So many diabetics?



G

Guy

Guest
I do not know how to approach this issue. I am seeing dozens of people being diagnosed as diabetic
and being put on meds. I see people disturbed by reading of 105, 110, and etc I see people becoming
upset thinking their life is over because of this type of diagnosis.

I am aware of the early diagnosis arguments.

But somehow I become paranoid and think some of the motives are questionable.

In other problems an early sign indicated a close watch on a person and periodic follow ups.

It does no harm to eat the proper amount but I do worry about some meds and the stress put on a
person by the trend I am noting.

A friend had an infection and had slightly high blood sugar. He was given the full treatment. He was
very upset. Several checks show blood sugars I would love to have.

Now my clincher Could money be a factor today? Posted to provoke some discussion. Guy
 
How lives will be saved by early dx? How much is that worth?

HMO's want to get on the "prevention" trail as early as possible. They realize that it costs them
more money to let diabetes go unchecked. The sooner the dx the better. Better for HMO bottom line,
better for "Joe Sixpack".

IMHO.

They should make the cut off-line to be just over normal. So what if they scare you, good. Stop
smoking too while you're at it.

IMHO
--

t2_lurking geabbottATabbottandabbottDOTcom Do not mail to t2_lurking (auto-delete)
============================
Well, i dreamed i saw the silver Space ships flying In the yellow haze of the sun -- Neil Young --
====================
New to Diabetes? Go to: http://www.alt-support-diabetes.org
====================================================
"Guy" <[email protected]> wrote in message news:[email protected]...
>
> I do not know how to approach this issue. I am seeing dozens of people being diagnosed as diabetic
> and being put on meds. I see people disturbed by reading of 105, 110, and etc I see people
> becoming upset thinking their life is over because of this type of diagnosis.
>
> I am aware of the early diagnosis arguments.
>
> But somehow I become paranoid and think some of the motives are questionable.
>
> In other problems an early sign indicated a close watch on a person and periodic follow ups.
>
> It does no harm to eat the proper amount but I do worry about some meds and the stress put on a
> person by the trend I am noting.
>
> A friend had an infection and had slightly high blood sugar. He was given the full treatment. He
> was very upset. Several checks show blood sugars I would love to have.
>
> Now my clincher Could money be a factor today? Posted to provoke some discussion. Guy
 
On Fri, 13 Feb 2004 11:23:57 -0600, Guy <[email protected]> wrote:

>
>I do not know how to approach this issue. I am seeing dozens of people being diagnosed as diabetic
>and being put on meds. I see people disturbed by reading of 105, 110, and etc I see people becoming
>upset thinking their life is over because of this type of diagnosis.
>
>I am aware of the early diagnosis arguments.
>
>But somehow I become paranoid and think some of the motives are questionable.
>
>In other problems an early sign indicated a close watch on a person and periodic follow ups.
>
>It does no harm to eat the proper amount but I do worry about some meds and the stress put on a
>person by the trend I am noting.
>
>A friend had an infection and had slightly high blood sugar. He was given the full treatment. He
>was very upset. Several checks show blood sugars I would love to have.
>
>Now my clincher Could money be a factor today? Posted to provoke some discussion. Guy

I suspect you are right.

However, whatever the reason, I don't have a problem with early diagnosis if it leads to treatment
with proper lifestyle and diet advice as a first line before drugs; allied to counselling to
minimise the fear effects.

Unfortunately, it seems to be the other way around at the moment. First the drugs, then maybe a
dietician. And lots of fear.

Early diagnosis coupled to correct advice may have led to me abusing my body with incorrect diet,
cigarettes and no exercise for just a few years less. Who knows if that may have led to different
outcomes in other aspects of my medical situation.

Then again, I may have ignored the advice at that earlier time, when I knew I'd live forever.

JMO.

Cheers Alan, T2, Oz. dx May 2002 , A1C 8.2=>5.8, wt 117kg=>90kg, no meds, diet and not enough
exercise. I have no medical qualifications beyond my own experience. Choose your advisers carefully,
because experience can be an expensive teacher.
--
Everything in Moderation - Except Laughter.
 
t2l,

I could not agree more. First, "normal" seems to be arbitrarily defined too high. In the OGTT, you
can spike to 160 after 2 hours and merely be Glucose Intolerant. This is just plain wrong. If you're
breaking ~130 under almost any circumstances, you're basically diabetic, no matter what they call
you. The bottomline is that if you don't think and act like a diabetic, you WILL damage your body in
exactly the same fashion as a diabetic.

I can easily break 160 if I eat the wrong things (or even 190 if I eat lots of really wrong things),
yet am diagnosed with IGT because my 2hr-OGTT was less than 120. If I start thinking I am not
diabetic, I will do things that lead to complications and death. I *am* a diabetic, regardless of
what they're telling me. My heart wishes this were not so, and sometimes I fantasize that I'm merely
IGT, not diabetic. But every rational approach tells me the difference is just completely made-up. I
almost certainly have pancreatic (beta-cell) damage and a body resistant to insulin that cannot
handle carbs well. My genes are predisposing me to this (my mother is diabetic). In what way, except
for some random made-up figures, is this not diabetes?

I don't think the problem is that too many people are being diagnosed with Diabetes. I think too FEW
people are.

"t2_lurking" <[email protected]> wrote in message news:<[email protected]
berlin.de>...
>
> They should make the cut off-line to be just over normal. So what if they scare you, good. Stop
> smoking too while you're at it.
>
> t2_lurking geabbottATabbottandabbottDOTcom Do not mail to t2_lurking (auto-delete)
 
It's interesting the different ways that the whole diabetes thing could go. HMO's could start
denying, or charging more for people who have a diabetic in their family. Possibly my daughter's
child. Ever seen the movie "Gattaca" I think it's closer than we believe. On the other hand there is
the positive side of the same coin. Even two years ago who would have predicted the lo-carb craze
and the attention its brought to diabetes. Or the different kinds of oral meds. There's a lot of dollar-
driven light being focused on diabetes. I think the future is bright for younger people who are
dxed. You'd be hard-pressed to find a better definition of the word "dichotomy" Hope and Fear in the
same bundle. IMHO of course.

btw: 1. a division or the process of dividing into two especially mutually exclusive or
contradictory groups or entities

--

t2_lurking geabbottATabbottandabbottDOTcom Do not mail to t2_lurking (auto-delete)
============================
Well, i dreamed i saw the silver Space ships flying In the yellow haze of the sun -- Neil Young --
====================
New to Diabetes? Go to: http://www.alt-support-diabetes.org
====================================================
"carterjp" <[email protected]> wrote in message
news:[email protected]...
> t2l,
>
> I could not agree more. First, "normal" seems to be arbitrarily defined too high. In the OGTT, you
> can spike to 160 after 2 hours and merely be Glucose Intolerant. This is just plain wrong. If
> you're breaking ~130 under almost any circumstances, you're basically diabetic, no matter what
> they call you. The bottomline is that if you don't think and act like a diabetic, you WILL damage
> your body in exactly the same fashion as a diabetic.
>
> I can easily break 160 if I eat the wrong things (or even 190 if I eat lots of really wrong
> things), yet am diagnosed with IGT because my 2hr-OGTT was less than 120. If I start thinking I am
> not diabetic, I will do things that lead to complications and death. I *am* a diabetic, regardless
> of what they're telling me. My heart wishes this were not so, and sometimes I fantasize that I'm
> merely IGT, not diabetic. But every rational approach tells me the difference is just completely
> made-up. I almost certainly have pancreatic (beta-cell) damage and a body resistant to insulin
> that cannot handle carbs well. My genes are predisposing me to this (my mother is diabetic). In
> what way, except for some random made-up figures, is this not diabetes?
>
> I don't think the problem is that too many people are being diagnosed with Diabetes. I think too
> FEW people are.
>
> "t2_lurking" <[email protected]> wrote in message
news:<[email protected]>...
> >
> > They should make the cut off-line to be just over normal. So what if they scare you, good. Stop
> > smoking too while you're at it.
> >
> > t2_lurking geabbottATabbottandabbottDOTcom Do not mail to t2_lurking (auto-delete)
 
t2_lurking <[email protected]> wrote on Fri, 13 Feb 2004
11:49:56 -0600:
> "Guy" <[email protected]> wrote in message news:[email protected]...

>> I do not know how to approach this issue. I am seeing dozens of people being diagnosed as
>> diabetic and being put on meds. I see people disturbed by reading of 105, 110, and etc I see
>> people becoming upset thinking their life is over because of this type of diagnosis.

>> I am aware of the early diagnosis arguments.

>> But somehow I become paranoid and think some of the motives are questionable.

>> In other problems an early sign indicated a close watch on a person and periodic follow ups.

>> It does no harm to eat the proper amount but I do worry about some meds and the stress put on a
>> person by the trend I am noting.

>> A friend had an infection and had slightly high blood sugar. He was given the full treatment. He
>> was very upset. Several checks show blood sugars I would love to have.

>> Now my clincher Could money be a factor today? Posted to provoke some discussion. Guy

> How lives will be saved by early dx? How much is that worth?

How many lives will be wrecked by a premature and spurious diagnosis?

> HMO's want to get on the "prevention" trail as early as possible. They realize that it costs them
> more money to let diabetes go unchecked. The sooner the dx the better. Better for HMO bottom line,
> better for "Joe Sixpack".

What's an HMO, exactly?

I have to disagree with much of this. So what, if a 60 year olds's fasting BS is 110 rather than 80?
Is 110 really enough to cause complications? I doubt it. And anyway, by the time the complications
set in, he'll have died of a heart attack, or stroke, or cancer, or whatever.

> IMHO.

> They should make the cut off-line to be just over normal. So what if they scare you, good.

Uuurkkk!! Scared people are easily controlled, heteronomous[*] people. Scare people about
"terrorism", and you can do anything you like with their civil liberties. Scare people about
diabetes, and you can do anything you like with their wallets and personal lives.

[*] look it up for yourself!

Being drug dependent is intrinsically damaging. Habitual self-injury is also damaging. Diabetics
suffer from both, though the pros outweigh the cons for them. Scare somebody "just over normal"
by telling them they're diabetic, and they'll never be truly free, ever again. That diagnosis is
a millstone round their neck, no matter how hard they try to persuade themselves "it doesn't
really matter".

> Stop smoking too while you're at it.

Now there's a good idea!

> IMHO
> --

--
Alan Mackenzie (Munich, Germany) Email: [email protected]; to decode, wherever there is a repeated
letter (like "aa"), remove half of them (leaving, say, "a").
 
>"Alan Mackenzie" > How many lives will be wrecked by a premature and spurious diagnosis?

Depends on whether or not you view dx as "The End Of Your Life". I don't. It was a wake up call!
Wake the F%$K up and start taking care of yourself!

> > HMO's want to get on the "prevention" trail as early as possible. They realize that it costs
> > them more money to let diabetes go unchecked. The sooner the dx the better. Better for HMO
> > bottom line, better for "Joe Sixpack".
>
> What's an HMO, exactly?

Health Maintenance Organization An organization that provides comprehensive health care to
voluntarily enrolled individuals and families in a particular geographic area by member physicians
with limited referral to outside specialists and that is financed by fixed periodic payments
determined in advance.

> I have to disagree with much of this. So what, if a 60 year olds's fasting BS is 110 rather than
> 80? Is 110 really enough to cause complications? I doubt it. And anyway, by the time the
> complications set in, he'll have died of a heart attack, or stroke, or cancer, or whatever.

Sorry, I was thinking more of younger people. Buuut, just for the sake of... How'd one know that the
stroke or CVD wasn't helped along by undiagnosed diabetes? Those are complications of diabetes also.

> > They should make the cut off-line to be just over normal. So what if they scare you, good.

> Uuurkkk!! Scared people are easily controlled, heteronomous[*] people. Scare people about
> "terrorism", and you can do anything you like with their civil liberties. Scare people about
> diabetes, and you can do anything you like with their wallets and personal lives.

Can't argue with Human Nature, but I think you're overly pessimistic

> [*] look it up for yourself!

eh?

> Being drug dependent is intrinsically damaging. Habitual self-injury is also damaging. Diabetics
> suffer from both, though the pros outweigh the cons for them. Scare somebody "just over normal" by
> telling them they're diabetic, and they'll never be truly free, ever again. That diagnosis is a
> millstone round their neck, no matter how hard they try to persuade themselves "it doesn't really
> matter".

Well I guess that would depend on if you believe that if you're pre-diabetic that unless you take
corrective action you will become fully diabetic sooner rather than later. I believe that if you're
diabetic then you're diabetic. You can delay the metabolic action for years, but in the end you will
still be diabetic. However, who can say? It's still early (relatively speaking) in the game. Someone
who was dxed T2 in 2001, say, and used the current knowledge and in particular metformin, kept on
with anti-oxes and generally ate like we do now, could easily live longer than would be expected 5
years ago with no complications.

IMHO, of course. Google "Pollyanna", that's me!

> > Stop smoking too while you're at it.
>
> Now there's a good idea!

<<BRAGGING TIME>> Father's Day 2000

> > IMHO
> > --

--

t2_lurking geabbottATabbottandabbottDOTcom Do not mail to t2_lurking (auto-delete)
============================
Well, i dreamed i saw the silver Space ships flying In the yellow haze of the sun -- Neil Young --
====================
New to Diabetes? Go to: http://www.alt-support-diabetes.org
====================================================
 
>
>> Being drug dependent is intrinsically damaging. Habitual self-injury is also damaging. Diabetics
>> suffer from both, though the pros outweigh the cons for them. Scare somebody "just over normal"
>> by telling them they're diabetic, and they'll never be truly free, ever again. That diagnosis is
>> a millstone round their neck, no matter how hard they try to persuade themselves "it doesn't
>> really matter".
>
>Well I guess that would depend on if you believe that if you're pre-diabetic that unless you take
>corrective action you will become fully diabetic sooner rather than later. I believe that if you're
>diabetic then you're diabetic. You can delay the metabolic action for years, but in the end you
>will still be diabetic. However, who can say? It's still early (relatively speaking) in the game.
>Someone who was dxed T2 in 2001, say, and used the current knowledge and in particular metformin,
>kept on with anti-oxes and generally ate like we do now, could easily live longer than would be
>expected 5 years ago with no complications.
>
The question I really wanted to ask is---- if some of the "early" diagnosis and the treatments may
do more harm than a wait and see approach. I do advocate a modified food input program, I have seen
counter productive results from the quickie pill fix. There is a time when meds are necessary. I
would not last long without them. But I see an approach so often here. A new pill--an easy fix. I
have observed several people recently where I would go to a tough self control program and wait for
a while on the pills. The psychological harm and the economic damage of being diagnosed as a
diabetic is not nol be ignored. I am a bit alarmed by watching TV and se the pushing of meds. The
ads are not to do us good. They are to make money. Because I am a very noticeable diabetic, new
people come here and are in a panic. My life is over!!! Guy
 
This is where the moniker "pre-diabetes" is, in itself, dangerous. There is really no such thing.
Pre-diabetes = Diabetes. Just earlier in the same progression. You don't go from one disease to
another when your BG crosses from 138 to 142 in a 2-hr OGTT. A diabetic phenomenon has begun when
your BG breaks the normal levels (120-130 would be the high) regardless of what you ate to make
that happen.

I heard on NPR Science Friday not too long ago (you could try the RealAudio program on Nutrigenomics
at http://www.sciencefriday.com/pages/2003/Dec/hour2_122603.html - very interesting, humourous
debate that points out the DA Food Pyramid is actually dangerous to human health) that a cluster of
100-300 genes is likely responsible for creating a diabetic situation. Basically, almost ALL humans
have some ancestry in them that is geared towards surviving times of famine - of course, some more
than others. If the current epidemic in obesity continues 30%, or more, of the US population could
fall into the MetabolicSyndrome-prediabetic-diabetic complex of diseases. Some estimates say upto
70% of Americans have some varying degrees of Insulin Resistance.

Since you can have IR for years/decades before the pancreas become overworked and start to die
causing bg rises, by the time you have even small abnormal bg rises, your pancreas are usually
already damaged. People like me, who are diagnosed with IGT/prediabetes, already have some beta-cell
death. People in this stage *are* diabetics, and someday will be called that. If they don't act like
diabetics, they will worsen their condition and head towards complications. I have read about at
least one doctor that said he finds early complications even at A1C levels of 5.5 or below.
Basically, if you have the tiniest persistent pot-belly, you should be tested for IR.

Diabetics can take charge of their lives when they know they are diabetics. Controlling BG to
control microvascular complications. Monitoring and controlling things like blood pressure,
which has been shown to help reduce macrovascular complications
(http://www.lipidsonline.org/slides/slide01.cfm?q=microvascular+complications&dpg=6).
Knowledge is power.

Also, 30%+ of the population is a massive pressure group - to fight for better treatment, easier
testing (e.g. intracellular fluid that doesn't require pricking, easier tests for insulin/IR levels
in addition to bg), more focus on control and that elusive cure - for our kids and grandkids, who
continue to carry the genes that make them vulnerable. In this last month, I have scoured Trader
Joes, Safeway and Albertsons (in California) with not ONE loaf of bread that I could find that was
free of refined carbs and sugar and honey and trans-fats. Why is that, when these substances are
somewhat toxic to 30-70% of the population?

>
> Well I guess that would depend on if you believe that if you're pre-diabetic that unless you take
> corrective action you will become fully diabetic sooner rather than later. I believe that if
> you're diabetic then you're diabetic. You can delay the metabolic action for years, but in the end
> you will still be diabetic.
 
I'm so wishy-washy that I can understand three approaches to diabetes dx.
1. Diet & Exercise Try to put off the evitable for as long as possible. No health insurance? Could
be most cost-effective.

2. Diet & Exercise & metformin Same as above, but metformin has other prophylactic characteristic,
it's being prescribed to people who don't have diabetes.

3. Insulin Why wait, as Al says "insulin works everytime".

The concept of using insulin to quickly knock down your BG's is valid to me IMHO! Remember I
said IMHO!

What isn't totally clear to me is how long and at what number to high BG's start to cause harm? I
accept that PP over 140 is is harmful, my program (as a T2) is geared toward sub 110 2 hrs PP.

Now the other thing I'm curious about is why the BG range seems to be different for T1's. But that's
an other thread.
--

t2_lurking geabbottATabbottandabbottDOTcom Do not mail to t2_lurking (auto-delete)
============================
Well, i dreamed i saw the silver Space ships flying In the yellow haze of the sun -- Neil Young --
====================
New to Diabetes? Go to: http://www.alt-support-diabetes.org
====================================================

"Guy" <[email protected]> wrote in message news:[email protected]...
>
> >
> >
> >> Being drug dependent is intrinsically damaging. Habitual self-injury
is
> >> also damaging. Diabetics suffer from both, though the pros outweigh
the
> >> cons for them. Scare somebody "just over normal" by telling them
they're
> >> diabetic, and they'll never be truly free, ever again. That diagnosis
is
> >> a millstone round their neck, no matter how hard they try to persuade themselves "it doesn't
> >> really matter".
> >
> >Well I guess that would depend on if you believe that if you're
pre-diabetic
> >that unless you take corrective action you will become fully diabetic
sooner
> >rather than later. I believe that if you're diabetic then you're
diabetic.
> >You can delay the metabolic action for years, but in the end you will
still
> >be diabetic. However, who can say? It's still early (relatively speaking) in the game. Someone
> >who was dxed T2 in 2001, say, and used the current knowledge and
in
> >particular metformin, kept on with anti-oxes and generally ate like we do now, could easily live
> >longer than would be expected 5 years ago with no complications.
> >
> The question I really wanted to ask is---- if some of the "early" diagnosis and the treatments may
> do more harm than a wait and see approach. I do advocate a modified food input program, I have
> seen counter productive results from the quickie pill fix. There is a time when meds are
> necessary. I would not last long without them. But I see an approach so often here. A new pill--an
> easy fix. I have observed several people recently where I would go to a tough self control program
> and wait for a while on the pills. The psychological harm and the economic damage of being
> diagnosed as a diabetic is not nol be ignored. I am a bit alarmed by watching TV and se the
> pushing of meds. The ads are not to do us good. They are to make money. Because I am a very
> noticeable diabetic, new people come here and are in a panic. My life is over!!! Guy
 
It's just the new name for Impaired Glucose Tolerance or Impaired Fasting Glucose. It's a diagnostic
category, not an opinion. If they change the diagnosis numbers downward again, then what is now "pre-
" will be "diabetes", just as what used to be almost high enough to be diagnosed is now firmly in
the club. I think I've heard they're changing the limits for "pre-" too, downward. bj

"carterjp" <[email protected]> wrote in message
news:[email protected]...
> This is where the moniker "pre-diabetes" is, in itself, dangerous.
 
In article <[email protected]>,
"bj" <[email protected]> wrote:

> It's just the new name for Impaired Glucose Tolerance or Impaired Fasting Glucose. It's a
> diagnostic category, not an opinion. If they change the diagnosis numbers downward again, then
> what is now "pre-" will be "diabetes", just as what used to be almost high enough to be diagnosed
> is now firmly in the club. I think I've heard they're changing the limits for "pre-" too,
> downward.

Yes, 100 is now the bottom limit for pre-diabetic. (Prior to that change it was 110.) They didn't
change the line between pre-diabetic and diabetic, though. Yet.

Priscilla
 
t2_lurking <[email protected]> wrote on Sat, 14 Feb 2004
15:50:39 -0600:

[ .... ]

> What isn't totally clear to me is how long and at what number to high BG's start to cause harm?

> I accept that PP over 140 is harmful, my program (as a T2) is geared toward sub 110 2 hrs PP.

Not exactly true. A PP over 140 _might_ be harmful. Mileages vary immensely between people. I
suspect that 140+ BS is only harmful to a minority. Otherwise I'd've been dead decades ago.

> Now the other thing I'm curious about is why the BG range seems to be different for T1's. But
> that's an other thread.

Oh no it's not! Speaking as one, I can say it's just not practical for a T1 to maintain BS
constantly in the range 90 to 95. To achieve that, one would have to live in a hospital constantly
hooked up to machines. And to try would mean suffering continual hypos. Probably. No thanks!

> I accept that PP over 140 is harmful, my program (as a T2) is geared toward sub 110 2 hrs PP.

How much life energy are you using up in this program, and wouldn't it perhaps better be used
for living?

--
Alan Mackenzie (Munich, Germany) Email: [email protected]; to decode, wherever there is a repeated
letter (like "aa"), remove half of them (leaving, say, "a").
 
>"Alan Mackenzie" wrote in message<
>
> > I accept that PP over 140 is harmful, my program (as a T2) is geared toward sub 110 2 hrs PP.
>
> How much life energy are you using up in this program, and wouldn't it perhaps better be used
> for living?
>
Actually it seems easy. I eat small frequent meals. I avoid "white carbs" and eat a 30/30/40 (or
close) balance. I've been doing this since about a month after my dx. <<BRAG ALERT>> MY last A1c
was 5.3 and all my lipids are below or are at normal. I see it as a lifestyle change. It's not
something I feel I HAVE to do, but something I WANT to do. I still have a ways to go in the overall
scheme of things, I'm still overweight and don't exercise as much as I should. But my plan was BG's
first and I've done that. I'm hoping to lose about 1-2 lbs. a week, I'm close to that number.
Attitude is everything. IMHO. I feel I'm living a pretty good life. I just got "Neverwinter Nights
Gold" (a D&D game), the NASCAR season is upon us and this weekend I removed most of the ice-dams
from my roof. I managed to make the three women in the house happy for V-day. The only thing that's
changed a lot is more time I've spent on the internet researching and chatting about diabetes.

Which brings another interesting question to mind, another thread, "What would you rather have had
as a disease other then diabetes"? (Default answer = "Nothing") Cardio? Lung?

I tend to look on the optimistic side.
--

t2_lurking geabbottATabbottandabbottDOTcom Do not mail to t2_lurking (auto-delete)
============================
Well, i dreamed i saw the silver Space ships flying In the yellow haze of the sun -- Neil Young --
====================
New to Diabetes? Go to: http://www.alt-support-diabetes.org
====================================================