Diabetes
Edited by Werner K. Waldhausl. 1979
Published by Expedia Medica, Amsterdam-Oxford-Princeton. 1980
Procceding of the 10th Congress
of the International Diabetes Federation.
Vienna, Austria, September 9-14, 1979.
Treatment State of the Art.
In this lecture author present how they studied non insulin diabetes, and what they found. At first, it is well know from the pre-insulin era that diet and exercise it most important treatment for non insulin dependent diabetics NIDDM patients. What is important why diabetics they studied non insulin dependent? Because of they do not take insulin in injections. So, it is first point which was taken for granted that they are not insulin dependent because they do not inject insulin. Why?
I still do not take it for granted, but it is not the point for my post today. The point is treatment. Not diet and exercise but the medicine non insulin dependent take.
First anti-diabetic agent is Sulfonylureas, medicine which stimulate secretion of preformed insulin by the b-cell both in vivo and in vitro. Dose run from 2.5 mg to 1g. It is very high dose, and what is after? B-cell stimulated with this dose, for how long it would still be able to secret insulin? Just simple question, for how long stimulation of b-cell can be effective? Not for long. This is why the dose of medicine in constant rise. 2.5mg=5.0mg=7.5mg=1g. Why it is the end for stimulation of b-cell? Probably at this time diabetic die. No insulin for living to support cells function.
It was congress in 1979 when SU were presented as an effective treatment for non insulin dependent diabetics type 2, insulin resistant type of diabetes. It is easy to see, if diabetic does not require insulin then why it is treatment to stimulate b-cell to secret more insulin? Why non insulin dependent diabetic needs SU, stimulation for pancreas to secret insulin?
As it is usual with all medical publications and presentations, one end does not meet another.
There is another question arises. For how long stimulation can be follow? Day? Week? Year? 10 years? 20years? It is important to know for how long this medicine can be taken? It is obwious that any stimulation eventually would be ended with full destroying of agent which was stimulated. So, eventually diabetic's type 2 insulin independent pancreas would be destroyed. No insulin secretion at all, stimulated or not. What after that?
After 10 years, less then 10 years actually, diabetics type 2 die. Painfully, partly crippled, with amputated one or both legs, they still take the same medicine they started when diabetes was mild and with insulin injections they could live pretty long and comfortable. Not the case. Diabetics type 2 are non insulin dependent, so there is no insulin injections, no insulin in medical box of diabetic type 2. Diabetic type 2 must reverse deeper progressed diabetes with diet and work outs. But let us to remember, no one diabetic after being diagnosed, lived over two years in pre-insulin era. Only insulin prolonged diabetic's life, regardless the body mass or BMI. Every one diabetic live with insulin injections. No one diabetic in severe diabetes state live longer then two years. Usually less then half year.
Now today, almost 100 years after insulin discovery, diabetics treated with diet and work outs. But if diabetic in hospital and sugar is high then regardless if it is insulin dependent diabetic type 1, or insulin independent diabetic type 2 treatment with insulin injections would be initiated. Now there are very reasonable question, why if it is skinny or fit person with lower level of sugar in blood then obese patient go home with Rx to insulin. Why obese or overweight diabetic go home with diagnose 'non insulin dependent diabetes type 2' and Rx to SU?
How and when insulin dependency was diagnosed? What test was run to classified dependence to insulin? No tests. Just body mass and this is only one reason why diabetic classified as 'insulin independent type 2 diabetic'. There is another question, are those diabetics type 1, insulin dependent diabetics who take insulin but still have poor diabetes control are in ideal body weight? Not at all. They are the same, overweight and obese. But they were diagnosed at the time when they were in smaller size. So, there is no any scientific prove that one type of diabetes is insulin independent when another type of diabetes victims are insulin dependent. Simple, there are no types of diabetes, but staged of its development.
Edited by Werner K. Waldhausl. 1979
Published by Expedia Medica, Amsterdam-Oxford-Princeton. 1980
Procceding of the 10th Congress
of the International Diabetes Federation.
Vienna, Austria, September 9-14, 1979.
Treatment State of the Art.
In this lecture author present how they studied non insulin diabetes, and what they found. At first, it is well know from the pre-insulin era that diet and exercise it most important treatment for non insulin dependent diabetics NIDDM patients. What is important why diabetics they studied non insulin dependent? Because of they do not take insulin in injections. So, it is first point which was taken for granted that they are not insulin dependent because they do not inject insulin. Why?
I still do not take it for granted, but it is not the point for my post today. The point is treatment. Not diet and exercise but the medicine non insulin dependent take.
First anti-diabetic agent is Sulfonylureas, medicine which stimulate secretion of preformed insulin by the b-cell both in vivo and in vitro. Dose run from 2.5 mg to 1g. It is very high dose, and what is after? B-cell stimulated with this dose, for how long it would still be able to secret insulin? Just simple question, for how long stimulation of b-cell can be effective? Not for long. This is why the dose of medicine in constant rise. 2.5mg=5.0mg=7.5mg=1g. Why it is the end for stimulation of b-cell? Probably at this time diabetic die. No insulin for living to support cells function.
It was congress in 1979 when SU were presented as an effective treatment for non insulin dependent diabetics type 2, insulin resistant type of diabetes. It is easy to see, if diabetic does not require insulin then why it is treatment to stimulate b-cell to secret more insulin? Why non insulin dependent diabetic needs SU, stimulation for pancreas to secret insulin?
As it is usual with all medical publications and presentations, one end does not meet another.
There is another question arises. For how long stimulation can be follow? Day? Week? Year? 10 years? 20years? It is important to know for how long this medicine can be taken? It is obwious that any stimulation eventually would be ended with full destroying of agent which was stimulated. So, eventually diabetic's type 2 insulin independent pancreas would be destroyed. No insulin secretion at all, stimulated or not. What after that?
After 10 years, less then 10 years actually, diabetics type 2 die. Painfully, partly crippled, with amputated one or both legs, they still take the same medicine they started when diabetes was mild and with insulin injections they could live pretty long and comfortable. Not the case. Diabetics type 2 are non insulin dependent, so there is no insulin injections, no insulin in medical box of diabetic type 2. Diabetic type 2 must reverse deeper progressed diabetes with diet and work outs. But let us to remember, no one diabetic after being diagnosed, lived over two years in pre-insulin era. Only insulin prolonged diabetic's life, regardless the body mass or BMI. Every one diabetic live with insulin injections. No one diabetic in severe diabetes state live longer then two years. Usually less then half year.
Now today, almost 100 years after insulin discovery, diabetics treated with diet and work outs. But if diabetic in hospital and sugar is high then regardless if it is insulin dependent diabetic type 1, or insulin independent diabetic type 2 treatment with insulin injections would be initiated. Now there are very reasonable question, why if it is skinny or fit person with lower level of sugar in blood then obese patient go home with Rx to insulin. Why obese or overweight diabetic go home with diagnose 'non insulin dependent diabetes type 2' and Rx to SU?
How and when insulin dependency was diagnosed? What test was run to classified dependence to insulin? No tests. Just body mass and this is only one reason why diabetic classified as 'insulin independent type 2 diabetic'. There is another question, are those diabetics type 1, insulin dependent diabetics who take insulin but still have poor diabetes control are in ideal body weight? Not at all. They are the same, overweight and obese. But they were diagnosed at the time when they were in smaller size. So, there is no any scientific prove that one type of diabetes is insulin independent when another type of diabetes victims are insulin dependent. Simple, there are no types of diabetes, but staged of its development.
via Ravenvoron
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