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Medical Forum / Diseases and Disorders / Diabetes / December 2006Diabetes Complications?
Hello, Diabetes is age related chronic and progressive disorder/disease with lifelong impacts. Moreover, it can be genetically predisposed, so may run in many generations. So diabetic complications may be lifelong or many generations hyperglycemic dependent. It looks quite impractical to conduct double binded studies with and without medication program, lifelong and in many generations. So there can be some thoughts about partly concluded DB studies for just few years. By looking at my near and dears ones with chronic diabetes who either followed serious medication program or other followed less seriously, still other carelessly, I am bit thoughtful about medication program. To understand more; Can you tell briefly, experiances or your near and dear ones with chronic diabetes esp. type2 with insulin resistance, who followed diabetic medication program (including those by diet & exercise, stress managements, other natural/alternative means) seriously, normally and carelessly? Such tellings can be beneficial in better understandings. Best wishes. Kumar: Problem is you might get "dirty data". For example T2s who are "careless" about their medication program are most likely careless about other aspects of their life such as diet control, exercise control etc. So unless you have a very well controlled study, anectodal information can be very misleading. There are many studies that have well established the merits of a medical program and compliance is required to be properly assessed. Larry > Hello, > [quoted text clipped - 20 lines] > > Best wishes. Thanks, but do we have lifelong or many generation DBPC studies of treatment or no treatment groups? Without it we may ot get final/real picuture of getting complications If not, we can only collect data from those people, who had not taken much treatments? > Kumar: Problem is you might get "dirty data". For example T2s who are > "careless" about their medication program are most likely careless [quoted text clipped - 29 lines] > > > > Best wishes. > Hello, > > Diabetes is age related chronic and progressive disorder/disease with > lifelong impacts. It's not age related at all.  SignatureBeav VN 750 Zed 1000 OMF# 19 > > Hello, > > [quoted text clipped - 9 lines] > Zed 1000 > OMF# 19 "Diabetes in Elderly Humans Posted on: October 15, 2003 Glucose tolerance progressively declines with age, resulting in a high prevalence of type 2 diabetes and impaired glucose tolerance in the older population. The interaction of many factors associated with aging likely contributes to the alterations in glucose tolerance in this population. These factors include increased adiposity, decreased physical activity, medications, coexisting illness, and insulin secretory defects associated with the aging process. The mechanism of age-related glucose intolerance is not completely clear. Age-related insulin secretory dysfunction may have a role in the alterations in glucose metabolism with age and may contribute to the high rates of glucose intolerance in the older population. Many studies have examined the effects of aging on pancreatic ?-cell function in humans, although there is a great deal of variability in the outcomes of these studies. http://www.innovitaresearch.org/news/03101501.html " Kumar: I agree with this assessment of older individuals with glucose intolerance. My friend who is quite well and is 95 yrs old started taking only Amaryl just recently. He has a very good Doctor and has determined a secretory dysfunction as primary rather than phenotypical obese type T2s requiring IR type drugs such as metformin etc. Kumar: On your first question, the past 150 yrs clearly shows what happens with T2s not on meds so your study to show impact of a medical program can only be relatively positive. Larry > > > Hello, > > > [quoted text clipped - 28 lines] > of these studies. > http://www.innovitaresearch.org/news/03101501.html " Whether your friend know when got the diabeties? Do we have systematic record of people with T2 not on med? > Kumar: I agree with this assessment of older individuals with glucose > intolerance. My friend who is quite well and is 95 yrs old started [quoted text clipped - 38 lines] > > of these studies. > > http://www.innovitaresearch.org/news/03101501.html " Kumar: I suspect in the last 2-3 years but reached T2 threshold this year. History tells you about T2s not on meds just like leukemia or infections prior to effective medicine for these diseases. Larry > Whether your friend know when got the diabeties? Do we have systematic > record of people with T2 not on med? [quoted text clipped - 41 lines] > > > of these studies. > > > http://www.innovitaresearch.org/news/03101501.html " Sorry, but can we expect today to get historical data of not diabetics on no med. esp. in light of so much propaganda. Legaly an practically, it may also not possible to conduct life long DB studies of diabetics on med. and on no med. We can't expect that anyone can dare on no medication program, so we may not get or having systematic historical data of non treated diabetics. At mx, we can just expect to collect some data, as I asked. I don't feel that any understanding can be absolute or final unless we can have data of patients as per the pathogenesis and age of persistance of any disease. If any disease is progressive, can't be cured but just treated or can just kept under control, persisting for whole life also in many generations than life long or many generations based DB stuidies/ clinical trials may only make these clear , absolute and final. Am I not right? > Kumar: I suspect in the last 2-3 years but reached T2 threshold this > year. History tells you about T2s not on meds just like leukemia or [quoted text clipped - 46 lines] > > > > of these studies. > > > > http://www.innovitaresearch.org/news/03101501.html " Kumar: We always need to study this disease more however however a pragmatic approach is as good as we can get so far as life long studies. Short term studies clearly show the merits of a drug program. No medical Institutional Review Board would allow a life long placebo controlled study in T2s. Also remember that T2 is a herterogenous disease and we don't yet know how to categorize the subgroups hence "Dirt in is dirt out" so far as a valid analysis would be concerned. Larry > Sorry, but can we expect today to get historical data of not diabetics > on no med. esp. in light of so much propaganda. Legaly an practically, [quoted text clipped - 59 lines] > > > > > of these studies. > > > > > http://www.innovitaresearch.org/news/03101501.html " That is the problem. Therefore I want to know experiances of near and dear ones, who remained on no or least med.Anything may look benefitting in short term but can be different in its long term effect. My knowledge of my near and dear ones don't satisfy me as commonly indicated. Moreover insulin have many type of actions and any med. can have its side effects.So we should understand long term effects. Probably, if insulin is abnormal or not optimal, we can think many things as per its indicated actions other than hypoglycemia. > Kumar: We always need to study this disease more however however a > pragmatic approach is as good as we can get so far as life long [quoted text clipped - 68 lines] > > > > > > of these studies. > > > > > > http://www.innovitaresearch.org/news/03101501.html " > Hello, > [quoted text clipped - 18 lines] > > Such tellings can be beneficial in better understandings. My mom's about 72 and her T2 diabetes has progressively improved. For the past year or so, she takes no medication at all for her diabetes and her 1ac numbers are normal. She had a stroke several years ago that hampered her mobility quite a bit, so she gets very little exercise, but she's also careful about what she eats. > > Hello, > > [quoted text clipped - 24 lines] > hampered her mobility quite a bit, so she gets very little exercise, but > she's also careful about what she eats. Thanks.This tells a lot. I want such observations from many people. Kumar: Maybe then you can write a book. But don't forget the statistical analysis in a "blinded" placebo controlled manner. :-) Larry > > > Hello, > > > [quoted text clipped - 26 lines] > > Thanks.This tells a lot. I want such observations from many people. > Kumar: Maybe then you can write a book. But don't forget the > statistical analysis in a "blinded" placebo controlled manner. :-) Short analysis or lifelong? > Larry > > > [quoted text clipped - 28 lines] > > > > Thanks.This tells a lot. I want such observations from many people. Larry, if you read foloowing article and other studies on IR, you may find more that 20 different theories still the issue is unclear. http://en.wikipedia.org/wiki/Insulin_resistance I can't say whether all theories are valid, any one is valid or no one is valid. As such, how can we be sure about such understandings unless an absolute and final theory is presented? > Kumar: Maybe then you can write a book. But don't forget the > statistical analysis in a "blinded" placebo controlled manner. :-) [quoted text clipped - 31 lines] > > > > Thanks.This tells a lot. I want such observations from many people. Kumar: I agree about the overuse of the word "IR". People say "I have more IR in the morning", "I have more IR because I am overweight", "This drug or that drug will lower IR" etc. I think of it as 2 definitions 1) a meaningful measured laboratory/clinical parameter and 2) a "catch all" qualitative terms which helps explain the bad things about being overweight and/or exhibiting lipid abnormalities. Have you ever heard of a healthy overweight non diabetic being treated for a PRIMARY diagnosis of IR with medication approved by an insurance company? A person would have to present with a lipid abnormality, metabolic abnormality or some other primary condition before one can even use the word IR. What approved drug is out there for a primary condition of IR? So you see in some cases the term IR is a "garbage term" even overused by the drug industry and discriptively by the medical community and patients too. Larry > Larry, if you read foloowing article and other studies on IR, you may > find more that 20 different theories still the issue is unclear. [quoted text clipped - 38 lines] > > > > > > Thanks.This tells a lot. I want such observations from many people. IR may not persist on progression of disease than a patient may experiance better control by added insulin. How? I think we should understand difference betwenn "diabetes2" and "frank diabetes". IR posiblity is indicated without getting diabetes. I am bit unclear how insulin is added by med. without getting "frank diabetes" or more insulin than normal insulin. Insulin is a much effective and senstive hormone and its "optimal levels" may be must, neither low nor higher, to avoid complications by both. Whether normal insulin secretions are commonly checked before medication program? By normal I mean as compared to normal secretions in a healthy person with similar food intake, age etc. Probably, we try to avoid hyperglycemia by abnormal insulin but it may be at the cost of other possible complications relevant to other insulin's action. Moreover our body may be trying to avoid toxicities, if possible, by excessive nutrients in blood and enabling their excretion via urine. Probably, we may be dealing on "couldn't yet be completely known aspects" by substances which may also have many adversities. > Kumar: I agree about the overuse of the word "IR". People say "I have > more IR in the morning", "I have more IR because I am overweight", [quoted text clipped - 54 lines] > > > > > > > > Thanks.This tells a lot. I want such observations from many people. |
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