Insulin in diabetes type 2 control and why it is failured. February 28, 2019

Pages from 90 to 96 is what to do and how to care for people with diabetes type 2. The conclusion is:

"Epidemiologists keep pointing out that the intervention of physicians over past 50 or more years has done little to prolong life eliminate serious morbidity. Where NIDDM is concerned this may well be true. At present there is an enormous gap between what we could do and what is actually being done." (page 96)

Care for diabetes type 2 patients

by Robert Tattersall
page 90
Recent trends in management of diabetes mellitus
eddited by N.Sakamoto
International Congress Series
Excerpta Medica 1987

"One of the points is that insulin failed to control blood sugar level, why? " One reason for the failure of insulin to produce better glycemic control in our study might be that we limited dose to 40 units a day because of fear of hypoglycemia."  

       To be more clear in this point let diabetic eat one bowl of soup a day, and see how long diabetic would keep blood sugar under control and able to work and live happily. It is the same with insulin. There is no one data how many units of insulin every one adult person need for healthy function. Also no one understand where insulin go when sugar raised at rainy days or in Flu season. But every one know perfectly well, what dose of insulin adult person needs daily. There is another fact, Dr. Joslin injected in his hospital 2400 units to diabetic just withing 24 hours to keep diabetic alive. Where this insulin gone?
      I inject from 400 to 500 units daily. Highest dose was 720 units withing 24 hours. No low blood sugar. Where insulin gone? What insulin had done in my body? After that dose of insulin started to drop, and not it is less then 500 units usually. It is Summer coming. Probably sugar will go down and so dose of insulin.
     In the same article it is published how care for diabetics feet. And say me how? Do not be surprise. We have to wash our feet to prevent gangrene. As I already posted, when we come to hospital no one care to wash our feet, and personally I cannot do it by myself. My legs covered by puss which run down to the shoe or to the bed, and no dressing to my feet. No Insulin at all. Skin flapped off, and pink bones stared at the doctors. Really, what doctor said? "Are you mind to go home?"
     Still there is education. It is all about education. We educated how to wash our feet to prevent infections and gangrene, how to eat to prevent diabetes type 2 and if we failed to prevent diabetes type 2 then we have to eat to re-verse diabetes type 2. Education is important.
      In present time there is nothing interesting could I find about diabetes and diabetes type 2 specially. In old published books, before a new classification started to take over there are a;ll the time both diabetes type 2 and NIDDM, diabetes type 2. Say me, what does it mean "insulin resistance"? Type 1 diabetes is "Insulin Dependent type of diabetes". Type 2 is Non Insulin Dependent Diabetes Mellitus, Insulin Resistant type of diabetes. How resistance identified and studied? The best way to study insulin resistance is in dogs when pancreas of dog was removed. So, insulin secretion of lab dog is "0". Now say me, when insulin dependency studies what is insulin secretion in this diabetics? Really, I lost.

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Diabetes type 2 treatments and lies. February 28, 2019

How should glycemic control attempted?

• Simple calorie-restrict diet;
• High fiber, low fat diet;

"The problem with diet is not how to define as effective  regime but how to teach it. Middle aged people find it hard to change the habits of a life time and the older diabetic often has a deficit in memory retrial which may compromise any therapy." (page 93)
    So, author talk about difficulties to follow diet because of they are unnecessary complicated. And also something about exercise to reduce level of sugar in blood, and how to take medicine. All about how to teach diabetic what to do without any attention that older diabetics often cannot walk without help, cannot count calories, or cook and do shopping. Also never forget that healthy meals are more expensive then any regular food, and diabetics have low mean of income.

• exercises;
• SU;
• Biguanides;
• Insulin;
• Insulin and SU. 

Care for diabetes type 2 patients

by Robert Tattersall
page 90
Recent trends in management of diabetes mellitus
eddited by N.Sakamoto
International Congress Series
Excerpta Medica 1987

        All attention in diabetes type 2 treatment  only to put ill patient to do what Med Pro have no one idea how to do. With diet regime we can see limitations of diet. With teaching, what can we say? Is it student not able to learn? Or it is teacher who is not able to teach? Question which never has answer. Still, article published, and all Old Wives teach every one diabetic what to do and how.
      At the same time, all diabetics type 2 do have CVD. This condition is going side by side with diabetes type 2 and developed long before diabetes was diagnosed. In diabetes type 2 treatment there is no one mention what to do with heart failure. The matter of fact, in any clinic in any hospital when diabetic come with chest pain one has only one type of therapy: Are you mind to go home? Some one will go home, so diabetic more lucky to survive. In many other times diabetic is so ill that to go home simple not the choice. Patient would be placed behind closed curtains till nurse will see, diabetic gone. Time to go "Home" to Father. Very sad. CVD is number one cause of death.
       COPD also in top leading causes of Death. The condition when we simple cannot take another portion of air into our lungs. COPD is difficult to differentiate from Asthma.  The treatement is about the same, Symbicort, Spirive, Ventolin, and many other medicine, all steroidal. Many diabetics cannot take this medicine. Allergy. Dizziness. Light-heading. Poisson effect. Without medicine breating became too difficult and once COPD can lead to death. How many diabetics tested for Asthma? I got my first Rx to Symbicort only 12 years after being diagnosed with Diabetes type 2.
        Sleep Aphnea. Some people diagnosed with this condition and they use C Pop or Bi Pop. Many do not. This machine can safe lives. Just think about, one cannot take any breath, for how long? When we take a look at the standards of diabetes type 2 care we can see many tests, but never test for Sleep Aphea, why? Really why? With time those of us who are very ill need to use C Pop all the time to be able to breath. This machine send air even we cannot take it. It is as artificial ventilation. For that reason we have to use portable machines with battery that we do not relay on electricity. These machines almost not possible to get.
       Food check up is in standards of medical care for diabetics type 2 till ulcers start to develop. When legs became infected and skin dropping and yellow liquid dripping from opened wounds, there is no treatment. Amputations can be prevented if treatment started early and right. But there is no one diet or work out possible to treat opened wounds. Admission to hospital is useless. At first Insulin would be stopped, and then treatment with diuretics would be initiated. As soon as diabetic discharged from hospital edema returns, wounds keep opened, and no one dressing hold yellow liquid. It is dropping and run all over the legs down to the feet and into shoe. I was able to stop this with wound care clinic treatment. Why my primary discharged me from hospital, and never said even one word about this clinic? Why in hospital there were no one Wound Care nurse who done wrapping and dressing? Questions, more questions, never answered.
       There are hundreds of different names of medicine to treat diabetes. Why it is only SU which mentioned in treatment? Because of it is only SU which work to increase level of insulin in blood. Now say me what older diabetics can do when sugar is low because of SU? These diabetics even have no one idea that they have low blood sugar. Left alone, and many are live alone, they simple die due to diabetes. It is not diabetes which kill diabetic. It is wrong treatment and lie doctors told diabetic about condition and disease one has.

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How should glycemic control attempted at Diabetes type 2, NIDDM. February 27, 2019

How should glycemic control attempted?

• Simple calorie-restrict diet;
• High fiber, low fat diet;
• exercises;
• SU;
• Biguanides;
• Insulin;
• Insulin and SU. 

Care for diabetes type 2 patients

by Robert Tattersall
page 90
Recent trends in management of diabetes mellitus
eddited by N.Sakamoto
International Congress Series
Excerpta Medica 1987

       As it was mentioned in the beginning of the article best results can be achieved with best high blood sugar control. So, how to control blood sugar? Author suggested to start with simplest and less expensive therapy. What can be more simple then diet? There is nothing to pay, just regular meal intake. With all restrictions the amount and simplicity of diet for diabetes control is beneficial for the budget. Does diet possible can control blood sugar level?
      Diet should not only to control blood sugar, it must also decrease level of sugar in blood, and there is no one evidence every studied what food to take to decrease level of sugar by 10mg/dl for instance. No one evidence what are the number of calories must be taken that sugar in blood would be decreased by any number. This logic applies to any diet, low calorie or high fat.
     What exercise is doing in body? How exercises decrease the numbers on glucose meter? How many sets to take, what work out to do? No one  ever will answer to this question. It is depend on the individual training. But what is important to remember, we are talking about ill people, diabetics, who very often not able to get out of bed. When I look at all those treatment options I see that the fact, diabetics are ill people, low energy, simple never taken into consideration. Our bodies heavy with water, severe edema. Try to do work out after taking water in big quantities. Don't you feel how heavy you are? Try to bend, to run, to jump. This is what author suggest to diabetic.
     Now finally SU, most effective medicine to decrease number on diabetic's glucose meter. For how long? Is this medicine control blood sugar numbers, blood sugar level? Not at all. Take a look at the medical articles, what are they about? Diabetes is progressive, very highly progressive disease. Why? Because of SU not only do not treat diabetic but slowly kill diabetic's beta cells and with time there is nothing what left. Think twice before taking SU, even it is less expensive then work out and diet.
     Metformin. Very simple to take test if Metformin work for you or not. Stop to take Metformin for awhile and check your numbers. If numbers go up, then Metformin is good for you. If numbers still the same or even dropping then show me reason to take this medicine. Every medicine has own side effects. It is better do not take medicine which we do not need to take.
      Insulin. Insulin leads to weight gain. Also it is highly effective in glycemic control. Worst what can be suggested or RX is to take medicine together with SU. Insulin is easy to decrease or increase in dosing. Combination SU + Insulin not possible to control. If one has medical degree then say me why this is published in medical test book? How possible it is suggested to combine SU and Insulin? Better do not trust in any one then trust in MD who suggest this potentially fatal combination.

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Aims for treating diabetes type 2

Aims for treating diabetes type 2:

Relieve symptoms;
Deliver total health care;
Achieve and maintain normal normal body weight;
Aim for normoglycaemia and if appropriate and the likely benefits outweigh the possible hazards;
Treat existing complications;
Do more good than harm.

Care for diabetes type 2 patients
by Robert Tattersall
page 90
Recent trends in management of diabetes mellitus
eddited by N.Sakamoto
International Congress Series
Excerpta Medica 1987

      Relieve symptoms; Easy to see if one has logical  mind, these aims never will be achieved. Why? Show me, how?
At first symptoms relieve, how? Does not matter how hard we try to reduce temperature of body, if infection still not treated it takes over, and finally patient gone. True? False? Easy to say, fle can be treated without any medicine and it is gone within one week without treatment. Why? Because of immune system fight virus. But what if immune system is not strong to fight? Patient will lost fight. This is why diabetics more prone to infections than any non diabetic healthy person.
      Why amputations are most common complication of diabetes? Because of heart failure and kidney failure is complications of diabetes. These failures lead to edema, and edema lead to gangrene. Proper and timely treatment will reduce risk of amputations. Treatment with diuretics lead to heart failure, so, edema would be worsened, lost limbs are not avoidable.
      This is only one reason how symptoms cannot be revealed without proper treatment.Does not matter how hard diabetic try to avoid meal consumption and how long diabetic take Starvation diet, this therapy never work, never will, and eventually diabetic die due to high blood sugar, heart failre, or any other cause of death, Starvation including.
      Deliver total health care; Really what does it mean? How total health can be delivered to diabetic without proper diabetes treatment? Regardless what medicine we use to decrease High blood pressure or high cholesterol, kidney problems or what size of glasses we do use, still, there is no improvement in diabetes control, so the total health dramatically decline.

      Achieve and maintain normal normal body weight; So, according to this statement all people with excess of weight are ill or diabetics, and all people with normal weight are healthy? Please, get real! So, if everyone do know that this is not true then why weight is above   glycemic control? There is no one evidence that diabetes caused by obesity or overweight. The matter of fact, 80% of obese and overweight people are not diabetics. Also it is fact that food process is abnormal in diabetic patient, so why it is surprise that diabetics do have  abnormally high or low body weight? Diabetics are ill people. There are a lot of abnormal tests in our body system. At first it is level of sugar, which is always abnormal without proper treatment regardless of food we eat.
        Aim for normoglycaemia and if appropriate and the likely benefits outweigh the possible hazards; This is finally really important aim in diabetes type 2 treatment. Do not try to find out how to finally achieve the good blood sugar control. No one MD will say you so. Every one of them do know very well what to eat, when to eat, and how many babied diabetic woman may have. Still, no one of them really helpful to treat diabetes. They do know only how many grapes will control level of sugar in blood. If control with grapes was not achieved than diabetic ate wrong grapes, or ate them in wrong way.
        Treat existing complications; In stead to treat complications why do not try to prevent these complications? It is the fact that many medical conditions come with deeper development of diabetes type 2, when blood sugar getting higher. Then higher blood sugar then more complications diabetic type 2 do develop. So, if blood sugar is lower then the risk of diabetes complications is decreases, right? Now all what we have to do just decrease blood sugar level and reduce it as low as normal level of sugar in healthy individuals. How to do so?
       To achieve the final aim is best way to take a look at the available medicine for diabetics, the same as type 2 such type 1. Then take good study, when blood sugar increased with treatment and when blood sugar level decreased with treatment. If sugar in blood slow getting down, then stick with this medicine and take it as carefully as it is possible. Keep good eye on blood sugar level. Do not rush it to go down as soon as possible. There is no rush in diabetes treatment. Then higher blood sugar level then longer way to reduce this level down to the normal healthy level. In some diabetics this strategy takes at least 5 years to achieve proper aim.
         Do more good than harm. This is important aim. Insulin is good for any diabetic, any type of diabetes. At least it is no one other medicine in present time as good as insulin in injections. SU are bad for any diabetic any type of diabetes. At first glance it looks like it is good, it is natural insulin secreted by diabetic's pancreas. But upon second thoughts, it is far away from being natural. At first,  it is ill pancreas which forced to secret more insulin. With time the ability of pancreas to secret insulin decline and finally stopped. Second, insulin secreted by ill pancreas under power of SU secreted without any need in it. As a result the beta cells decline needlessly. Third, the secretion of insulin under power of SU is uncontrollable. The amount of medicine is all the time the same, but the need in insulin is all the time is different. When it is sunny day, there is less insulin is needed. When it is Flu season, then the demand in insulin is high. So, diabetic swing on high-low swings, down to super low blood sugar and up to high. Do not say, it is no harm in this medicine.

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Da - by - Day. February 27, 2019

        It is time for delivery Insulin. Not that I do not have any insulin, I do have what to inject. But it is time, and I am in biggest stress: Would be insulin delivered on-time or I have to fight for supply? My endocrinologist left office, and now I have to go to another doctor. Would another doctor Rx insulin to me? I am type 2 diabetic, Non Insulin Dependent Diabetic who live on large dose of insulin and according to definition of diabetes type 2 I do not need insulin at all.
       How a new doctor can see, am I diabetic at all? My sugar is just very good. With large dose of insulin I no longer have 599 mg/dl sugar in blood. My sugar is nice and smooth. Even I skip full day of insulin injections, I still do not have level of sugar up to 500 mg/dl.  All what I need just re-start injections as soon as I can, and there's no high numbers on glucose meter, nether there high A1c sugar in blood test. How new doctor will see that I need this large dose of insulin?
     It looks like doctor must trust in me. We all lie. Doctors lie to patients, patients lie to doctors. We simple cannot trust to each other. If supply would not come what I suppose to do? I already pass a few times when insulin supply was broken. This is why dose of insulin is so high right now. Every interruption in insulin supply lead to higher and deeper damage and diabetes development. Every restore in insulin supply lead to longer time in recovery. I am already getting old.
        Would I recovery next time? Right now obesity is high. I am almost 400 pounds. Just stop insulin supply, and my kidney and heart finally would give up. It is already high edema. I hardly able to keep my leg functional, hardly able to walk to my bathroom in my apartment. Now I am able to get up in my bed.
      I do not have any mean of income. It is all the time that my man must sing some paper and he refuse to do so. He is 68 years old, still working, and it is not low income job. He has medical plan which cover my medical expenses. What I suppose to get if he is not my husband anymore? This was why I lost Medicaid in first place when my man lost his previous job. I must pay $11,000.00 from my income which is $0.00. No mean of income at all. What dirty play is it? We pay by life for that dirt. 

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Day - by - Day. February 25, 2019

Blood sugar today is 136 mg/dl.
        Yesterday there were no one shot of insulin. I am sick with Flu, almost do not eat. Day before I ate something and I felt sick. Was it what I ate? Or it was something different? I do not know. But Yesterday I did not eat almost all day, did not want to. And I do not drink, even tea. So, I did not take insulin at all. Insulin without food is very bad idea. If sugar would go up, I can fix it later. For my biggest surprise, today sugar is not high at all.
       This is my constant point, no one diabetic type 1 will die if one missed shot of insulin. It is take time to develop high sugar which eventually will be fatal. There is no one difference between type 1 and type 2 diabetes. The matter of fact, Metabolic diabetes is consequence of abnormalities in insulin secretion. Regardless insulin secretion was destroyed by medicine such as Metformin, SU, and Invokana, or it is any other cause of defect in insulin secretion, the consequences are the same, we die without insulin in blood.
       Treatment for any type of diabetes is the same, insulin added in injections. Then early treatment started then easy control diabetes development, and easy to avoid all complications of diabetes such as amputations, MI, stroke, blindness, you name it. Started as soon as blood sugar elevation was detected the dose of insulin is less aggressive, and recovery will be easy and faster.
       The same as many other disease diabetes treated with time. Remember Consumption? In present time it is TB, but in past the name for TB was Consumption. Today we do not see people with TB around us. But TB is still present. Bacteria is very adaptive and every child has vaccination to prevent TB development. Th same with Flu. We take Flu shots every year, and still we are sick every season. Virus is highly adaptive. Still with every season we are not so ill and is is very abnormal, when someone die due to Flu or TB.
       Insulin Deficiency is nothing different then any other medical conditions. The matter of fact, it is most important part our body. It is determine how we fight bacteria and virus, or how smart we are, how strong we are, how healthy or how ill we are. Treatment for diabetes will open a new era in human development. The life longevity, the productive middle age when we are most sufficient in our development.
      In present time we pay high price to fill greedy pockets. Out sweet blood is very important part of social development. If Old Wives and Pussy Hats do not understand it then those who spoon high income from social $$$ pool understand it perfectly. This is why today it is 80,000 diabetics die every year due to diabetes only in America. In all cause of Death there are more then 200,000 diabetics lost lives every year. Find any more sufficient war against humanity. No one dictator able to kill more then our Hospitals and Medical Clinics.

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Certified Diabetes Educator. February 23, 2019

Certified Diabetes Educator.
What do we learn when we educated by Certified educator? What Educator do know about Diabetes, and how this Educator able to answer to our questions?
Difference between diabetes type 1 and type 2. 
But before Educator start to educate diabetics what are those difference educator must know what types of diabetes in practice.
Type 1;
type 2;
LADA;
Tropical Diabetes;
Diabetes resulted by protein malnutrition;
Idiopatic diabetes;
unknown type of diabetes.
        No one Educator know what types of diabetes developed by humanity. Educator do know only type 1, children or those who were diagnosed as children or those who were diagnosed with diabetes before 1980 when a new classification divided diabetics to two not even parts: 95% of type 2 diabetics, Non Insulin Dependent Diabetics (NIDDM), and type 1,and 5% of Insulin Dependent diabetics who treat diabetes with insulin or even without it.
        Now any one diabetic type 2, or mother diabetic type 2 child wish to know why and how diagnose of type of diabetes was made? Is there are any Diabetes Educator capable to answer to this very reasonable and very simple question: How type of diabetes diagnosed? Why one is type 1 diabetic with fasting level of sugar around normal and with insulin injections 7 units daily; and another diabetic with fasting sugar 370 mg/dl and level of random sugar over 599 mg/dl, diagnosed as type 2 diabetic insulin independent which treated with diet and work outs?
      Do not bother to ask Educator how diagnose type of diabetes was made. The only one standard answer is possible to get: diabetes type 2 diagnosed usually at age of 40+ and people with diabetes type 2 are overweight or obese. To have this answer why do I need to go to education lessons? every one is already do know it. Still, every one of us, diabetic type 2 still wonder to get answer to this question: Why I am diabetic type 2? I was not obese when all symptoms started to surface, and I al ill all my life.
What goals do you have  for various health measures such as blood pressure, blood sugar, lipid values and body weight?
       To answer to all these questions I wish to say only one, I wish to have all measures as close to normal as it is possible. What is interesting, how many people will say they do have goal to have blood pressure 240/130 ? No one. Do how many people wish to set up goal as blood sugar level such as 599 mg/dl? And how many people wish to have body weight 400 pounds? At least I did not meet one of any of those. So, what does Educator really ask, and what Educator must to say to diabetic with these numbers? Educator must call 911!!!!!!!!!!!! Regardless of amount of pounds diabetic is in critical condition and in severe pain. Better to sent client to hospital before start to teach victim what to do.
       How many Educators will do so? No one. Even when diabetic transported to ER in hospital, there is no admission to hospital. Usually diabetic would be sent home after a few hours after admission into ER. It is education to all practitioners, do not admit critically ill people who need urgent care. They may die, and really what Med Pro can do for them? To educate diabetic in coma how to eat and how often do work outs? Does not matter. Victim of that medical care is already out of reach and not every one return home form Emergency Department.
      But still on the room of Diabetic's Educator clients are not in such critical condition, and Educator try to educate them to set up goals. OK, client with body 400 pounds said, one wish to be as one was in high school, 120 pounds. Is this realistic goal? Not at all. So, why this question really so important?  Well, at least Educator has some topic to discuss. Otherwise what Educator suppose to talk about? The idea to set up goals is simple not reasonable.
       It is so difficult to get out of standards and see the obvious absurd in the subject of discussion. There is no such needs as goal to set up. Every one ill person need to be as healthy as it is possible to be, at least to keep own functionality. The question is not the goal but what to do when one is sick or ill. Every one who got flu try own best to get rid of it and be healthy, no headaches, no running nose. We prefer to go to work then call for sick days. What is difference with diabetes? Diabetics are the same as every other ill or sick people. The goal is only one, to get healthy as much as possible, as soon as possible.
Demonstration.
Skills such as blood sugar testing or insulin injection can be learned by demonstration. As Dr. A. Peters educated diabetic one must take off cup from needle before put needle into belly. It is really important to tech diabetic what end of pen to put into stomach. Otherwise insulin will spring into air in stead to go under skin. But what I never encounter, why there is no teaching how to swallow Oral Agents. Really, one can take oral agents by another end, and it will not provide proper effect on blood sugar level.
Diabetes Self Management Education. (DSME) ADA program.
 There are a lot to learn in this program. What I tried to find out the answer to twoquestions:
How to see if medicine and any treatement I take work for me or not?
How to count dose of insulin in everyday injections according to my personal needs to keep diabetes under control, and at the same time avoid low blood sugar, which is dangerous and unpleasant?
Try to ask Educator when you are on this program. No answer every will be given. Every educator do know very well what diabetic must eat and how often diabetic must go into fitness club. No one educator will every answer to the question, how to count dose of insulin. They all do know very well how to inject insulin. No one do know how to find dose of insulin injection. Really, what all this Education about?
Orientation.
 The person believes that fate, luck or chance determine his or her outcome.
          Educator suppose to help to diabetic to recognize importance of self- management in diabetes outcome. I would be positively accept that. But remember, it is MD who made us type 1 or type 2 diabetics, and so, it is MD who determined any outcome we will have in any self management. If one diagnosed as type 2 diabetic with needs in large dose of insulin, and as diabetic type 2 it was determined that diabetic is non insulin dependent and so there is no need in insulin then say me, how to self manage diabetes type 2 control without proper treatment?
       In some countries diabetes type 2 diagnosed as 'non sugar type of diabetes' with diagnostic tool of having elevated sugar in blood. Say what is absurd in this definition?
So I stick with luck and chance and fate. I can do my part of job. But it was my luck when I found proper treatment I need, and it was my fate when I met my doctor who took good care for my needs and Rx large dose of insulin. Today I live.

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Treatment of diabetes back to 1988 and now. Post 1. February 22, 2019

Pathology of diabetes, symptoms of diabetes, and many other issue are very important. But the reason we all need to know is only one, how to control diabetes, how to treat diabetes, how to stay healthy or at least functional with diabetes.
So, let us see, what medical providers suggest to us.
"The successful treatment lasts for lifetime and the patient must be treated not only now but for the future, restoring the physiological condition to as normal as possible." (page 75)

World Book of Diabetes in Practice.
volume 3.
edited by L.F. Krall
Published November 1988
Elsevier
 What is the treatment?

"This is one of the most critical aspects of treatment and, for this reason, should be considered first. it is necessary a continuous education process for the diabetic and his family involving their physical and emotional problems, looking forward to the patient's health and happiness." (page 75)

         I am flattered! Looks like my health really under good attention. To good to be true. In stead to look at papers how doctors and all medical team care for people with diabetes, I took a look at CDC Mortality tables. Diabetes type 2 is number 7 cause of Death around The Globe. In NYC where I do live, it is number 4 cause of Death. Also what I do know from all medical publications I read online Diabetics type 2 gone less then 10 years after being diagnosed with Diabetes type 2. This make me wonder, what kill 80,000 American diabetics every year? Is this diabetes, or it is treatment diabetic do have? Just pay attention to the data: in  NYC diabetes is #4 cause of Death. It is higher then in any developed country. Probably diabetics in that countries do not have so many clinical visits as diabetics do have in NYC?

"The proper diagnostic of type  of diabetes is very important before prescription of a diet or any other treatment." (page 76)

Sorry, it is difficult for me to get humor when it is said about diabetes.  As I posted many many times, what is diabetes type 2 and how it was diagnosed?
Level of sugar is one tool for any one type of diabetes.
We all do have age. In present time youngest diabetic type 2 was diagnosed at age of 2 years. Needless to say that every one with elevated level of sugar would be candidate to be diagnosed with diabetes type 2. But what about other types of diabetes?
Diet. My favorite part of treatment.
      At first we should know that once type of diabetes was stamped it never changes. So, if diabetic has type 1 diabetes and need 7 units of insulin daily dose, then diabetic with other types of diabetes such as FCPD or LADA, or any other Unknown type of diabetes would be diagnosed as type 2 diabetic, and treated with Life style modifications, Healthy diet. What I still do not understand, how diabetic's type 1 diet is different from diabetic's type 2 diet? When we say it is Restriction diet I suppose it is Starvation diet, yes? If so then there is risk to develop malnutrition type of diabetes. What is not possible is to reduce high glucose level in blood. Diabetics die regardless of diet we do have. Even we do not eat at all, we still die, and level of sugar in blood still abnormally high.
        Every time I come to clinic, any clinic to any MD, I do have the same discussion, diet and weight Loss Surgery. I an 400 pounds lady, a lot to discuss. What I wish to ask all of those MD, can they say to what I do not know? Would they please to say something new? Now there is the question, do they recommend different diets for their every day patients? No. They sing the same song over and over, and they forgot that one month or three song ago they already sang this song for me. They do not mind. They just ready to sing it over and over till patient in room patiently listen. What else they may to say? Nothing. This song make them feel, they are doing important job, they educate patient, and they deserved high payment as medical provider. In  contrary, they are just cheap cooks.
      There is another interesting question I wish to ask: do they eat what they recommend to patients? Many of them are obese.

"Dietary therapy must supply caloric requirements for carbohydrate, protein and fat both in proper quantities and at regular intervals. This is to maintain both homeostatic mechanism and ideal body weight. There has to be special consideration for adequate intake of vitamins and minerals.
When possible, nutritionist or dietitian should enplane and amplify physician' prescriptions and in follow-up make any needed changes i diet to achieve the desire nutritional goals." (page 76)

         How does it sound? At first, "when possible....", so if it is not possible then diabetic type 2 must do this calculation alone? Before count all that fats and proteins and calories intake, one must remember the cost of all products. So, if we take into consideration, what one may buy there are big differences in products. The question is, are they have the same value in calorie, in fat or protein? Not at all. Best food is healthy food, and it is expensive. Not every one diabetic can afford it. The matter of fact, diabetics cannot afford it at all. 
       Now about calories, timing, and all proteins and vitamins and so so on.  For how long one will count what is in which one? Of cause, there are tables, and of cause .... but diabetics are full job working class, with family and children. As it is usual in America if one has job then be ready to work overtime. 
       Lastly what I wish to say, it is  in this book, just read it, every diabetic has headaches. For some of us these headaches are very severe. Also take all that calculations, add nerves effected by diabetes and add depression every one diabetics do has. Do not stop calculation we are not finished yet. Every diabetic has BP, high cholesterol, and take medicine which kill but never hill. Add time we have to spend in medical clinics, just follow - up visits to take dirty Barking Therapy that we are fatty and have to lose weight. Also never forget, we are talking about ill people who are ill from the birth and whose all organs and every cell effected by diabetes. 
     Sorry, I was going to add medicine we take but it is too much stress for me right now. I hate diets!!!!!!!!!!! All of them and every one. The talk rise my blood sugar. I am done for today.

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Pathology of Diabetes. post 1. february 22,2019

FCPD ------Fibro - Calculous Pancreatic Diabetes

FCPD is usually severe. Blood glucose level in the range of 500 - 600 mg/dl is not unusual. Sometimes, however, diabetes can be mild. As with the PDPD variety of MRDM, patients with FCPD  are also believed to show the phenomenon of ketosis resistance. About 80% of FCPD patients require insulin for CONTROL of hyperglycemia. However, the vast majority  of insulin - requiring  patients do not readily become ketosis on withdrawal of insulin. A small percentage however do, and the authors have occasionally seen established ketoacidosis in FCPD patients. at the other end of the spectrum are patients who can be controlled with oral agents and a few even on diet alone. (page 34)
World Book of Diabetes in Practice.
volume 3.
edited by L.F. Krall
Published November 1988
Elsevier

         Interesting, is not it? The diabetes is severe. Level of sugar run from 500 mg/dl and up. But ....  there is no ketosis. So, treatment with insulin is not needed. Oral agents can do the job. Can they?  Now  oral agents such as SU which actually the same as insulin but this insulin secreted by already severely ill diabetic's organ replace insulin. For how long the secretion of insulin would be running? So, regardless is oral agent or injectable insulin, insulin is required to keep diabetic alive and functional. Why do not start with insulin right after diagnose of FCDP made? At least there are 80% of FCDP diabetics in this situation who need insulin, and in large dose.
       Does some one met any one who was diagnosed for FCPD? I do not think so. We all diagnosed with Diabetes type 2, regardless of level of sugar in blood, or any fibrosis wrapped our pancreas. We are all Insulin Independent ketisis resistant diabetics, NIDDM.
        I probably would except it if treatment for diabetes type 2 was the same as for diabetes type 1, insulin. It is not. We are Non Insulin Dependent Diabetics type 2 who need lager dose of insulin.

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Diabetes Type 2 Cause and Development. Post 7. Frbruary 21, 2019

Fibro-calculous pancreatic diabetes. (FCPD)
"The onset of pancreatic disease in most cases is during childhood with recurrent attacks of abdominal pain. Peak onset of symptoms of diabetes occurs between the age of 15 and 30 years. Although both sexes effected, the ratio fevers the male 3:1. The patients are underweight and may show gross emaciation and wasting; other stigma of past and present malnutrition such as angular stomatitis or high blindness may be present. Moderate to severe hyperglycemia without ketoacidisis and requirement large dose of insulin for control, constitute the key metabolic feature." (page 26)

World Book of Diabetes in Practice.
volume 3.
edited by L.F. Krall
Published November 1988
Elsevier
Ovarian Cystic Fibrosis is one of the main cause of of infertility. Many women cannot get pregnant because of PCOS. After surgery pregnancy often follow. During pregnancy these woman would have diabetes. But because of there is no attention to the woman after delivery, treatment stopped and later woman would develop diabetes type 2. In most countries even now there is no treatment for pregnant women with diabetes. After delivery women cannot lose bay weight. With time sugar in blood getting higher and finally woman diagnosed with obesity disorder, Metabolic Syndrome. Treatment with metformin, SU, and Invokana would be follow.
     This treatment never worked never will be. Small dose of insulin, and problem would be solved. With time this diabetic would get better and dose of insulin would be dropped. There is no insulin for diabetics type 2. This type of diabetes classified as non insulin dependent diabetes mellitus, so there is no insulin in medical box of diabetic.
      In contrary with American medical presentations diabetics type 2 in developing  countries consume from 1750 to 1952 kcal per day. They do have diet based on plants and roots. Malnutrition in proteins. They do have very high blood sugar level. It is really very confusing to know this fact.
       Author of this article present that it is food to blame why diabetes is so prevalent in those countries. The same way as it is in America where no one of us take this food. But still, the general idea, diabetics get diabetes because of food still prevalent. I simple wander, do that diabetics have high dose of insulin they need to survive? Insulin is expensive in America. I do not think it is better price for insulin for diabetics in developing countries. So, as I guess the same as in America these diabetics diagnosed with Non Insulin Dependent Type 2 diabetes, and treated cost effectively with life style modifications. Do they need to lose weight? Do they need to gain weight? I am sure, they cannot ether lose nether gain wight and fit into medical treatment requirements.

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Diabetes Type 2 Cause and Development. Post 6. Frbruary 21, 2019

"Malnutrition related diabetes mellitus presents at a young age with onset usually below the age of 30 years.It may constitute 30-60% of all cases of young-onset diabetes in developing countries. Clinical features include characteristics leanness with sub-normal body mass index (usually below 19), moderate to severe hyperglycemia,lack of ketosis in the absence of stressful situations, requirements of large dose of insulin for metabolic control, and frequently history of malnutrition in childhood." (page 25)
World Book of Diabetes in Practice.
volume 3.
edited by L.F. Krall
Published November 1988
Elsevier
Today in America many people come from the countries where malnutrition was the way of life, and most kids in those countries simple go to bed hungry. Now these kids are adult.  Now these kids are adult. There is no hunger anymore for them. It is easy to pretend, they come to America and started to eat in large portions of meal. But what is easy to skip that those kids, who are adult now, the requirement of large dose of insulin is the way to survive. This fact avoided, and in stead to be treated with large dose of insulin they diagnosed as type 2 diabetic, non insulin dependent. There is no insulin for those diabetics type 2, ether small dose, nether large dose. Just life style modifications. And Invokana if they did not lose weight naturally.
      At the same time there are another group of diabetics type 2. They has onset of diabetes with very high level of sugar in blood and with ketosis. They survived. Even coma possible to pass and diabetic would awake with some time. Never forget, level of sugar is not vital, never was. Even in America in present time 1 out of 2 diabetic is not diagnosed with diabetes. Later diabetic probably would have diagnose, and it will be type 2, non insulin dependent type of diabetes. Treatment with metformin and Invokana, and SU will speed fatality. Diabetic who survived many years without treatment would gone less then withing ten years after diagnose of diabetes type 2 was stamped. Heavy abuse, Barking Therapy, and Cook Book Medicine do great job to make life of medical victim miserable and short.

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Diabetes Type 2 Cause and Development. Post 5. Frbruary 20, 2019

Classification of diabetes.
In 1979 national diabetes data group (NDDG) in 1979 suggested a new classification to diagnose diabetes:
type 1 insulin dependent diabetes;
type 2 insilin independent diabetes;
diabetes in pregnancy.
 It was stated in that time that once type of diabetes was diagnosed it stay for the life with patient, even patient does not have those marks as it was in time of diagnose. So, regardless how advanced diabetes type 2 become, it still insulin independent type of diabetes and so treated with oral agents rather then with insulin. The absurd of this classification was clear even at the time this system had  been introduced. But soon a new classification become most popular and medical providers welcomed it gladly. Why not? At first MD decide what is best for MD to Rx to patient, and then diagnose made. Usually there are no endorsement for insulin therapy. At contrary all oral agents manufactures fight for doctor's Rx. Also with insulin there is danger that patient will get low sugar. No any problems with oral agents.
   Treatment Before Diagnose was widely acceptable. In present time 95% of all diabetic population are not insulin dependent diabetics type 2, even we take insulin in high dose, or admitted to hospital with ketons in urine. Diagnose stay effective regardless what the condition of patient.

While proposing the intern classification based on clinical and laboratory characteristics they should be usable even when the information is incomplete. It was further emphasized that "cases in clinical or epidemiological reports be described by certain ready available indices that are, in a scene, classifying terms. they include age, sex, proneness to ketosis, types of treatment (insulin or non insulin) , age group at onset, fatness as appropriately defined, and familial tendency." ( page 25)

World Book of Diabetes in Practice.
volume 3.
edited by L.F. Krall
Published November 1988
Elsevier
         As it is seen from this classification standards there is diagnose according to treatment, insulin or non insulin. So, if diagnose was wrong then there is noway to change it. Diagnosed type of diabetes stay for the rest of diabetic's life, and so the treatment, insulin or no insulin.
      Right after classification of diabetes was developed it became clear that significant port of diabetics do not fit into these two types. One type of diabetics are those living in tropical developing countries. They were grouped into Tropical Type of diabetes. Later this type of diabetes was re-named as Malnutrition - related type of diabetes classified in two major groups:
pancreatic fibrosis calcification syndrome;
ketosis resistant type of malnutrition - related type of diabetes.
     In present time only two types of diabetes remained in active diagnostic for all diabetics. 95% are diabetics type 2, and 5% left to all type 1 diabetics and pregnant woman with diabetes. Today it does not matter if diabetic fit into classification or not. The stamp is clear, type 2. Children as young as 6 years old, or even 2 years old diagnosed with type 2 diabetes and treated without insulin, with life style modification. Classification of types of diabetes fit perfectly into MD pocket. Mortality of diabetics type 2 is higher then it was in time before insulin discovery.

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Diabetes Type 2 Cause and Development. Post 4. Frbruary 19, 2019

Prediction from the past by MD.

"We pay great attention to weight loss in the treatment of type 2 diabetes despite the fact that many of those patients are nor fat and that many who are respond to treatment without, or before, losing weight. The problem is not that we do not know how to lose weight but that the mean of doing so, under-eating, is often unacceptable.
      I predict with confidence that dietary teaching and fashion, which have changed so much in recent years, will continue to change. Passionate controversy will not cease.
      Self - monitoring of blood glucose will improve and spread, to the good of most diabetics, but the confusion and distress of same.
      In this chapter i have attempted to make prediction about clinical diabetes over such a long period that i will not be possible to refute them in my lifetime. but that prediction may be wrong. (page 389)

      What is right in this prediction and what is wrong? Prediction was published in 1987. At that time a new classification divided diabetics to type 1 and type 2, non insulin dependent diabetes, NIDD.  Now it is 2019. Almost 30 years after this prediction was published.
       According to ADA diabetes type 2 can be cured with starvation diet. Professor R. Tylor cured his patients with his well paid to him commercial shakes. 11 diabetics type 2 were cured. How? For how long? No evidence. At the time when treatment was done level of sugar was about normal. After that Professor R. Tylor did not see his patients. Are they cured and stay diabetes free for now? Are they alive? Are they still diabetics? As professor R. Tylot said, they still eating. Good to know. At least they are alive.
      Based on the discovery of professor R. Taylor Dr. Oz developed his own diet plan and he present that 11 millions of diabetics where cured with this plan.I posted this post, and I got some comments on my blog. People posted, he did not return money as he promised if they do wish to stop this treatment. So, I think that 11 millions are those who paid for treatment but never were cured with Dr. Oz diet plan. But it is only what do I think. Personally I do not trust that diabetes would be cured withing 11 days, 45 days, and any days. I am skeptical.
      There is another treatment for diabetics type 2 to cure diabetes. It is Weight Loss Surgery. So, if I do have generic abnormalities in some part of my body which leads to effect insulin secretion by my pancreas, then stomach  reduction is best way to cease these abnormalities and cure diabetes, right? I am still skeptical. As I do know so far, after three years weight return, and really what is the point to suffer? Second what I do know when I lost 60 pounds, I still need to take insulin. So, what is the point in all that weight loss if I need insulin anyway? And finally, after surgery there are so many complications that with my very delicate health I probably would not survive to enjoy healthy diabetes free life. I better to stay with my 400 pounds, and ride my Swallow to Metropolitan Opera. I even still able to get to Family Circle. It is top of the house.
      As I posted many times, the fact is, from all overweight and obese population only 20% are diabetics type 2. Another 80% are not diabetics.
     Another part of prediction that with weight loss by any mean diabetes would not ceased or prevented or cured. Is it wrong? Was it right?
Today diabetes type 2 is number 7 cause of Death in Death Certificates. 80, 000 Americans lost lives to diabetes every year. In contrary with weight loss passion that it is best treatment for diabetics type 2, they lost weight right before their death. This action did not safe their lives. Another fact that about 200,000 diabetics type 2 die every year by any cause of death. Most of these deaths are 100% preventable.
      With so many complications and so devastated effect on human lives why level of sugar in blood still not vital? I see only one reason for that. Diabetes is not contentious. We are not tread for society. Ebola was ceased. STD were ceased. TB is not tread right now. Diabetes takes higher toll. We blamed we do not care, we are just lazy people. Show me how to lose weight without food restriction? No evidence it is possible. Still there are many evidence that with any attempt to lose weight, only 5% able to keep what they lost. 95% get it back and usually with ++++++.

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Diabetes Type 2 Cause and Development. Post 3. Frbruary 18, 2019

Classification of Diabetes.
       In present time classification of diabetes present diabetes as type 1, diagnosed usually in young people, type 2 diagnosed in adults, LADA diagnosed adults without obesity, and diabetes in pregnancy. If classification is wrong then diagnostic will be wrong, so do treatment will be wrong. Now, with the fact that 95% of diabetic population are diabetics type 2, type of diabetes developed as the result of overweight and obesity, then it is easy to see the confusion in classification. Maybe it is time to a new diabetes classification, regarding on medical state rather then weight f the body?
      There are well known classification in medical treatment for all sociological states of human development. It is infancy, childhood, adolescence, adulthood, geriatric stage of human grow. In every stage of it the medical treatment and disease development are different. No one pretend to treat infant in the same way as it is senior. Even they do have the same decease such as TB or diabetes, or flu, the treatment will be different. The same we can say about development of disease. It is fast riding in infants, and slow developed in adults. What is fatal for infant will not kill adult.
      It is the same rule for development of diabetes. In some patient diabetes developed in late stage of life, in senior years. In other patient diabetes developed in childhood. The same as some infants born diabetics. The treatment cannot be the same. So, the classification of diabetes, if it is type 1, type 2, type 1.5, or any other types it would be, wrong.

"Occasionally some infants suffer from hypoglycemia following protein intake. This has been shown to be +due to the absorbed leucine, to which the beta cells of these infants are sensitive."  (page118)

     What MD doing in this case? Low sugar is very danger, for infant it can be fatal. Low sugar lead to bran damage. Treated wrongly, infant can be destroyed right before mother took baby on her hands. In some hospitals infant's pancreas would be removed. This is barbarism in diabetes education to medical providers. It is sound stupid and that it is my fantasy. It is not, sad to say so. With open mind it is easy to see the same barbarism in treatment of millions of adult with diabetes type 2. What is idea that diabetes type 2 may be reversed with starvation diet? Is this scientific study, or primitive barbarism? It is not my fantasy. It is ADA recommendations.
       The same I can say about pre-diabetes. Really, what does it mean? One is not diabetic yet, but one will be if one will not lose weight. What are the scientific studies behind this? What are evidence that this patient is not diabetic? No one. One is already diabetic, was born diabetic. If proper examination of kidney, eyes, plasma blood, and many other tests would be run, it will sow that diabetes was before any diagnose was made. If so then say me, how proper diet can fix pancreas abnormalities? What are those abnormalities? No one understanding in the cause of diabetes.
      It is understandable. Medicine is not the fantasy, and it cannot be in front of human industrial development. The problem is not with demand to answer to the question which today has no answer. The problem is in the understanding the place of medical profession and where these providers stand. Every one of them know very well, diabetes was not caused by obesity. If so then why it is so hardly pushed to blame ill people that all what they have is caused by their laziness and careless? It is not. We were born diabetics. Diabetes abnormality is in our genetic.
        OK, today it is not possible to diagnose diabetes according to genetic diagnostic. Still, it is possible to treat diabetes effectively in present time and avoid millions of unnecessary death, pain, amputations, suicides, you name the rest.     

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Diabetes Type 2 Cause and Development. Post 2. Frbruary 18, 2019

          In present time it is wide spread medical assurance that with right diet and weight control diabetes type 2 can be reversed. How this was proved? The blood sugar dropped, so it mean that diabetes reversed. The same point as it is with starvation diet, or any other diets with restricted meal supply. Most important prove of this starvation medicine and diabetes control, after 'treatment ' was done, do not take blood sugar level, and of cause do not record how fast blood sugar raised after 'treatment' and 'reversed' diabetes returned to the higher stage of its development.
      There are reading of medical book I copied from.

Clinical Symposia.
volume 15, number 4, October - November - December, 1963. 
Diabetes Mellitus
by Bachmeil, Levine, MD. 
J. Harold Walton, M.D., editor.

"First was discovered that a young woman from diabetic family would tend to have babies with birth weights as high as 10 to 11 pounds, A large number of such women develop typical metabolic diabetes some years later." (page 122)

        In present time before woman will give birth to baby with high birth weight woman tested for diabetes, and treatment with insulin would be started.  There are many chances that baby would be born normal weight and diabetes - free or with mild diabetes in its development. Still, what is about mother? after baby was born is there are some medical attention to the mother? No. Attention to the baby, but not to mother. This is why women develop diabetes later. They already did have it, and the damage of diabetes was present in every cell of these women. No diagnose. No treatment. Only if woman try to get health insurance the blood sugar test would be run and .... insurance would be denied due to pre-existing condition. Sad story.

"Recently when insulin essays become available, it was found that in most pre-diabetics the insulin level tends to be higher than normal. Also found in pre-diabetics and diabetics are substances in their plasma which inhibit the action of insulin." (page 123)

This substances  mistakenly assumed to be cholesterol, and this is why all diabetics type 2 have high cholesterol level. The treatment is not expensive so all diabetics type 2 have statins in their medical box. No one of them work. Cholesterol level getting higher and higher till finally kill the  diabetic';s heart. When instead of all Atrovastatin, provastatin, simvastatin and all other statins Lipitor taken, cholesterol level returns back to normal. Good way to safe diabetic's type 2 heart. Lipitor is Brand Medicine. It is very expensive, so it is never in medical box of diabetic type 2. Only those who have good doctor and good health coverage able to get this medicine and safe own life.

 "Another characteristic abnormality in people now called "prediabetics" was the occurrence of low blood sugar rather than high, indicating perhaps a hyperirritability of the beta cells." (page 123)

      In present time medicine such as Metformin used to increase sensitivity to insulin by liver and muscles.  In spite of all stimuli blood sugar still high. The ability of cells to reduce devastating abnormalities which lead to fatal end, already used, and do not effective any longer. Those who take Metformin as first line of anti diabetes medicine, stop to take it, and see, if sugar in blood would rise or drop. If sugar in blood rising then re-start metformin. This medicine is right for you. If blood sugar dropping or stay the same then why do you need to take metformin? Only to collect side effects if you need them.

"Still another line of evidence has been derived through the electron microscope. Kidney biopsy, long before functional abnormality is present, has shown thickening of the basement membrane in glomerular capillaries." (page 123)

This is message for good mother. Do not blame little one that bed is wet.  Ask doctor if your kid is diabetic. And even more then that. Buy your own glucose meter and check blood sugar level every time when your kid has school tests, or there is rainy days, or it is flu season, or it is Winter. Do not let your kid to develop level of sugar up to 800 mg/dl. And do not let your kid to take any anti diabetic medicine but insulin. Low dose of insulin is safe for kid, or any adult. Regardless one is diabetic or not. Less then 10 units, and every one is fine.

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Diabetes Type 2 Cause and Development. Post 1. Frbruary 18, 2019

       As we have pointed out in previous sections, derangement of beta cells function is not the entire story in the development of diabetes. Other glands of internal secretion may be involved, insulin may circulate in a bound, inactive form, or antibodies destroying its effect be formed.
       Moreover, as diabetes were seen for longer and longer period and other members of diabetic families were studied, it become obvious that diabetes is an inhereditary disease. Certain members of the families of known diabetics were found to have a number of peculiar characteristics even though their blood sugar were normal at the time of examination.
      From all the evidence it has become obvious that the diabetic inherits some unknown abnormality which causes changes in blood vessels throughout the body, including pancreas itself. Thus from many standpoints, the "prediabetes" is a diabetes long before the metabolic abnormalities become apparent. In order to emphasize this fact, we prefer the term "diabetes premelitus," or diabetes before sugar abnormality. Research  in the area is essential if diabetes is to be better controlled than it is today. (page 122, 123)

Clinical Symposia.
volume 15, number 4, October - November - December, 1963. 
by Bachmeil, Levine, MD. 
J. Harold Walton, M.D., editor. 

      After insulin discovery there are many studies were run and published before 1980 when classification of diabetes had been changed and diabetes type 2 as it is non-insulin dependent type of diabetes started its Deadly harvest. Those who were diagnosed with diabetes before 1980 still have insulin as treatment. For 95% of diabetic population insulin no longer was available. Barking Therapy, Weight Mocking, and other types of abuse therapy were developed. To add drama, there one after another oral anti-diabetic agents started to flood market. If without them diabetics could live then with this therapy beta cells started to stop secret insulin, and diabetes, which was considered as mild form of diabetes took its toll. Today every one out of ten is diabetic. Every one out of two diabetic population is not diagnosed diabetic. 
      How diabetes diagnosed according to ADA recommendations? Level of sugar in blood. It is higher then 100 mg/dl fasting, or higher then 200 mg/dl random level of sugar. No other tests. GTT test or A1c test are the same, just level of sugar in blood. What is pre-diabetes? It is medical condition when sugar in blood higher then normal but still is not so high to be treated. Even in this stage there are complications already developed, diabetic has no treatment, no understanding what is going ob with his or her health. 
      As it is said by Bachmeil, Levine, MD., if treatment started early then it is easy to control blood sugar. At the same time many devastated fatal complications never would be developed because of abnormalities under treatment and control. And the fear of devastated low blood sugar would be vanished. When level of sugar is not on critical scale the less dose of insulin needed, and the gap between insulin secretion and insulin in demand is narrow and shrinking. 
      If today older generation like me and my peers is not possible to save then our children and our grandchildren can be effectively and successfully treated and cured. Every new generation out of diabetic patients will come healthier and stronger. Yes, they will live longer.

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Business of Medicine for Diabetics type 2. post 5. February 17, 2019

       The matter of fact, changes coming regardless of how they were suppressed. It is progress, and it never stops. There is no need to post about history or any sociological effect changes bring to human society. So, it is only matter of time when diabetes finally would be cured, with insulin or with some sort of genetic modifications. For today millions of us suffer needlessly. If we cannot be cured then we can be effectively treated and our lives would be less miserable then it is now.
       The point is, why try to stop progress and keep humans in suffering? As I posted not once, just the one change, such as accept level of sugar in blood as it is Vital, and millions of diabetics would be diagnosed with diabetes right away. Start treatment with insulin injections, and there is no need to let diabetes be developed in type 2 stage, when dose of insulin is higher then 200 units, and blood sugar level above A1c=11.2%. Just think, what is this level? How diabetic was bring to develop this level of sugar in blood in out modern society where medical check up must be done starting from birth? But it is in medical ADA standard recommendations how to treat diabetes type 2 with injectables. It is nothing unusual for medical teams to have diabetics type 2 in medical clinic with such blood sugar level.
      My point of today's post is not about how to treat diabetes type 2 but about place of diabetics in modern society. Today we are mocked and bulled. We are fatty and very weak. Very often we hardly able to walk. This presented it is because of overeating. As I said above, make blood sugar vital and see if it is true of false. With blood sugar tested early in life the myth that diabetes type 2 developed because of overweight and obesity would be broken. Millions of perfectly fit diabetics would be diagnosed with diabetes. Today they are out of check up. They are not in rick to develop diabetes. Why they must be in stage of risk to develop what they already do have? They are those diabetics who are not diagnosed with diabetes. One out of two diabetics is not diagnosed diabetic. Still, they are not healthy. Slow but steady they go toward obesity trying to survive.
     I was a student in college when I started to feel very hungry. After meal, regardless if it is small meal or big meal, I was more hungry then before I started to eat. It was against all odds. We eat to be full, just take a little bit more and there is no hunger. This does not work for diabetics type 2. Regardless we eat more or less, we still hungry, extremely hungry.
     So, I decided, it is sort of nerve effect. I am full, I have to be. All what I need just accept I am full, and do not eat more. I had done it. It was no so difficult. Just less then two hours, and there is no hunger at all. It is not that I am full. I am weak. I could not eat anything. Vomiting took out all what I tried to swallow. Very severe headache. My man called 911. I spent a few hours in ER, and was sent out in the middle of the night. I was not diagnosed with diabetes at that time, and no one checked the level of sugar in my blood.
      I learned my lesson. No any resistance. If I an hungry I must eat, regardless how much I have to swallow. It worked very good. I added 100 pounds in short time, but I survived. About year after that I was diagnosed with diabetes type 2. Why not? I was overweight at that time.
      I do not post it hear to get some sort of pity. I do not need that. All what I try to say, if level of sugar was vital then diagnose of diabetes was early, treatment with insulin was started right after diagnose, and today I would not have body of 400 pounds. As it is published by ADA diabetics gain weight with insulin, but it is about 5 to 10 pounds. I could live with that.
      Without insulin I collected almost 300 pounds. If I was diagnosed back then and started to take insulin injections today I would be able to function, and less then 50 units a day may be good for me. I inject 480 units daily right now. Highest dose of insulin I injected was 814 units within 24 hours. It is $10,000 for three month supply. It is $40,000 per year. To add cost of diabetes add cost of motor wheelchair, all medicine I take right now, and cost of home care, I do not have but I do need it. I am not able to take shower, or to dress.

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Choosing a First Injectable in Type 2 Diabetes: Try a GLP-1. February 15, 2019

Choosing a First Injectable in Type 2 Diabetes: Try a GLP-1
by Jay H. Shubrook, DO; Neil S. Skolnik, MD
Reallly, why take any injectable but not insulin? Is there some reason for that?

GLP-1s that used to be given as twice-a-day injectables and then daily injectables have now become available as once-weekly injectables, making the idea of injectable therapy a lot more tolerable for our patients.

       It is good to take one shot weekly rather then  four shots daily. Why do I take four shots daily? Because of my diabetes is so advanced that dose of insulin I have to take is very high, so I have to divide it for four portion, at least keep injections under 100 units. Now, when it is said that medication to treat diabetes must be taken once weekly, what does it mean? Simple, it is mean-less. In the Standards of Care for people with diabetes ADA suggest to provide individualized care, and now what? One dose - fit- all ? It is diabetes type 2. Dose of insulin is not only different for every diabetic type 2, but even for the same diabetic it is different day from day.

Shubrook: Absolutely. I know that when I tell my patients that there are injections that can help them lose weight, I see a big change in the acceptance of injections. Now that we can administer them less frequently, they are even more attractive to our patients.

      I think that Mr.  Shubrook has no one idea that diabetes type 2 never resulted by obesity. The matter of fact that 80% obese people have no diabetes. Less the 20% are obese and diabetics. Also when sugar got out from system diabetics start to lose weight. At the time of treatment many not only do not lose weight but gain it. So, what really do GLP-1 doing? Are they effective as anti-diabetic drugs? Not at all. They cannot be.

 Skolnik: That is one of the important reasons why GLP-1s, not insulin, are now recommended as the first injectable for our patients with type 2 diabetes who have not reached their A1c goals with two or three oral agents. This is not an unusual scenario.

       So, when diabetic takes two or three oral agents and did not reach A1c goal, what does it mean? Should diabetic add-on injectable GLP-1? Should diabetic drop all oral agents and take only GLP-1? We can speculate about effect of any anti-diabetic agents or injectables, but still, they are not effective. It is said right above, two or three oral agents taken by diabetic type 2 and still A1c is higher then goal. To add drama the goal is not as it is non-diabetics level of sugar, healthy level, but  recommended for diabetics as a goal by ADA.  Normal A1c =4.5% ADA recommend to have A1c=7%, and sometimes even 8% considered to be acceptable. Why? because of no one anti-diabetic medicine works the same as it is oral agent or any injectables.

When you think about it, in the old days—which right now in medicine is prior to 2 months ago—we used to always start with insulin. Patients were afraid of insulin because it could cause hypoglycemic episodes and it predictably caused a good bit of weight gain, about 5-10 pounds.

The matter of fact, in past when Insulin was first line treatment for diabetes patient took it and now they live with every day injections 60+ years after being diagnosed as insulin-dependent diabetics. In contrary, those who were diagnosed with diabetes type 2 and treated with oral agents departed withing less then 10 years after treatment started.  

Now we're able to offer a GLP-1 receptor agonist as the preferred agent for the first injectable.

Good question is, what good is this medicine for?  To speed trip to Funeral Home? Or to delivery more money into someone pocket? Who you serve, Mr.Skolnik, MD?

Shubrook: I want to fine-tune it a bit. Does that apply to everyone, regardless of the person's A1c? Is that everyone, regardless of the medical history? Who are the best people for a GLP-1 receptor agonist?

Very good question.

That's a great point. We always want to be careful about blanket statements. Since our time is limited, let's say that this applies to most people. Patients with a very high A1c, over 11%, who are symptomatic and losing weight may benefit from insulin as the first injectable. They may have an insulin deficiency, which will not be addressed by a GLP-1 alone. 

Now I lost. Just above it was said that

When the GLP-1 receptor agonists have been compared with insulin in head-to-head trials, they are as good or better than insulin at lowering the A1c and controlling glucose. For those three reasons—efficacy, decreased hypoglycemia, and weight loss instead of weight gain—the new guidelines clearly recommend GLP-1 receptor agonists as the preferred first injectable for patients who have not achieved adequate control on two or three oral agents.

and just next paragraph, insulin must be used and GLP-1 alone would not effective. Am I messed something? Insulin is effective without GLP-1. GLP-1 is not effective without insulin. So, how data were collected in head-to-head trails that GLP-1 is better then insulin? LOLOLOL. At least, read what you publish. Someone able to read what you said with opened mind, and do not let spaghetti hang on from nose.

Shubrook: What I'm hearing you say is that when considering a first injectable for someone on two or three oral meds who is not at goal, following the guidelines should lead to consideration of a GLP-1 as one of our first choices, for two reasons.
First, we're potentially going to get weight loss rather than weight gain. Second, we are going to have a lower risk for hypoglycemia with an equivalent, or sometimes more effective, lowering of the A1c.
Shubrook: Now we also have evidence that GLP-1s may actually reduce cardiovascular (CV) risk. We know that insulin doesn't necessarily raise CV risk but it certainly doesn't lower CV risk, so that's icing on the cake for people who have established CV disease.

It is good to have so nice effect:
no low sugar;
weight loss;
lower CV risk.
What about lowering blood sugar?  How blood sugar lowering with GLP-1? No one word about it. How to get from A1c=11% down to 4.5%? That's right. It is all about : "I told you so!" but nothing about main point, how to control blood sugar with GLP-1? Just nothing.

Shubrook: I also want to highlight, as we mentioned earlier, that if you have someone with a very high A1c who appears to be glucose toxic, insulin may be your better first choice. As you mentioned, insulin and a GLP-1 combination may provide even more benefits by reducing glucose toxicity in addition to some of the benefits of the GLP-1.

       Insulin by itself is difficult to dose. If there are GLP-1 which as it is presented  low blood sugar and GLP-1 which also low blood sugar, then what about side effects and medicine interaction? Of cause it is just rhetorical question. In hospital no one MD will treat diabetic with this combination therapy. Why at home patient has to use medicine which no one MD can use properly?
     At least, this medicine is not for me. No Combination Therapy!

via Ravenvoron

Business of Medicine for Diabetics type 2. February 15, 2019

       Treatment with insulin has two main value. At first, with right insulin therapy at right time diabetes type 2 may be cured. This means that many Med. Pro, who today educate diabetics how to eat, or MD who know only how to Rx SU and Metformin, would lose the job. Second, is high complication of treatment with insulin. If there is too much insulin then low sugar and coma may follow. If there is too little insulin then slow death is follow. Most important, there is no any formula how to find right dose of insulin right for every injection.
     This is why it is important to detect diabetes type 2 as soon as it is possible, and start Insulin Therapy right away. When sugar is not high, then dose of insulin is low, so there is no low drop in glucose level. When sugar is too high then every insulin shot is stress. After insulin shot sugar drops and then higher level of sugar then lower it is dropping after insulin shot. With moderate level of sugar diabetic type 2 adapts slow, and easy to find the way to use insulin the best unique way.
      Insulin may be started with lowest dose, just 10 units a day. Even non diabetic can inject this dose safely. Then slow rise the dose. Better to take two injections to spread insulin dose in two parts. Usually it is recommended to take two different types of insulin: long acting slow release type of insulin to cover base needs, and rapid acting insulin which works only two or one hour and used to be taken with meals. My personal way is only one type of insulin, slow release Insulin.
      Slow release insulin will work in both ways, to cover meal, and to cover base needs for glycogen which released by liver between meals. ( I usually miss glycogen and glucagon, sorry I am not med pro and all this is only my own experience, no medical advice).
       As I see from my experience when I take insulin shot before meal, it start to work right away. I even use insulin when sugar is low. It is odd, not as it is usually recommended. The point is, when there is no insulin then we are hungry, extremely hungry, and eat more then we need. Cell is hungry, demand nutrition, but there is no insulin and nutrition cannot be used. Satisfaction come too late and very slow. In contrary with insulin shot even when sugar is low, there is no hunger. All going smooth, right as it is needed.
      I never was told to take shot of insulin in case of low sugar. I just started it, and it worked for me perfectly. But really it is too scared to take insulin shot when sugar is already low. This is why I take very low dose, just to speed process of food utilization. With time I got used it and be comfortable. Also with time low sugar is not so devastating low as it is 38 mg/dl. I do not remember when last time I had so low sugar, even now I take highest dose of insulin, around 500 units daily. As I see from my experience, it is not dose of insulin which leads to devastating low sugar, but the condition diabetic is. Low sugar as low as 38mg/dl and in this situation I was not able to eat by myself, might be with insulin dose 100 units, or even 60 units, but no low sugar with 800 units.
     This is greatest paradox in Insulin Therapy.

via Ravenvoron

Spare A Rose, Save A Child

I've been MIA in the DOC since mid January. I'm back. 

#####

Click HERE to spare a rose, save a child. 

It's Valentine's Day and I have no doubt many are still scrambling for gifts. 

Instead of buying 12 roses, (or cookies 😉,) for someone you love, Spare a Rose, Save a Child, buy 11 roses (or cookies, or whatever,) and donate the cost of one rose ($5) to help deliver life-sustaining insulin and supplies to children who are in desperate need of insulin 

in under-developed countries. 

Over 140k has been raised since #sparearose began in 2013 - hopefully this year that number will be over $180,000. 

And if you don't have a Valentine, no worries - donate in honor of someone you've never met, but who will be thankful for your gift and impact your heart and soul in the process~

If you're able to #SpareARose and donate, please do. 

http://lfacinternational.org/sparearose/

via Diabetesaliciousness

Business of Medicine for Diabetics type 2. February 14, 2019

        Now, there is another look. Let picture that there is no business in medicine, it is just mercy and help to those who suffer, morally pure human passion. Would this work? No. And who would be suffer at first? Those who are poor and ill. Those whop is able to pay will have medicine regardless it is business or mercy. Those who has no money would relay only on charity. There would not be so many MD who is able to provide care and care cost money does not matter how and by whom it paid.
       Is there are some solution for this so controversial reality? I hope it is possible. But at first business of medicine should not be on expense of patients, regardless what are those   expenses. Every illness or sickness, every health condition or health complication must be treated for everyone, if we pretend to call ourselves to be developed and advanced society. 
       Is this really true that Med Pro have nothing to do but only collect money out of patient pocket or society? There are a lot of work to do, studies, prevention, education, and of cause treatment  when it is needed. It is interesting that when one got flu or cold then no one MD educate patient to put on worm jacket when it is cold outside. This is Elementary. But at the same time everyone MD educate diabetic type 2 what to eat and how to do so. Every one of them know very well, diabetes is not resulted by body shape. It is body shape developed in the way how diabetes effected it. This is also Elementary.
     When patient enter into clinic what is first step MD is doing? Takes vitals: temperature of body, BP, breathing, heart rate, and so on. Blood sugar level never checked up. Why? Glucose strip does not cost more then any needle or thermometer.  No one can see by naked eye if there is insulin in blood or high sugar. In regard of level of sugar in blood any treatment for any condition would be effective or not.
    Millions $$$$$ spent to prevent Diabetes type 2. Millions of lives saved with reduced Soda can size. Why not? It is only one out of ten people is diabetic. Nine people still diabetes-free. At the same time every one out of two diabetics is not diagnosed with diabetes. Why not? Because of they are not in risk  to develop diabetes, they are still not overweight or obese.
     In his books Dr. E. Joslin all the time presented that diabetics who are overweight eat without stopping, and this caused diabetes. It is all the time easy to say, when there is no responsibility to hold. The question is, why people do not stop to eat? Of cause if one eat without stopping then obesity is not possible to avoid. Is it possible to stop overeating? I wish to say, why Alcoholism is out of discussions? Why drug abuse is out of discussions? These patients have rights, and no one will be allowed to take picture of drunk man or woman. But it is custom for every one who wish to take picture of obese person and post it all over internet, collect them in gallery, and so so so on. Then it is discussions. mocking, abuse. Is there are someone will stop these humiliation of fatally ill people? No. We die because of we refuse to stop to eat.
     Really, why should I stop to eat? Would I diabetes-free if I do not eat? Not at all. My skeleton hold sugar. So even after ultimate weight loss my remains still hold sugar, and it is diabetes, regardless where sugar stored, in urine, in blood, or in bones. We eat because nutrition is primary need to survive. Without food human done less then two weeks. There is no need in alcohol. Just stop to drink it, and one is no longer ill alcoholic. There are many programs to treat alcoholics in this way. They have to stay clean, no alcohol at all. Very small shot of alcohol will lead to break all what was done to keep ex-alcoholic alcohol-free. But it is presumed that every one diabetic can do that, simple stop to eat, and there is no diabetes, diabetes type 2 reversed forever. Many believe in this nonsense.
      Still, there is medicine to treat  diabetes deep, right on to its roots. It is Insulin. Insulin only in present time. When this medicine would be as first line in diabetes treatment and level of sugar would be vital, then diabetes type 2 would be cured, and no obesity at all.

via Ravenvoron