The progressive nature of type 2 diabetes (T2D) requires practitioners to periodically evaluate patients and intensify glucose-lowering treatment once glycemic targets are not attained. With guidelines moving away from a one-size-fits-all approach toward setting patient-centered goals and allowing flexibility in choosing a second-/third-line drug from the growing number of U.S. Food and Drug Administration–approved glucose-lowering agents, keen personalized management in T2D has become a challenge for health care providers in daily practice.Let us take very close look at the statement which published under ADA honorable name.
SGLT2 Inhibitors in Combination Therapy: From Mechanisms to Clinical Considerations in Type 2 Diabetes Management
http://care.diabetesjournals.org/content/41/8/1543
The progressive nature of type 2 diabetes (T2D)Say me what and how many diseases not progressive if left untreated or treated wrongly?You name it, I do know no one. If left untreated every disease lead to complications in one way or another. Diabetes type 2 is not different. What about type 1 diabetes? Does this type of diabetes progressive? Of cause, if it left untreated or treated wrongly with incorrect dose of insulin. But when treated, type 1 diabetes stop in progress and can even regress, be reversed. Take a look at the history. Type 1 diabetics who were diagnosed with diabetes before 1980 still alive, and do live about the same as long as non diabetic population of their time and place.
What is conclusion? The progress in diabetes type 2 development from pre-diabetes is result of treatment, wrong treatment with wrong medicine. With right medicine diabetes type 2 would be stopped. In present time there is only one medicine which can do the job, Insulin. Insulin is effective to treat any type of diabetes, in the same way.
With guidelines moving away from a one-size-fits-all approach toward setting patient-centered goals and allowing flexibility in choosing a second-/third-line drug from the growing number of U.S. Food and Drug Administration–approved glucose-lowering agents, keen personalized management in T2D has become a challenge for health care providers in daily practice.What is difference between "a one-size-fits-all" and "patient-centered goals"? There is no such goal as patient-centered. The goal is to treat diabetes type 2 and cure it, or at least with treatment to hold diabetes under tight control. So, what s the reason to move to the goal which has no meaning? Of cause providers need freedom and flexibility to choose drugs but to say it is a challenge to them is way too odd. Really, whom do you fool? All that drugs are the same, and the fact that there are so many of them is only to let providers to play with them, to chose one which does not work and replace it with another, which does not work.
Take a look at the drug ADA suggest to chose from?
Food and Drug Administration–approved glucose-lowering agents...The cause of diabetes is problem with insulin secretion, demand in insulin needs for healthy body system function is higher then available insulin secretion by body system. So, regardless what tricks ADA or FDA or any MD use to fool diabetic, the result is the same, mortality. When insulin added as add-on to personal insulin secretion there is no other glucose lowering agents needed. The end of Diabetes. With every new generation diabetes would regress, and finally all other medical conditions will delay in development. Just start to treat diabetics type 2, stop to kill us. We are survivors.
The preferred and most used first-line pharmacotherapy to manage hyperglycemia in T2D is indisputably metformin.Every one diabetic able to check up, is metformin reduce blood sugar? Take reading without metformin for a few days, and then start to take metformin. Compare readings. Do readings go down? If they do then metformin is right for you, but keep eye on readings. If readings does not go down, or even go up, then stop metformin. It is wrong medicine. Usually in this case MD increases dose of metformin. But if metformin does not do the job then it dos not matter what dose diabetic take. It is only increased side effects, and poison effects.
Yet, six drug classes are currently recommended by the American Diabetes Association (ADA) and European Association for the Study of Diabetes for combination therapy on top of metformin: sodium–glucose cotransporter 2 inhibitors (SGLT2is), glucagon-like peptide 1 receptor agonists (GLP-1RAs), dipeptidyl peptidase 4 inhibitors (DPP-4is), sulfonylureas, thiazolidinediones, and basal insulin.The same as it is with metformin do with every other drug which clamed to be glucose lovering medicine.
SGLT2 - is strong diuretic. When you start to take this medicine weight go down. Do not let be fooled by this peasant effect. All pounds will return, and pretty soon. Heart is most suffering organ when diuretics are in medical box. Stop to take diuretics, and heart rate go much better, smooth. Also before take this medicine think, for how long you can take diuretics? Diabetes is chronic condition. Medicine to treat diabetes must be for life long. Can you take diuretic for so long time?
sulfonylureas is medicine which force diabetic's pancreas to secret more insulin. When? Odd, is not it? Really what does it mean when SU force pancreas to secret insulin? As soon as they are taken. But I am sorry, it is not the time that my body system need them. What I try to say, if I took SU and watch TV why do I need insulin be secreted? I do not need it. But SU force my pancreas to work very hard. It is heat inside, like oven burning. All Beta Cells used to accommodate this SU just wasted. Remember, when insulin secretion dropped, SU stop to work. Blood sugar going up and up. Time to start insulin.
basal insulin is only medicine which works to reduce high glucose numbers. Diabetics type 2 are those who are Not Insulin Dependent Diabetes Mellitus patient. What is this ? Really odd. To treat diabetes diabetic type 2 must take over 200 units of basal insulin, and still, this diabetic is not insulin dependent. At the same time type 2 diabetics who take less then 25 units of insulin, and very often about 10 units of insulin, dose which can be safely taken by anyone non diabetic, they will die if the skip one shot of insulin.
Actually I think I already fooled over my limits. Time to take insulin and watch video when there is someone who looks fool, rather then play that role in reality.
via Ravenvoron
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