216 mg/dl
             13%           234 mg/dl
             14%           252 mg/dl
It is easy to see from the table that A1c and mg/dl cannot be interchangeable.  One part orf table show the number of routine right now level of sugar, and another part show average level of sugar withing three month.
       Still very often people post:
    " I had A1c=12.2% and just withing 6 month my blood sugar dropped down to 100 mg/dl".  Really, why not? This person never was diabetic.  At least never was in stage of diabetes when A1c=12.2% if test taken in lab, real A1c level.
     
     I love doing shopping on Walmart. Why mot? The price is decent. Shipping usually free with order $35. And about quality.... well, the quality depend on product. For me it is most important, only in Walmart I can buy size 5X clothing. Recently I got parka, just $55. It is worm, it looks nice, and it is affordable. At least, I am not so upset when I have to buy another jacket next Winter.
     There are no size 5X clothing. It is easy to find good items size 2X or even 3X. Size 5X is practically out of market. I do have edema on my foot. Say me, what I suppose to put on my foot in Winter? Usually in Summer I wear water flip-flops. Regardless of weather, it is the same flip-flop for Summer to go to outdoor, to medical office or to go to opera. There are nothing I can put on on my foot. In Winter it is very difficult. Edema is getting worse. Also I have to wrap more on my gels, to keep them worm. In The Met sometimes I walk to my seat without shoe, just to be safe to walk. Ugly, but what may I do?
     Sometimes I do have problems with delivery and I send e-mail or call to customer service. Usually problem getting solved very fast. Then one or two days later there is e-mail and they ask to survey, how representative was good in service. They always good. Why? They do know very well, I will have call, or e-mail, or any type of communication, and I will say what service I got.
     I wish to ask, why there are no service like that in medical industry? No one ever asked me, how I was survey by official public representative. Or any medical staff. Why? I do not think I may answer to this question. But still I wonder.
     Barking therapy or Barking service is Gold Standard in every medical clinic or hospital. Say me, what does it mean when all staff, one after another ask me if I ate today (it is 5 pm, what do you think?) and what did I eat today. Every staff in every office. I am ill person. I do have medical problem with nerves. It took me a lot to stop to bark in response. But I curb my emotions.
    Another Gold Standard is that as diabetic type 2 I can reverse diabetes type 2 with starvation and increased activity. How absurd this is no one see. The point is not how to treat diabetic but to whom to blame. It is I whom to blame. It is I who is ill. If one has dental problem then one go to dentist. What dentist will say? Well, if It is I then it is at first dentist will bark, I have to lose weigh, to starve myself.
    Let us put it in other way. Let us blame every skeleton that one developed flu or dental problem because of weight. One must gain weight. Why not? Also I suggest to start to bark at people who is higher then 1 foot. Look at new generation. How toll they are! We are almost half of them. Really, why it is only how wide we are taken into account? Let us take into account how long one is, and blame longest for every medical condition they do have because of they cannot stop to grow longer. The Procrustes' Bed is the same for every one, long or short, wide or narrow.

via Ravenvoron

day-by-day November 25, 2018

Sugar is good. Just very good. It is 73 mg/dl. Nothing can be better then this level of sugar.
       The question is, why my sugar is good and under tight control now? It was not under control in 2002 when I started to take Metformin and two weeks later Glipizide as add-on? At that time I went to Bally Fitness every week three-four times weekly. My GP told, he wish I go five times weekly. I simple could not go so often. In spite of all activities and work outs, regular blood sugar check up was higher every day. Not in clinic check up. There sugar was all the time pretty good, but not si good as GP wish I do have. It was always above 100 mg/dl. Doctor wish, it is 100 mg/dl. I never had that level of sugar.
     Now I do have 73 mg/dl, and this is my normal level. Because of I am diabetic it is always up and down. But it is how do I have it very often and feel pretty good about the sugar in blood. It is good level of sugar in blood for me.
       Now my pulmonary doctor fixed my old C POP, gave me a new better face mask which able to hold high pressure of air, and I sleep with it every night. I do not have so sever headaches now.I still have headaches but not so severe that I have to take from 10 to 20 tablets of Excedrin. The matter of fact, I almost do not take this medicine now. Do not remember when last time I took two tablets. I am OK without Excedrin.
       Say me, why? Why I was able to find my way to reduce the pain, very severe pain with lead me to coma. I was not in coma. But I used to fall one time after another. At that time I had health insurance, went to clinic regularly, and scout from one medical office to another. MD told me, she check up one organ after another, and there is no problem with any one of them. LOL! I am not death yet. Why do I have to have so many problems? Just because I had health insurance and all tests were well paid.
     Needless to say why today I do not go to clinic till it is very very necessary. Also it is easy to understand why I do not trust in MD and very negative about medical care.
     Now say me, why it is I who have to find way how to deal with all that problems and complications I do have? Why there are no clinic, no doctor who able to solve pretty obviouse and easy to solve problem?

 There are many of us with wounds like mine used to be. What is the treatment for us? No treatment. Why? What they are waiting for?
They are weighting till it is infection take over and legs must be amputated. Is it so necessary? Not at all. I keep both my legs. But it takes effort, everyday wrapping both legs and money to buy wrapping. Still, it is better for me to walk on wrapped legs then stay home without legs.
     Usually it is stated that diabetics type 2 do eat wrong and do not care for ourselves. Just simple look at these legs show, it is not fat around middle area, it is high edema.This condition must be treated. No any treatment for me for this problem. It is just my man who care that edema go down. He wrap my legs every day. He pay for wrap $3 each one. No mocking or abusing that I cost too much for him.
      Today I do have insulin I need, thanks to my good doctors I shopped for long time, and good health care insurance who pay very high for high dose of Insulin I have to inject every day. My legs are no longer shed the skin. The skin is dry, and slow, very very slow getting light. Burgundy color lightened, and pain inside of dark burgundy spots vanishing. It is DVT. I try to heal my legs, and I try very hard too keep my legs on place, attached to my body.
      The question is, why there are so many amputations for diabetics type 2? Why do not diabetics type 2 control blood sugar level?
      I also did not control blood sugar for ten years after being diagnosed with diabetes type 2. I took Metformin 2000 mg daily, and Glipizide 10 mg two times daily. Also I was active, went to work out, and curbed calories intake. Nothing worked. At the end of 2010 I got MI, stroke, and near Death condition.
     In 2011 I injected my first dose of insulin. Since that I inject insulin every day. Highest dose was 720 units. But if everything is OK and I do not have underling condition dose from 350 units to 400 units is good for me, and I control blood sugar level very well.

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Treatment for diabetics any type. November 25, 2018

How to see if medicine we take effective or not?
     Well, we cannot check up the insulin secretion in our body. Even in hospital this never done. The matter of fact, insulin is out of question in diabetes type 2 care practice. It is taken for granted that diabetics type 2 have abnormally high insulin level in blood. How this level was checked out? It never done with first visit to clinic. Also, it is not standard to diagnose diabetes type 2 according to level of insulin in blood. All diagnoses based on level of sugar in blood. So, there is only one test for us to check up if medicine effective or not effective, actually danger for us, level of sugar in blood.
     Then all types of medicine combined with diet and work out, activity. Reduced amount of meal leads to malnutrition. Weight Loss Surgery is the prove of this point. All victims of weight Loss Surgery must take Vitamins. They even cannot take water as much as they need, and they need to take Vit. one by one all day long. very inconvenient, I would like to say. Do not say, it is 'Well Being'.     
     Increased activity is also pretty complicated. Diabetics type 2 have already increased tiredness. It is low energy supply supply due to limited nutrition use. So, when energy is low, and activity is high, it is easy to predict that heart would  finally give up, simple stop. Not the effect we wish to have.
     At the same time level of sugar in blood will go down as a result of these actions, and the false sing of effectiveness would be introduced as positive type of therapy. With time this effect will be down, sugar in blood will go up.If I am wrong in this point then diabetes type 2 would be curable. If therapy is effective then disease would not be progressive. It is not the case. With time level of sugar is going up, diabetes type 2 complications get stronger and more dangerous. Finally, it is coma and Death.
     In contrary, diabetics type 1 if do not recovery then they do not progress to the fatality. With insulin injections they live practically normal life, longer then 60 years after being diagnosed with diabetes type 1. No one diabetic type 2 live for 60 years after being diagnosed with diabetes type 2, even if this patient was diagnosed with diabetes type 2 as child.
     The conclusion is very simple, the problem is in wrong diagnose and wrong treatment. Start to teat diabetics type 2with insulin, and we will live over 60 years after being diagnosed with diabetes.
     To check up if this hypotheses is right or wrong, just start to treat diabetics type 1 with all Junk Medicine diabetics type 2 have to take, and see the outcome. Would these type 1 diabetics develop wide middle area? They will.  Would they die right after insulin injection stopped? Not at all.
     To prove this point I suggest to take a look at the diabetics type 2 who crossed the line of being children and became adult. They are no longer have health plan to get insulin supply. Insulin is very expensive medicine, and it must be in efficient dose to provide effect. This population no longer children. They are in adult pool. So, they stop to take insulin in injections, and all the problem with health as diabetics type 2 do have now apply to diabetic type 1. Just from 10 to 20 units of insulin was good for them to support healthy lifestyle.  There are no insulin in med. box. So, they skip into deeper diabetes complications with every day they live without insulin.
     There are no one support for them that they are diabetics type 1 or type 2. Diabetics have a lot of attention and there are a lot of studies what medicine to take, there is no health care plan, and no money to buy it.

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Type 2 Diabetes in Youth. November 23 2018

Is this really true that:

There are fundamental differences in the pathogenesis and course of type 2 diabetes between young people and adults that necessitate a different approach in youth with the disease, with an emphasis on the patient's social context and long-term management, say experts in a new position statement.
https://www.medscape.com/viewarticle/905309?nlid=126196_381&src=WNL_mdplsnews_181123_mscpedit_wir&uac=164666HZ&spon=17&impID=1810650&faf=1

      According to many Med Pro publications and studies diabetics type 2 gone less then 10 years after being diagnosed with diabetes type 2. It was not said that it is adult or youth. Just being diagnosed with diabetes type 2 cut life and victim die less then withing 10 years after being diagnosed with diabetes type 2. So, do not be surprised that if it was child who was diagnosed with type 2 diabetes in age of 13, will die by the age on 23. There is no one difference between grown-up or little one in diabetes type 2 Destiny.  we all do have the same problem. Our body system does not secret insulin to support our body needs. Diabetes of any type is potentially fatal. The end is only  one, and only difference is time and speed to rash to this end.

They stress the need for risk-based screening in overweight and obese children and the development of culturally and contextually sensitive education and lifestyle management programs, particularly given the demographic profile of young patients with type 2 diabetes.

        Why it is risk-based screening?  If anyone of us enter into clinic or working company what do we have? Screen for STD and Drug in blood. It is not the risk factor. It is requirement for every one regardless of any risk factors if any present. Just do it. But diabetes, level of sugar in blood, is not the vital! Why? Just why? Is this so expensive to take this test? Not at all. Just cost of glucose strip $1.
      Why really this is not guidance to check up level of sugar in blood? Because for great surprise of all public number of diabetics will rise dramatically, and level of sugar will not reflect amount of pounds and wideness of middle area. The ugly abusive myth that diabetes type 2 caused by obesity will be broken. More skinny people will be diagnosed with diabetes then obese.
     BTW, how type of diabetes diagnosed? Good way to ask. No one way to get answer. There are no one guidance how to diagnose type of diabetes. No one mark to check up what type of diabetes is it. But 95% of diabetics population diagnosed with this Scam Diagnose.
     Then the treatment started, based on diagnose MD has no one idea what does it mean. The treatment is based on diagnose, and it is two significantly different medicine to be used:
Insulin, if diabetes resulted by Beta Cells limited insulin secretion, so insulin must be added in injections;
Metformin, which does not effect level of sugar in blood but effect liver and poison all body system.
     Well, it is easy to say, Metformin is effective medicine and this medicine what diabetics type 2 need. If so, then what authors really talking about? How Type 2 diabetes different in youth compare with adults? We all take Metformin as first line treatment.
     As usual, it all based on understanding by MD and any med pro that public does not understand what they are up to, and that we all will swallow all crap they posted and rained on us.

The statement, published online November 13 in Diabetes Care, was issued as the incidence of type 2 diabetes in the United States is estimated to have increased by 4.8% in people aged under 20 years in the decade between 2002 and 2012.

Why this happened? Why Diabetes type 2 increased in new generation? Because of in 1980 adults were diagnosed with diabetes type 2, and treatment for them was oral medicine in stead of Insulin. Now next generation come to life with diabetes, rather then be diabetes-free.
Today the diagnose for youth is the same as it was for adults only back in 1980. It is type 2 diabetes. What is interesting in all that crap that animals, our pets diagnosed all with type 1 diabetes and treatment for them first line is .... INSULIN! The way to take into consideration, how reliable our Medical Care is. Probably it is better to go to vet doctor and get right diagnose with right medicine as first line.

Type 2 diabetes also "appears to be more aggressive in youth than in adults, with a faster rate of deterioration of beta-cell function and poorer response to glucose-lowering medication," lead author Silva Arslanian, MD, from the University of Pittsburgh, Pennsylvania, said in an ADA news release.

Is it True? No, it is SCAM!
Take a look at the first use of insulin and see how children reacted to insulin. Today they are adult. Some of them have diabetes for more then 60 years.  How many diabetics type 2 will survive on diabetes lowering medication? No one! Level of sugar going up and up. When it is A1c> 8.4% ADA recommend to initiate Insulin Therapy. The question is, why do not start to take insulin early? What Med Pro afraid of? That with Insulin therapy diabetics will recovery, and ... yes, they have empty clinics. So MD push hard to modify our lives and create more diabetics type 2 to secure income and own well being in expense of our well being and our lives.

"Over the last 20 years, there has been a tremendous increase in knowledge of youth-onset type 2 diabetes and the important differences that exist from diabetes presenting at an older age," he explained.

It is understandable, if today child will be diagnosed with type 1 diabetes then 20 years after it will still be diabetic type 1, not type 2. So, diabetics type 2 will come from where? In past there are were many diabetics adult to enter into diabetes type 2 pool. Today this pool emptied. To have patients MD  must diagnose properly to secure incoming pool. So, we are all type 2 diabetics. Simple and effective way to keep us on the tight hard hook

via Ravenvoron

Scam Published by Society for Endocrinology. November 23, 2018.

True or Scam? :

 Society for Endocrinology. "Routine vitamin B12 screening may prevent irreversible nerve damage in type-2 diabetes." ScienceDaily. ScienceDaily, 20 November 2018. <www.sciencedaily.com/releases/2018/11/181120211642.htm>

       How screening may prevent anything? There are screenings for diabetes type 2, a lot of them, and what? Did diabetes type 2 stop to be killer number 7 in America? No. Diabetes type 2 is number 7 cause of death in mortality table.  Every year about 80,000 Americans lost life to diabetes. 95% of all American diabetics population is diabetics type 2. Diabetics type 2 life expectancy is less then 10 years after being diagnosed with diabetes type 2. It is not just screening, it is already treated diabetes type 2 with all attention to vitalin B 12,Vit D, and lifestyle. Why diabetics type 2 die less then ten years after being diagnosed with diabetes and treatment started?
      This is fact. Why Society for Endocrinology not familiar with that and publish this scam?

The increasing incidence of type-2 diabetes is a serious health issue worldwide. Its prevalence is associated with poor diet and unhealthy lifestyle choices, and it is characterised by high blood glucose levels that need to be controlled by medication.

 Why it is so that Society for Endocrinology publish this scam? Because of in this case it is diabetic type 2 to blame why we are chronically ill. It is our life style, extremely unhealthy. It is our chice to be ill.

Nerve damage in the periphery (e.g. face, limbs, organs) is a common complication of diabetes, with symptoms that range from numbness to pain, and can lead to debilitating loss of balance and co-ordination.

      Do authors of this publication familiar with pain? I can say you, I cannot eat any oil, or batter, or any fatty meal. My liver is very complicated since I was born. The sensation is so unpleasant that not only I do not eat this because of my liver, but because of I do not want it!
      Does someone love pain? If it is dental pain, no one of us eat with on this site, and every one of us go to dentist as soon as we can. This is about pain and how people love pain to chose. Nerve pain is the condition when we cannot even breath without pain. Pain is so severe that any movement such as breathing, lung move, lead to unbearable pain.  The way is only one, stop to move. Freeze. Severe pain leads to lost balance, to fall, and to coma.
     Very interesting, why Society for Endocrinology think it is our choice? Why they are immune to make that choice?

Metformin is the recommended and most effective first-line drug for type-2 diabetes but its use has also been linked to vitamin B12 deficiency, which increases the risk of peripheral nerve damage. 

      What does it mean, 'first - line drug'? Simple, what absurd is this about? When we do have high body temperature do we have first line treatment such as Green Tea? No. It is X-ray to see if there is no lung inflammation.  If it is so, then the treatment with antibiotics started right from the first hour patient in hospital. Why treatment for diabetics with highly elevated blood sugar is always started with 'first - line' Metformin and life style intervention?
     Treatment for diabetics type 2 never different from the first time when diabetic was diagnosed with diabetes type 2 for the coma and death. It is all the time the same, life style modifications, lose weight.

Despite the irreversibility of peripheral nerve damage, no official guidelines exist on screening vitamin B12 levels in patients treated with metformin.

     There we are. Does not matter how effective treatment can be or how ineffective or danger treatment for diabetic type 2 is, there is no official guidance. Just one way, lose weight and be healthy. Of cause with this official way to address to patients needs, Society for Endocrinology, any MD Pro can freely publish the scam that diabetes type 2 resulted by wrong life style, and it is actually our choice to be diabetics, to suffer from pain, and finally lost our legs, both of them. Great choice I would like to say. I beg my Destiny do not let me to make this choice and stop my heart before my legs would be cut off. To prevent it today my man wrap my legs to reduce edema, to stop blood to cloth, and to keep my legs functional. Not healthy, they are in pain, but in place and partly functional.

The audit findings indicated that 64% of patients had not had their vitamin B12 levels checked at all, and that 9.6% of patients were deficient but only 6.4% were being treated with vitamin B12.

       Sorry  Dr Kaenat Mulla and your GP colleagues at Hucknall Road Medical Centre, Nottingham. This is full scam. Show me American who does not take vitamins. Simple, study how high sale of vitamines in Costco, and see if Americans take B 12 without any need to be screened. we all do. The problem is, vitamins does not work when we are diabetics type 2.
     Every time when my Endo check up Vit D it is low, or at lowest level to be considered to be normal. Why? Why my Vit D is all the time low? I spend full Summer outdoor, under sunshine on Adirondack beautiful lakes. I do have all right feed I need, which provide full ranger of essential vitamins. I buy in Costco Vit D, and I very love fish. Why vit D is so low? What is the reason for that? No reason. It is fact. No one screning can fix this problem. Because of there is no medicine to improve vit level.
    The level of Vit. is the sign of desease. Probably when in healthy non diabetic person this level is low, or Vit D is low, it is time to initiate treatment with Insulin to prevent diabetes development to the higher level of it, to the next stage of it.
    It is not the goal for Society for Endocrinology. The goal is to keep diabetics on hard hook. For this reason it is best way to blame victims of medical malpractice to be the cause of death, wrong way of life, wrong doing. It is not members of Society for Endocrinology who induced scam but it is victims of this scam whome to blame in high cost of sufferings. Well, it is reaonable. Suffering induced for victim, income infused into medical care. All in balance. Then more victims then more money will be flow to stop diabetes. Then more sufferning then more publick attention to the case and higher doonations to pull on into med pro pockets.
     Stop Diabetes type 2!
     Stop Donate to our mistreatment and abuse!
     Every penny which was infused into med pockets go to increase the reason to create more of us, to create higher sufferings, and to bring more deaths to simple Americans.
    Stop findings of all that studies and researchers which blame victim of medical genocide.

via Ravenvoron

Life With Diabetes Means Never Packing Light :)

Life with diabetes means never packing light - even when it’s a 24-hour trip. 

And that’s OK - I’ve made my peace with being high maintenance in all dimensions. 

I love and am grateful for my family/family time; any and all opportunities to travel, and having extra diabetes supplies… just incase. I am blessed and I know it! 

#####

Last night I made a list of what I need to pack for my 24-hour trip to my sister’s for Thanksgiving and some much needed family time. 

24-hours away from my house - I leave tomorrow and comeback Friday afternoon. 

I’ll be wearing my Thanksgiving Day outfit (including my most comfy dress jeans,) and my medical ID bracelet on my drive to the festivities. 

My overnight bag will include: 

1. Toiletries, because this chick needs help to look this good
2. Pajamas 
3. An extra sweater
4. Underwear
5. Socks
6. Sheepskin slippers because my feet get cold and I need my slippies.

And then course there’s ALL the diabetes stuff. 

1. Insulin (and even though I’ll be putting in a freshly filled pod tonight,) 
2. 2 extra Omnipods and skin-tac
3. 1 vial of glucose test strips - 50 in total 
4. Back-up lancets because Murphy's Law, diabetes style says there's a good chance you will misplace your one and only if you don't pack extra
5. 1 Needle that may or may not be required for ginormous injection correction(s) that may or may not happen
6. Juice boxes - just in case I have a middle of the night low and because I want to avoid stumbling around, waking up the house, and setting off the doggo alarms at all costs
7. Glucose tabs - see juice box explanation. 

And just as important, the 3 bottles of Red and 1 bottle of Prosecco that represent my contribution to our Thanksgiving meal. 

Whatever your plans are for the 4 day weekend - I hope it's filled with laughter, love, yummy food and good times! 

Happy Turkey Day, turkeys! 

via Diabetesaliciousness

Surviving the Holidays With MD Recommendations. November 20, 2018

It is a well-studied fact that blood sugars, body weight, and triglycerides tend to run higher during the holidays, but many of our patients can avoid excessive glycemic surges with a few simple steps.

     Well, if we will take Starvation Diet as rule for holidays, then it is definitely  we will survive. In any words, when family gathered around holiday table, go out, to avoid temptation, and keep away from food. The fact is, in this case blood sugar will drop. It is guaranty.
     Body weight goes up not only because of meal, and fat, and sugars. Higher weight collection when kidney effected by diabetes and water retention widened body. So, to avoid weight gain, take run around the streets, one round after another. Because of every one at home around the table, streets are almost empty. You will be safe there.
     Do not put on heavy weight jacket. It is good to shred some weight, but it will increase TG level because being in  heavy jacket and run heart may give up. There is no people on the street at this time, so no help will be for sometime, be ready to accept it. I suggest, do not wear heavy weight jacket. 

I shudder to think of my appointments in January and February when I notice high A1c levels and patients shrugging them off as a normal consequence of holiday eating. Surprisingly, this reasoning sounds acceptable to many healthcare providers, too, and many of us have acceded to higher blood glucose levels being the norm during the winter months.     

        To see if MD is right or wrong, it is easy to check up sugar before holidays, in Fall, in October. At this time sugar usually start to go up in all diabetic's regardless it is type 2 or type 1.  Then after holidays are over, take reading another time and see, what A1c going, up or down. If diabetic is not ill, then sugar will go down in Spring. If it is advanced stage of diabetes, sugar still go up. It is usual for diabetics type 2, because of diabetes type 2 is highly progressive, to compare with type 1, diabetes type of children.
      If author would be more educated then he would run studies when sugar and A1c level dropping, and when it is going up. For instance, if it is rain outside, sugar going up. Even diabetic sleep all day, because of rain and he/she is very sleepy, still sugar going up. In Sunny days sugar going down. This is why In January sugar start to drop, regardless of out diet.
    BTW, why it is only holidays considered to be so danger time for diabetics type 2? what about Birthdays? We also cook and have family gatherings in Birthdays, weddings, and Independence day, Memorial Day, and so so on. Why these holidays are not considered to be weight gaining season?

Do your own cooking from scratch and keep the purchase of premade holiday foods to a minimum. Cook the right quantities to avoid being stuck with excess food that you might eat just so that it doesn't go to waste.

     So, do not go to a restaurant  or accept invitations. Stay home all the time to avoid eating and temptations of food. Anyway, MD will not mined you do have depression. Because of with depression weight also go up and sugar also go up, MD will say, it is because of you do have eating disorder, eat when you stressed out.
     My suggest, avoid all what MD said, and be happy in Winter. If you do have diabetes, do not hesitate add some units to keep blood sugar in normal range. Good Winter time, skiing, skating, and snow-shoeing most rewarding time in the year. Enjoy it till you can. What MD do not see that in holidays people prefer to be together, to celebrate happy mood. When it is tragedy, or depression we do not want to see people around. In holidays people not only eat, but play outdoor, go swimming, go to travel. In other words, people just happy. And really very active.

On the day of a party, eat healthy, balanced meals throughout the day and plan to have something small to curb your hunger before you go. Sometimes people will "save their calories" for the party, which can lead to overeating as a result of difficulty controlling portions and recognizing fullness cues.

     To avoid overeating, take sandwich when go to party. Because of you will shame yourself to eat your own sandwich, you will keep it. At the same time, because of you do have sandwich in pocket of handbag, you will all the time remember, do not sit by the table. Avoid feed in all means.

2. Be Picky and Have Your Favorites

Wait for the entire meal spread to be laid out and then pick your favorites. This helps limit food intake compared with eating as each new item comes out. Eat the better-for-you foods first (eg, soups, salads) before having the holiday delicacies.

     It is really great to wait till all meal would be out of kitchen. Probably, till you wait all meal would be already taken by others. Do not forget about alcohol. This drink reduce appetite, and red wine reduce blood sugar.  So, drink more - eat less is greatest way to avoid weight gain and blood sugar ride up.

In addition to increasing caloric intake, alcohol can lead people to lose control of their eating and give up on making mindful food choices. Drink slowly. Alternate alcoholic beverages with low-calorie drinks like sparkling water with lime, sugar-free Kool-Aid or Crystal Light Pure, or cranberry juice with soda.

It is right choice to drink slowly. If you take shots fast, it does not have time to adapt in your system, so you will not lose control.  When you drink slowly, at first you will do not feel you are already taken too much. In addition, you will wish to take more. This is how alcohol work in our system. When your system if full with alcohol, you will be knocked down, so no more eating problem, no calories, no fats.

Plan events with family and friends that are centered around activities instead of food. Skating, tobogganing, snowshoeing, and skiing are all great sports to enjoy with your loved ones during the holiday season.

As I just said, when your family gathered around Christmas table, go skating. Or snowshoeing. Do not even think about food. Starve Yourself for the rest of the Holiday Season!!!!!!!!!!!!!!!!!! 


Surviving the Holidays With Diabetes by

Akshay B. Jain, MD

November 14, 2018

https://www.medscape.com/viewarticle/904843?nlid=126228_1521&src=WNL_mdplsfeat_181120_mscpedit_wir&uac=164666HZ&spon=17&impID=1806884&faf=1

via Ravenvoron

Office Visits to Primary Care Physicians Down Sharply. November 2018.

In 2012, 51% of office visits were to PCPs; in 2016, the PCP share of total office visits had fallen to 43%, the report notes. Office visits to PCPs declined 18% between 2012 and 2016, from 1510 visits per 1000 members in 2012 to 1237 in 2016.
At the same time, office visits to NPs and PAs jumped by 129%, from 88 visits per 1000 people in 2012 to 201 in 2016. The rate of office visits to specialists and other nonphysician providers remained relatively unchanged over the period.

Office Visits to Primary Care Physicians Down Sharply by Megan Brooks.
 November 15, 2018
 https://www.medscape.com/viewarticle/904939?nlid=126228_1521&src=WNL_mdplsfeat_181120_mscpedit_wir&uac=164666HZ&spon=17&impID=1806884&faf=1

       Is this good, or it is bad stat? I really did not understand from the article I read. 
First, if PCP visits go down then it mean population getting healthier. This suppose to be a good news, right? If so then why there are concern that PCP visits are down, and at the same time visits of NP and PAs getting up? Cost of NP is lower then cost of PCP. The cost of PA suppose to be even lower then cost PS. I really do not understand, how PA can work without PCP. It is suppose to be 'assistant' not in any way practitioner, right? In stead we do have appointment to PCP, and seen by PA, and even scribe. This is how PCP and Med Pro serve patients.
       Anyway, Cook Book Primary Care every one house wife can do without any medical degree. No any cost out of pocket, just cost of groceries.
      In every article Diabetics type 2 blamed that we cost too much for taxpayers. If we do not go to medical clinic, then we considered I do know how, but anyway, we lost health assistance. The price for insulin for me, just insulin is $3000 monthly, every month, one month after another. Poverty line, to be qualified for Social Security check and Medicaid only if our income less then $1100 monthly for two persons. Those who today cross Mexico and US border are poor refuge seekers.  They do have Medicaid, SSI for full family, Food Stamps, very low cost housing, and so so so on. I do have nothing.
      How many Americans cannot go to PCP to have regular check-up? No one count.
      Now let us see, what after check up? If diabetes diagnosed then it is type 2, treatment with Metformin and Life Style Modifications. Usually in present time they diagnose it as Metabolic Syndrome. What does it mean? It mean that we can reverse our every day pain with work out and starvation. Diabetics type 2 gone less then 10 years after being diagnosed with diabetes type 2. Now say me, why should I go to PCP to be diagnosed with diabetes type 2? I do know very well how to use cook book therapy. I do not need every one in medical clinic teach me how many times spoon must hit my lips. But if I  do not go to PCP then I can live longer. It is easy to see, diabetics type 2 perish less then 10 years after being diagnosed with diabetes type 2. So, If I delay diabetes type 2 diagnose, and I can do have treatment still with cooking book therapy, then I will live till I still not diagnosed.
Comments to article:

We ONLY go to our doctor if we are seriously ill.  The offices are flooded with third worlders with a huge variety of contagious diseases.  The brown clown allowed everyone over the border without health screening.

Very reasonable comment. Add also what do we have as a result of our visits to PCP?  Unnecessary papers to visits other doctors; Rx to unneeded medicine to destroy healthy well working organs, not needed tests to be done in all offices around the City;  and right to repeat all this circle next month. Plus we have to pay co-pay as add-on to lost time many hours standing in overcrowded  weighting room. No sit for every one.

I was thinking the same thing as well. Patient goes to their PCP but is actually seem by NP/PA who are employed by the MD. The statistics is not the whole picture. VERY MISLEADING information.

My PCP simple refuse to see me at any time.  No, of cause I do have appointments. He cancel then a few days before visit. Then I have to weight another three month to get the same treatment. Last time I saw my PCP last year, and it is already Thanksgiving, end of November. Of cause when I am in office he does not come into room. When NR come to do his job, I am OK with that. She is good nurse, and she always do her job perfect. But often he sent to room his scribe. She rush from to room to his office back and front, back and front. Then finally she state: I will not give Rx to medicine, because of you do not need it.WOW! What I am doing in this room?

I wonder if these patients are choosing midlevels or if they are being forced by insurance or the practice/hospital.  Are patients being educated about this?  Also, it does not address if these midlevel providers are being supervised by physicians.

Good point. Really good point. Who they are, MD in clinic? Are they MD at all?

When u make the job about clicking irrelevant boxes on an EHR, a high school student can be trained to do it. Time for internists to take back control. I am going to be Medicare age in 20 years and want to find a good doctor who has an MD or DO, can actually understand what other consultants write and knows how to coordinate complex care. Primary care is not the same as writing a Z pack script.

There are many comments already, and more to come. Every one of us do have our own reason to do what we do.

via Ravenvoron

Rapid Weight Loss: Motivating Patients to Change Lifestyle. November 19, 2018

Lifestyle change to prevent diabetes has proven to be a tough goal, but there's promising news. At a recent European diabetes meeting, the findings of a large, multinational study were presented. More than 2300 adults with prediabetes, aged 25-70, with an average body mass index of 35 kg/m², followed a 2-month intensive weight loss program with meal replacements.
Rapid Weight Loss: Motivating Patients to Change Lifestyle  by Arefa Cassoobhoy, MD, MPH
https://www.medscape.com/viewarticle/903923?nlid=126056_1521&src=WNL_mdplsfeat_181113_mscpedit_wir&uac=164666HZ&spon=17&impID=1799763&faf=1

 Just think about, study of how to prevent diabetes. Most important, they got results:

In the end, the type of maintenance intervention didn't matter. Only 4% of the entire group developed diabetes, and 22% no longer had prediabetes.

      Only 4% out of 2300 developed diabetes withing three years of study. So, life style prevented diabetes development by those 2300 - 4% . Sounds creepy, is not it? Studies show that diabetes was 'prevented'. Even if I will take it as a true then what after 3 years? The meaning of 'prevention' creepy. Why?
     In present time there are many high rank officials like to 'safe lives'. In other words, to prevent Death. Is this the same, to 'safe live' and 'to prevent death'? It is obvious, Death cannot be 'prevented'. Sooner or later every one of us eventually will die. It is very obvious in this case. Still, when we read the result of studies, what do we take in mind? That diabetes can be prevented with proper diet, and there is prove, studies. The absurd of the presumption is not obvious. In public eyes there is presumption, diabetes type 2 can be 'prevented' and diabetics type 2 done it for themselves.
        The studies were based only on the level of sugar in blood. No one of participants was tested how pancreas looks inside. I posted Yesterday, my sugar was 190 mg/dl fasting.  I took regular insulin injections, and today sugar is 78 mg/dl, fasting. It is obvious, there are no big changes in pancreas. My pancreas still the same as it was two days before Yesterday, Yesterday, and Today. If we will take some test, the results will be the same. For instance, if in stead to check up level of sugar it was test how much insulin secreted by my own pancreas. It would be the same amount of units at any of those days.
      The activity of my pancreas is low. It cannot supply insulin for my body daily needs. So, I have to add insulin in injections. With this therapy I can function almost normal, take care for myself, and live day after day. But if there is no insulin added in injections, my own pancreas cannot support my daily activity. Even simple breath would be complicated because of absence of energy to spread the lungs.

via Ravenvoron

Myths about Diabetes type 1. November 18, 2018

Blood sugar is 190 mg/dl today, fasting.
WOW! Yesterday it was 101 mg/dl, and today it is 190 mg/dl, why?
      Really, why today it is so high? Simple, Yesterday I did not take Insulin injections. No one unit.  I did not mean to do it. I simple forgot. We ave consents in Lincoln Center, Friday, Saturday, and Sunday. We return home very late. So, next morning I sleep long. I do not follow my usual routine. I forget to inject insulin. This is why sugar run so high. Just one day in without insulin injections, and sugar going to 190 mg/dl fasting. But.... . Yes, there are all the time 'but .....'. Is this good or is this bad? It is depend.
      In medical propaganda, and every one diabetic type 1 hardly and very passionate post about, it is said that if diabetic type 1 skip just one dose of insulin, diabetic type 1 even may die. Scam. No one every will die because of one shot of insulin was skipped.
      It is easy to say, I am not type 1 diabetic, I am type 2 diabetic, so I cannot pretend that my sugar can be used as prove. I do not pretend to use my level of sugar. I use prove presented by History. Does anyone remember how Dr. Banting started his study in insulin discovery? He took healthy dog, and removed his pancreas. It is 100% prove, there were no insulin secretion after. Dog died withing two weeks after, developing all symptoms of diabetes. But it took two weeks suffering of poor unfortunate animal. This fact is 100% prove, no one diabetic type 1 will ever die because of one injection of insulin was missed.
       There is another fact, dog died withing two weeks after pancreas was removed. There were no many complications or symptoms of diabetes development at the time dog's death. In contrary, diabetics type 2 develop many complications before take last breath. The time is wary. Some die as short as a few month after diabetes first symptoms. Others live years, ill all the time, never healthy, no any effective treatment, mocked by society. Then finally it is all over. At age between 35 and 45 all combat done. Diabetic lied in rest.
       Why so? Why diabetics so wary in symptoms and in life duration? Probably it is because of how much diabetic's pancreas effected. In present time it is very aggressively pushed that diabetics type 2 refuse to live healthy. Does not it sound too ridiculous? Does not it sound so Fantastic Scam! Is this really we are, who refuse to live healthy life style? Or it is our health is so poor that we cannot live at all, long, active, healthy? Is this really our choice to suffer?
     Going back to dog, why dog died withing two weeks, and diabetics type 2 may live years, unhealthy, collecting many complications. Is there are so much mystery in diabetes type 2?
     We are Survivors! We fight for every day, every hour of our lives. Healthily or not, we fight.

via Ravenvoron

Importance of Log Book color in blood sugar control. November 17, 2018

For diabetics type 2 blood sugar control essential. Also, it is diabetics type 2 who usually poorly control own blood sugar, why? Korean research group find out the answer to this question.
Young Min Cho, MD, PhD, Department of Internal Medicine, Seoul National University College of Medicine, South Korea, and colleagues developed a mobile healthcare platform with an individualized diabetes management algorithm, as well as many others features typically not seen in other systems. Result published in Diabetes care journal.

We conducted a 24-week, multicenter, randomized controlled trial with adult patients with inadequately controlled type 2 diabetes. The patients were randomly assigned to the mDiabetes group or the paper logbook (pLogbook) group. The primary end point was the difference of the change in HbA_1c from baseline between the two groups.
 http://care.diabetesjournals.org/content/early/2018/10/26/dc17-2197

I can prove, the findings are 'true'.
          I usually used log book which come with meter. When in 2011 I started to take insulin paper log book no longer was good for my blood sugar control. My personal A1c>9.4% was too high to be accommodated by small log book  which usually a size of palm.So, I adapted another book, bigger in size. I did not have smart phone. So, I had to use only paper book, but bigger in size. This hit the boll. Now my blood sugar is A1c=4.6%.
        I just thinking, if I do have smart phone, probably I will be needed lower dose of insulin to bring high numbers down? Unfortunately, I do not have smart phone.
        I found this way long before Korean researchers published their findings.  I posted this very often in my blog. I just did not know that blood sugar improvement was caused by using a new log book in stead of small log book which come with glucose meter.
      Now I am thinking, if simple way to use different paper work so effectively, there are more ways to control blood sugar then we usually were told such as diet and work out. We can try to use different pens to wright down numbers. I usually use cheapest pen, one box of probably 100 of them, and it is about $5. There are no cheaper pens I every was able to find. Last boz I got about 10 years ago, and still use them.
      What if I will switch to gel pens? Would it work better? I usually use simple pen to put down everything in log book, such as time of first reading and number on the meter screen, order to Walmart and price I paid, what credit card I used, and all into I need to be handy. This log book is all the time on my table, so any info cannot be lost. I even never discharge these log books, just put them in box.
     To record dose of insulin I used I use  gel pen, another color. For me it is important to see where I put record of dose of insulin and where I put info regarding my Walmart order. Gel pens I buy in Staples, and they are also sold in boxes, different colors. I can use different colors to write down level of sugar, and dose of insulin.
     Now I wandering, is the color important in blood sugar control? There are good way to experiment. Probably, with different colors of pen I can reduce not only blood sugar level but dose of insulin as well. It is too expensive to pay for Insulin. I need very high dose. Cost is higher then $3000 for month. It is more effective to use different pens and books then pay for insulin, needles.

RESULTS HbA_1c reduction from baseline was greater in the mDiabetes group (−0.40 ± 0.09%, n = 90) than in the pLogbook group (−0.06 ± 0.10%, n = 82). The difference of adjusted mean changes was 0.35% (95% CI 0.14–0.55, P = 0.001). The proportion of patients whose HbA_1c fell below 7.0% (53 mmol/mol) was 41.1% for the mDiabetes group and 20.7% for the pLogbook group (odds ratio [OR] 2.01, 95% CI 1.24–3.25, P = 0.003). The percentage of patients who attained HbA_1c levels below 7.0% (53 mmol/mol) without hypoglycemia was 31.1% in the mDiabetes group and 17.1% in the pLogbook group (OR 1.82, 95% CI 1.03–3.21, P = 0.024). There was no difference in the event numbers of severe hyperglycemia and hypoglycemia between the two groups.

As it is easy to see, difference in color of writing, paper of log book, size of log book, and many other tools we usually use to record our blood sugar and medicine play so significant role that even low blood sugar can be avoided with proper color of log book.
      I think, Korean researchers must be honored Noble Price.

via Ravenvoron

Diabetes and diabetic's foot ulcers. November 16, 2018

Around the world, 425 million people live with diabetes and upwards of 15 percent develop foot ulcers, which increases their risk of death 2.5 times. A new nitric oxide-releasing technology has the potential to cut down the healing time of diabetic foot ulcers from 120 days to 21 days. 

    At first, how ulcers increase  risk of death? Long before death happened it is ulcer on foot. So, simple cure the ulcers, regardless it is 120 days or it will be 21 days, and there is no risk of death, right?
     Second, why it is ulcers on foot taking into consideration? Why wounds on leg out of concern?  Start to treat wounds on legs, and there is no risk of speedy death, right?
     Lastly, how ulcers developed in first place? If diabetes treated effectively then there is no never healing wounds, right? So, ulcers resulted by wrongly treated diabetes type 2. If so, then the full article which present that  ulcers can be healed in 21 days, just Pure Scam, right?
     How ulcers treated now, and what a new technology suggest to do?

However, simply pumping up nitric oxide is not necessarily better. The long-term plan of Michigan Technological University researchers is to create nitric oxide-laden bandages that adjust the chemical release depending on the cell conditions.

There is the problem.
       What does it mean, "ulcers are healed'? That's right, they never heal because of diabetes still active. If so, then ulcers never will be healed. Regardless what type of bandage applied, ulcers present after they developed in first place.
         When it is presented that ulcers healed after 21 days with a new bandage, what does this mean? if healing present, so, there is no longer need in bandage. So, if bandage stopped to be applied, what will be next? The same condition as it was before, 21 days ago.

Diabetes stats from the World Health Organization, International Diabetes Federation, "Diabetic foot ulcers and their recurrence" in New England Journal of Medicine, and "Advanced biological therapies for diabetic foot ulcers" in Archives of Dermatology reveal the challenge researchers in this field face:

• 1.5 million deaths globally in 2012
• 425 million people worldwide live with diabetes
• 15 percent or more live with diabetic foot ulcers
• 2.5 times more likely to die
• 90-150 days to heal
• $176 billion spent in U.S. every year on diabetes

       Very dramatic, is not it. Then more drama then more  articles needed to wake up diabetes awareness. So, more money into authors pockets. As it said long ago, put net where the money flow. There are something for every one. As I posted all the time, diabetics type 2 are very profitable for members of society. Our Sweet Blood and our Sweet Death are huge money flow to the Medical  and Social Net.

Collaboration is a key part of the engineering design process. To build a nitric oxide bandage with personalized healing power, the team plans to work next with the UP Portage Health System to gather cell samples from local patients. By expanding their cell samples -- and applying the tech to real-world patients -- the team will continue to broaden their database while deepening their knowledge of nitric oxide mechanisms.

       Money, money, more money needed. But say me, how bandage will heal the ulcer?  Ulcer is the wound. Bandage is only the way to cover wound, to protect wound from infecting. as it is clear for every one, we do not apply special bandages on our wounds, regardless it is diabetics wound or simple cut. We put on medicine to the effected area, and put bandage to secure medicine in place.
     Why this way is not the way how to treat diabetic ulcer? Apply medicine on all the effected area, regardless how big it is, and secure the medicine in its place. In this case, there is no need in special bandage, which will never applied to diabetic's  type 2 ulcers. Diabetics type 2 mostly low income  members of society. If it is high rank of social ladder then it is diabetic type 1. We are type 2, number 2 population.

In a few years, they plan to have a working bandage prototype, one that leaves off the clunky nitrite proxies and nitric oxide dumps. Instead, patients dealing with diabetic foot ulcers will see a light at the end of the tunnel much sooner than half a year or more -- the nitric oxide-releasing bandage could help heal one of healthcare's toughest diseases in less than a month.

Sorry guys, there is no light for diabetic type 2.
        At first, there are a few years in developing bandage prototype.  This is way to secure good paid study for developers, but nothing for diabetics type 2. One after another those who developed that condition, will perish.
       Second, millions of diabetics type 2 live without health insurance. No one of them would  buy that bandages. Too expensive and useless. In this condition diabetic type 2 develop gangrene and subject to surgery.
       Lastly, if it was true as it was said in the first paragraph, ulcers healing within 120 days. We will take it, three month only, and there is no need to lose foot. Sorry, it does not work in this way. Ulcers do not heal within 120 days, nether will be they heal in 21 day. They never heal, and authors do know it very well.

References to the article: 
Maria P. Kwesiga, Emily Cook, Jennifer Hannon, Sarah Wayward, Caroline Gwaltney, Smitha Rao, Megan C. Frost. Investigative Study on Nitric Oxide Production in Human Dermal Fibroblast Cells under Normal and High Glucose Conditions. Medical Sciences, 2018; 6 (4): 99 DOI: 10.3390/medsci6040099
 https://www.sciencedaily.com/releases/2018/11/181114104116.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fhealth_medicine%2Fdiabetes+%28Diabetes+News+--+ScienceDaily%29   

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Shamanism for Blood Sugar Control. November 16, 2018

How many types of medicine diabetic type 2 need to control blood sugar numbers?
It is depend on the Shaman Dancing around Fair. Every bit of dumb is add-on medicine for diabetic type 2. Try to survive, if you can.

If you give your patients complex regimens that have to be taken in the morning and then again in the evening, patients tend to forget doses. Therefore, adherence may be compromised, leading to diminished diabetes control.

     How diabetic can forget the dose of medication? It is all the time on the bottle with medicine. Simple, take a look at the Rx, and take the dose one need to take, regardless it is morning or evening.
      With our very busy lifestyle we easy forget to take medicine then forget dose of it, and it is also regardless it is morning or eve, and if it is once or twice a day.
      Next, what does it mean when patient forget to take medicine? Who will remind to patient that medicine must be taken? If patient self-concerned then there is no one will remain better then own condition. If I forget to take BP medicine then my BP is strike, and I do have severe headache. To avoid to take additional Excedrin, I try really very hard never forget to take medicine.
    If I forget to take Insulin then soon I will hive high sugar, hunger, be weak, and ... take Insulin right away. Because of most of us live with families, our families also remember, we have to take our medicine, and they remain it to us.

On a background of metformin, if the patient has failed other combinations, such as with a sulfonylurea or a DPP-4 inhibitor, people have added basal insulin. If your patient is failing with basal insulin and you need to take another step, remember that the largest meal is often in the evening.

      As many times it was presented that diabetes type 2 caused by obesity, high calorie intake, and it is well established, how? Simple question, and there is no any answer to this question: how was established that diabetes type 2 caused by high calorie diet? Let us start with the fact that type of diabetes has no marks to be diagnosed.  It is also very well established and widelly presented by Medical Publications. If there is no mark to diagnose type of diabetes then say me, how cause of what is not known what, was established? Simple absurd.
      Still, this absurd is widely presented by every one Med Pro, and every one of then educate diabetics what to do.
      There is another absurd in this publication. There are combination of Metfromin and SU, and this combination fail to treat diabetes, to control high blood sugar numbers, so ...MD suggest to add-on basal insulin. Sorry, if SU combined with Insulin then it is really very high ride on high-low swings. No one blood sugar control possible. DID author of article tried this combination of drug cocktail by himself? I suggest to try it. I will not.

 You could combine the basal insulin with a GLP-1 agonist, such as a combination of insulin degludec plus liraglutide. Patients could take that just once with their largest meal, which would be in the evening, and it would be very effective in controlling their blood sugars.

      So, it is already fourth medicine to take, and all time remember, there are side effects, and of cause interactions. Why so many medicine needed to control blood sugar? Because of author has no one idea what he is talking about. It is said in the beginning about dose of medicine, but at the end of own publication author simple forgot that any medicine must be taken in certain dose. There are four different types of medicine sugessted, and no one medicine given in what dose it must be taken. At least, before add -on any additional number of medicine it is better to try to increase dose of medicine. At least, probably with higher dose there will no need to take add-on?
     Why medicine does not do the job?
It is wrong type of medicine.
it is wrong dose of medicine.
It is wrong regime of medicine.
In medicine is right, dose is right and regime is right, medicine will do the job.
     Well, it is easy to say, I am wrong. There are many patients take different medicine to control, to maintain, or to cure disease. Tha's right. But in case of diabetes every one add-on simple do not do the job. Numbers still high, regardless of number add-ons. So, there is something wrong with add-ons.
    Now, let us take a look at the suggested medicine.
Metformin. 
This medicine never decreased level of sugar in blood. Yes, many diabetics type 2 suggest they 'reversed' diabetes type 2 with Metformin.This is the nature of diabetes. Numbers all the time go up and down, regardless if it is with metformin or better without it.
GLP-1. 

GLP-1 has multiple physiological effects that make it an attractive candidate for type 2 diabetes therapy. It increases insulin secretion while inhibiting glucagon release, but only when glucose levels are elevated , thus offering the potential to lower plasma glucose while reducing the likelihood of hypoglycemia. Furthermore, gastric emptying is delayed  and food intake is decreased after GLP-1 administration.

At first, it is closer to SU. This medicine increases insulin secretion by diabetic's type 2 ill pancreas. Needless to say, with time insulin secretion will decline. Diabetes type 2 progress to the fatally high level.
Second, in time between meals our body system uses glucagon which released by liver. GLP-1 effect liver, and this is why every diabetic type 2 has non-alcoholic fatty liver disease.
Lastly, if there is no low blood sugar then medicine does not effect diabetes cause, and so it is nether ether treatment, nether cure of diabetes. Because of Insulin is very well established most effective treatment and even cure for diabetes type 1, it is obvious that low sugar is not avoidable when medicine is effective to treat diabetes type 2.
SU,
Sorry, SU never worked good for diabetics type 2. It is ether safe, nether effective medicine for diabetics type 2. It has side effect to lead to uncontrolled and very unpredictable low sugar. It is also destroy insulin secreting Beta Cells, so with time there is no insulin secretion by diabetic's type 2 own pancreas. This is why diabetics type 2 die less then within 10 years after being diagnosed with diabetes type 2.
Basal insulin.
Why basal insulin does not control blood sugar level?
Simple, add - on dose, amount of units, and insulin will do the job.

Basal insulin does not depend on the meal diabetic take, or time of the day. Just take this shot in the regular time. What is very effective, the dose of basal insulin. It is the same as if we take one bread, and we were told that we were fed, then do not be surprise that we are hungry. This is elementary, and every one do know it. If so, then say me, why it is only type of medicine in discussion, no numbers of level of sugar, or dose of medicine? How this discussion can be reliable?
Still, people, Med. Pro,. put their voices, and discuss how to treat what they do not know what they treat.
Does not all this looks familiar? Yes, it is 1000's years, and the same therapy. It was all the time named Shamanism.

Put the Focus on Dinner for Blood Sugar Control by Cyrus V. Desouza, MBBS
https://www.medscape.com/viewarticle/904180?nlid=126056_1521&src=WNL_mdplsfeat_181113_mscpedit_wir&uac=164666HZ&spon=17&impID=1799763&faf=1

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