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Diabetes Epidemic
Old 06-24-2008, 02:55 PM   #1
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Diabetes Epidemic

This report lists the grim stats on a totally preventable (most cases) and highly curable disease: type II diabetes. The trouble is the cure requires lifestyle changes: shun refined carbs, sugar and get some exercise. I can't recall the exact stat but know that a huge portion of medicare costs are directly related to diabetes and its complications (and private insurance costs as well).
http://www.msnbc.msn.com/id/25350702/
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Old 06-24-2008, 03:08 PM   #2
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The trouble is the cure requires lifestyle changes: shun refined carbs, sugar and get some exercise.
Heaven forbid that people should actually be required to take responsibility for their own health! It's so much easier to pop a few pills.

Related links:

(1) Diabetes management: How lifestyle, daily routine affect blood sugar - MayoClinic.com

(2) Diabetes and lifestyle

(3) MedlinePlus: Lifestyle Changes Can Keep Diabetes at Bay for 14 Years

(4) Mindless Eating: Brian Wansink Ph.D.
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Old 06-24-2008, 03:10 PM   #3
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I used to be an investor in a company that specialized in managing diabetes patients who were also Medicare beneficiaries (they do all those goofy cable commercials with Wilford Brimley). The scale of the problem is mind-boggling, and the costs are astronomical. Even worse, once people get the disease, actually get checked out and diagnosed, and get started with treatment, patient compliance is pretty low even when they are hounded/cajolled/educated.
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Old 06-24-2008, 03:15 PM   #4
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My FIL died after a 30 year fight with diabetes. He ended up a brittle diabetic on Medcaid, and that's NO WAY to go through life.............
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Old 06-24-2008, 03:57 PM   #5
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I used to be an investor in a company that specialized in managing diabetes patients who were also Medicare beneficiaries (they do all those goofy cable commercials with Wilford Brimley). The scale of the problem is mind-boggling, and the costs are astronomical. Even worse, once people get the disease, actually get checked out and diagnosed, and get started with treatment, patient compliance is pretty low even when they are hounded/cajolled/educated.

I made a few bucks on PLMD, but they had some legal issues which caused me to sell...
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Old 06-24-2008, 04:14 PM   #6
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I made a few bucks on PLMD, but they had some legal issues which caused me to sell...
Heh, I made mucho dinero buying when the stock sold off over those very issues and waiting out the nonsense qui tam stuff.
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Old 06-24-2008, 04:54 PM   #7
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My FIL died after a 30 year fight with diabetes. He ended up a brittle diabetic on Medcaid, and that's NO WAY to go through life.............
My mother spent the last ~30 years of her life diabetic (brittle at least for a while) (on a first name basis with the local EMS). Having much improved my health since retiring, I may have dodged the bullet.
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Old 06-24-2008, 05:00 PM   #8
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This report lists the grim stats on a totally preventable (most cases) and highly curable disease: type II diabetes. The trouble is the cure requires lifestyle changes
In some cases (like mine) T2 diabetes was not the result of a "preventable" lifestyle (well, OK, if I went to Canada ).

Here's what I'm talking about:
Agent Orange Home

My exposure lead to my "situation". It does not run in my family, nor has it been a major impact to my life.

Unlike the challanges of a T1 (early death, due to a "brittle" condition) as noted, T2 can be managed if you are willing to "invest" a bit of your time.

I lost weight (50+ pounds), watch my diet (low carb), exercise most days (treadmill/Bowflex) and actually, I'm probably in better physical shape than I was 30+ ago.

Currently not on any meds, although I understand that the normal "progression" as I age will lead to some type of meds in the future.

My stepfather was diagnosed as a T2 when he retired (due to a supposedly unhealthly lifestyle). He was a truck driver for many years, no exercise, overweight, and I would have bet he would have not lived long when he was diagnosed (at 60, now 78 ). He went from close to 300 lbs to 170 and at age 78, still walks 5+ miles every day.

He also went from insulin injections when he was diagnosed to a daily oral pill (a great reduction).

Just to show that in "some cases", the control (and sometimes the reversal of the disease management) can be done. However, it's up to the indivudial to manage their indivudial situation.

- Ron
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Old 06-24-2008, 08:05 PM   #9
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Bravo, Ron. You took the bull by the horns. I admire your resolve and focus. Kudos to you and your stepdad.
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Old 06-24-2008, 08:17 PM   #10
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There are type 2 diabetics whose disease is due to a combination of insulin resistance and insulin deficiency. It is not always associated with obesity, genes, or sedentary lifestyle. Typically it starts with impaired fasting blood glucose, then impaired glucose tolerance, and then after 5 or 6 years, frank diabetes. While this is the exception it isn't rare.

Serious exercise and diet are in order for these people but most end up on metformin or other drugs sooner or later.
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Old 06-24-2008, 08:32 PM   #11
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Insulin resistance is the elephant in the room. Pasta, cereals, cookies, bagels, soda, crackers, cookies, potatoes, white rice, bread, jelly, fructose, corn syrup, pancakes. I have eaten tons of the stuff in my life and didn't realize until about ten years ago that I was well on the path of joining many of my diabetic relatives. The inflammatory sequelae of insulin resistance and diabetes include cardiac disease and probably many other degenerative diseases. A major ongoing bonanza for pharma companies. Of course, if you indulge, you bow to pharma.
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Old 06-25-2008, 07:09 AM   #12
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Pasta, cereals, cookies, bagels, soda, crackers, cookies, potatoes, white rice, bread, jelly, fructose, corn syrup, pancakes.
Well, even though most of these foods are no longer on my "menu", a point that should be brought up is that while a large portion of any food is "dangerous" (for your health), as a diabetic, you can eat such things as pasta and bread (examples). However, you must limit your "intake". Its surprising how much a 1/2 cup of pasta actually is (expecially when mixed with veggies).

Of course, cookies and pancakes are no longer on my list. Not that I could not do with a small portion, but I know that these are "trigger" foods for me and I don't want to risk starting down that path again. It is almost in the same vein as somebody who has a drinking problem. If I have one cookie, I'll have the entire bag (can't risk it).

On the flip side, I now drink (red) wine, which is something I did not do before I was diagnosed (in 2001). In fact (Rich should comment) my doctor recommended the 2-glass/day "perscription". Funny, but I drank (anything) rarely before I was diagnosed. Now I'm drinking more than I ever have in my "past life" ...

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Old 06-25-2008, 10:11 AM   #13
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Insulin resistance is the elephant in the room. Pasta, cereals, cookies, bagels, soda, crackers, cookies, potatoes, white rice, bread, jelly, fructose, corn syrup, pancakes. I have eaten tons of the stuff in my life and didn't realize until about ten years ago that I was well on the path of joining many of my diabetic relatives. The inflammatory sequelae of insulin resistance and diabetes include cardiac disease and probably many other degenerative diseases. A major ongoing bonanza for pharma companies. Of course, if you indulge, you bow to pharma.
I really think High Fructose Corn Syrup is to blame for some of this, it's literally in EVERYTHING...........
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Old 07-01-2008, 01:04 AM   #14
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I was skinny when diagnosed. Unfortunately its a matter of genes. Its always interesting that its one of those diseases thats the patients fault......
They do have studies that say that even if your "prediabetic" its better to be on the glucophage. Or one of the other newer medications. They say it has a protective effect and may slow the onset of the full blown diabetes.
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Old 07-01-2008, 11:34 AM   #15
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I was skinny when diagnosed. Unfortunately its a matter of genes. Its always interesting that its one of those diseases thats the patients fault......
Good observation. It gets harder and harder to find some group you can look down on and blame for things.

So far at least it seems safe to the sort of people who are always on the lookout for scapegoats to pick diabetics, or people with heart disease, or people who struggle with theirweight. Just one more ugly aspect of human nature.

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Old 07-01-2008, 02:54 PM   #16
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I was skinny when diagnosed. Unfortunately its a matter of genes.
Sounds like you are a T1?

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Old 07-01-2008, 03:25 PM   #17
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Sounds like you are a T1?
While many type 1 DM patients are thin, not all thin patients with DM are type 1. The latter refers more strongly to the way the patient's metabolism works. Here are some criteria:
  • Patients with type 2 diabetes are generally overweight but not always
  • Type 1 usually is diagnosed before age 15
  • Insulin resistance - usually type 2, often with high lipids, etc.
  • Ketoacidosis Patients with type 1 diabetes are more likely to present with ketoacidosis ("diabetic coma"), due to low insulin production. But this can be seen with type 2, also.
  • Type 1 diabetes is suggested by the presence of pancreatic (islet) autoantibodies.
To further complicate things, we now know that there is considerable overlap between types 1 and 2. Fancier tests can sort it out if doing so will affect management.
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Old 07-01-2008, 03:31 PM   #18
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While many type 1 DM patients are thin, not all thin patients with DM are type 1. The latter refers more strongly to the way the patient's metabolism works. Here are some criteria:
  • Patients with type 2 diabetes are generally overweight but not always
  • Type 1 usually is diagnosed before age 15
  • Insulin resistance - usually type 2, often with high lipids, etc.
  • Ketoacidosis Patients with type 1 diabetes are more likely to present with ketoacidosis ("diabetic coma"), due to low insulin production. But this can be seen with type 2, also.
  • Type 1 diabetes is suggested by the presence of pancreatic (islet) autoantibodies.
To further complicate things, we now know that there is considerable overlap between types 1 and 2. Fancier tests can sort it out if doing so will affect management.
Seems to me the docs are doing a lot more with heart disease than diabetics for testing...........
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Old 07-01-2008, 04:40 PM   #19
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Heaven forbid that people should actually be required to take responsibility for their own health! It's so much easier to pop a few pills.
It's always so easy to sneer when it's not you.

When I was diagnosed T2, I personally was sedentary, overweight, and a consumer of all those fast foody things people who work on call are always eating out of convenience and boredom. I'm fairly well educated and knew I wasn't doing the healthy thing, but diabetes wasn't mentioned all that often back then. Mostly heart attacks were what we were being warned about.

When I got tested due to a low iron count when donating blood, I was diagnosed T2. My doctor said "lose some weight, don't eat anything white, and take this bunch of pills". And that was pretty much that.

The pills made me feel like sh*t, so I started researching the condition on my own. I found I wasn't truly diabetic, I had what is called metabolic syndrome, which has similar symptoms. I changed my lifestyle, stopped the medicines that where making me feel bad ,and am getting healthier by the day (with an occasional backslide due to pizza addiction).

My point is that while many people aren't doing what they should, the medical community is following the newest fad, like they have done with depression, ADHD, etc. Diagnose anything that comes close, throw pharmacueticals at it, and move on.

There is a ton of information available now that wasn't there 5-7 years ago. I think many people will do the right thing. Education takes years to show results. Just look at all the people who haven't yet learned to take care of their own finances.

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Old 07-01-2008, 05:46 PM   #20
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While many type 1 DM patients are thin, not all thin patients with DM are type 1.
Rich,

The reason I asked the question was when I was taking my "T2 diabetes management course " (strongly suggested by my doc/medical plan), there was a women attending the first session that didn't "fit the mold" (you know, "overweight") as the other dozen or so folks there.

The next session, she was not there. We found out later that she was a T1, and you know that the suggested personal goals are a bit different than T2's.

- Ron
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