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Sunday, 30 December 2018

Diabetes Understanding in 1979 by Medical Pro. Post 1. December 30. 2018

I take a book edited by Warner K.Waldhausl "Diabetes 1979". Excerpta Medica . International congress series 500. 865 pages written by medical pro for medical pro. I hope it is understandable I do not read all book, and .... is this true they someone read it all? I just take what is interesting for me.
 "Treatment of Diabetes Mellitus: pathophysological aspects and state of the art"
by W.K. Waldhausl.
      In his lecture author present types of diabetes, and studies which were done. Very interesting point. Studies were done for normal non diabetic man (women). It must be looks like it is normal not pathological way of metabolism and glucose utilization. The problem is, who eat glucose in normal life? we all do eat something sweet. We eat cherries and cookies. What is obvious for me, not medical pro or scientist that metabolism of cookies and cherries are different. The same as metabolism of chicken and bread, pork and beef. Why in studies it is taken glucose load? No one diabetic or not eat glucose.
      It is normal GTT. All studies abnormally conducted and then  result presented as it is actual result how human body works. Really?
     All the time I do have the same question. Why when diagnose of diabetes must be confirmed it is GTT must be conducted. Hungry diabetic come to lab, and there is test  after load of glucose. How diabetic react on the glucose load. Why do not start to diagnose diabetes according to the highest level of sugar in blood? Patient come to testing in clinical setting. At first one has good dinner, usual meal one normally eat, such as soup, meat with sides, salads, and desert. Level of sugar taken before meal, right after meal and then every 30 min till sugar is getting up, and then down. Time of when sugar started to rise, the highest level of raised sugar, and how long it dropped down to the normal level or even down to see how long it takes to get lowest level of sugar.
      Because of this test is time consuming it is very reasonable take in hospital or in ED where beds are available and patient can be comfortable. all tests with glucose load are not natural, so they are not present real diabetes understanding.
     
      There is another test. How many units of insulin needed to cover basil needs in case of absolute insulin deficiency? This test is for what? I do understand we need to know how many units iof insulin we need to inject to be functional but do not have low blood sugar. Really I do understand it very well. What I do not accept is that this dose can be counted with math. Then after someone idea no one tested if this idea right or wrong, the treatement started. Dose of insulin based on the math. It is presented as a minimum dose of insulin for basal needs to body system to function.
     How this test can be right? Even the same man has different demand in insulin day from day, and hour from hour. There are as many diabetic man on Earth the same amount of math can be. Is this possible to count? Not at all. No question, the math would not work, and diabetic cannot relay on it.  It is possible to create any formulas and try to push men on Procrust's bed. There is no one formula is right.Why? Because of glucose level in blood is not stable, so dose of insulin is in constant need to be changed, titrated.


via Ravenvoron

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