Diabetes Epidemic

[windsurf]

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/

[Milton]

Originally Posted by windsurf

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.

[brewer12345]

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.

[FinanceDude]

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.............

[HFWR]

Originally Posted by brewer12345

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...

[brewer12345]

Originally Posted by HFWR

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.

[Khan]

Originally Posted by FinanceDude

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.

[rs0460a]

Originally Posted by windsurf

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

[windsurf]

Bravo, Ron. You took the bull by the horns. I admire your resolve and focus. Kudos to you and your stepdad.

[Rich_in_Tampa]

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.

[windsurf]

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.

[rs0460a]

Originally Posted by windsurf

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" ...

- Ron

[FinanceDude]

Originally Posted by windsurf

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...........

[spideyrdpd]

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.

[haha]

Originally Posted by spideyrdpd

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.

Ha

[rs0460a]

Originally Posted by spideyrdpd

I was skinny when diagnosed. Unfortunately its a matter of genes.

Sounds like you are a T1?

- Ron

[Rich_in_Tampa]

Originally Posted by rs0460a

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.

[FinanceDude]

Originally Posted by Rich_in_Tampa

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...........