Discussion of diabetes management in day to day life

Archive for December, 2011

Diabetese is autoimmune lear to cure it at www.cidpusa.org

Diabetese is autoimmune lear to cure it at www.cidpusa.org

Jennifer

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Fasting glucose, retinopathy and diagnosis criteria

I’m going back through various subscriptions I have to
different medical reports servers.

Please excuse me if any of the reports I post have been
discussed while I was away.

A discussion on this one appeared in Endocrine Today
http://www.endocrinetoday.com/view.aspx?rid=26757

"Relation between fasting glucose and retinopathy for
diagnosis of diabetes: three population-based
cross-sectional studies."

http://tinyurl.com/3g8oo5 or
http://www.ncbi.nlm.nih.gov/pubmed/18313502?ordinalpos=1&itool=Entrez…

Full version (pay)
http://www.thelancet.com/journals/lancet/article/PIIS0140673608603189…

The important bits:

"However, we found inconsistent evidence of a uniform
glycaemic threshold for prevalent and incident retinopathy,
with analyses suggesting a continuous relation. The widely
used diabetes FPG cutoff of 7.0 mmol/L or higher had
sensitivity less than 40% (range 14.8-39.1) for detecting
retinopathy, with specificity between 80.8% and 95.8%."
and
"The current FPG cutoff of 7.0 mmol/L used to diagnose
diabetes did not accurately identify people with and without
retinopathy. These findings suggest that the criteria for
diagnosing diabetes could need reassessment."

7 mmol/l is 126mg/dl.

The abstract:

Centre for Eye Research Australia, University of Melbourne,
VIC, Australia. tw…@unimelb.edu.au

BACKGROUND: The WHO and American Diabetes Association
criteria for diagnosing diabetes mellitus assume the
presence of a glycaemic threshold with high sensitivity for
identifying retinopathy. However, this assumption is based
on data from three previous studies that had important
limitations in detecting retinopathy. We aimed to provide
updated data for the relation between fasting plasma glucose
(FPG) and retinopathy, and to assess the diagnostic accuracy
of current FPG thresholds in identifying both prevalent and
incident retinopathy. METHODS: We examined the data from
three cross-sectional adult populations: those in the Blue
Mountains Eye Study (BMES, Australia, n=3162), the
Australian Diabetes, Obesity and Lifestyle Study (AusDiab,
Australia, n=2182), and the Multi-Ethnic Study of
Atherosclerosis (MESA, USA, n=6079). Retinopathy was
diagnosed from multiple retinal photographs of each eye, and
graded according to the modified Airlie House Classification
system. Plasma glucose concentrations were measured from
fasting venous blood samples. FINDINGS: The overall
prevalence of retinopathy was 11.5% in BMES (95% CI
10.4-12.6%), 9.6% in AusDiab (8.4-10.9), and 15.8% in MESA
(14.9-16.7). However, we found inconsistent evidence of a
uniform glycaemic threshold for prevalent and incident
retinopathy, with analyses suggesting a continuous relation.
The widely used diabetes FPG cutoff of 7.0 mmol/L or higher
had sensitivity less than 40% (range 14.8-39.1) for
detecting retinopathy, with specificity between 80.8% and
95.8%. The area under receiver operating characteristic
curves for FPG and retinopathy was low and ranged from 0.56
to 0.61. INTERPRETATION: We saw no evidence of a clear and
consistent glycaemic threshold for the presence or incidence
of retinopathy across different populations. The current FPG
cutoff of 7.0 mmol/L used to diagnose diabetes did not
accurately identify people with and without retinopathy.
These findings suggest that the criteria for diagnosing
diabetes could need reassessment.

Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation – Except Laughter.

http://loraldiabetes.blogspot.com
Latest:Is Testing Worthwhile?
and Cambodia
http://loraltravel.blogspot.com/2008/03/cambodia.html

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Controversy around the definition of PCOS

Read here:
http://www.endocrinetoday.com/view.aspx?rid=27868

Too long to quote.

Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation – Except Laughter.

http://loraldiabetes.blogspot.com
Latest:Is Testing Worthwhile?
and Cambodia
http://loraltravel.blogspot.com/2008/03/cambodia.html

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end abuse

The internet is a wonderful invention and used in a responsible manor
it brings joy to billions of people, sadly there are some people in
the world who wish to ruin the fun for others, they abuse, threaten,
intimidate, they harrasse, many people have had terrible experiences
from these sort of people that put them off ever using the internet
again, let all decent and responsible people join together to show
these people that cause the misery that we will no longer put up with
such behaviour, please sign this petition to make the internet a
safer
place, lets get rid of those awaful people who have nothing better to
do than make other peoples lives a misery, thanks very much for your
support.

http://www.thepetitionsite.com/1/internet-users-of-the-world-unite-to…

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Re: Diabetes or not diabetes?

Nancy wrote:

> Hi,

> A few months ago I was told I had type 2 diabetes.  My A1C was 6.5.  But I
> have read on line that we need to keep it below 7.  So do I have diabetes or
> not?

Because your doctor has given you the diagnosis of type-2 diabetes,
you have diabetes as far as all are concerned.

Sad to verify the bad news.

The good news is that it is curable upon losing the VAT (black fat):

http://HeartMDPhD.com/BlackFat

This can be done by eating less, down to the right amount:

http://HeartMDPhD.com/BeSmart

Here is a simple parable given in hopes of promoting greater
understanding:

http://HeartMDPhD.com/Parable

Be hungry… be healthy… be hungrier… be euglycemic:

http://TheWellnessFoundation.com/BeHealthier

Prayerfully in the infinite power and might of the Holy Spirit,

Andrew <><

Andrew B. Chung, MD/PhD
Lawful steward of http://EmoryCardiology.com
A latter-day disciple of the KING of kings and LORD of lords.
http://HeartMDPhD.com/HolySpirit/DiscipleNow

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Metabolic syndrome and overeating

Overeating can trigger metabolic syndrome, which can lead to
type 2 diabetes:

http://www.healthscout.com/news/322/614669/main.html

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Natural health

Live healthy at ceosec . com. Lower blood pressure – cholesterol – fats –
blood sugar , improve respiratory responce.

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Aggressive Lowering of Cholesterol and Blood Pressure in Diabetics Disappointing.

http://www.cardiosmart.org/News/Default.aspx?id=1010

DIABETES STUDY ENCOURAGING BUT QUESTIONS REMAIN

Aggressive Lowering of Cholesterol and Blood Pressure Shows Partial
Benefits
By Salynn Boyles
WebMD Medical News
Reviewed by Elizabeth Klodas, MD

April 8, 2008 — Diabetes patients who used medicine to lower their
cholesterol and blood pressure to below target levels displayed
improvements in several important markers of heart and vascular
disease, a study shows. But the patients were just as likely as less
aggressively treated patients to have heart attacks and strokes.
The study appears in the April 9 edition of The Journal of the
American Medical Association.

Heart disease is the leading cause of death in adults with diabetes.
There has been much debate about how much to reduce systolic blood
pressure (SBP) and LDL "bad" cholesterol readings in these high-risk
patients.

In one of the first controlled trials to address the issue,
researchers randomly assigned 499 middle-aged American Indians with
type 2 diabetes to treatment aimed at reaching either standard blood
pressure and lipid targets (LDL of no more than 100mg/DL and SBP of no
more than 130 mm Hg) or more aggressive lowering of these levels (LDL
of no more than 70 mg/dL and SBP of no more than115 mm Hg).

The patients were all obese (BMI range of 32-34, normal <25); two-
thirds were women.

Aggressive Treatment vs. Standard Treatment
Over the course of the trial, the more aggressively treated patients
experienced regression of plaque buildup in neck arteries (not seen in
the standard treatment group), and greater improvement in heart muscle
thickening, researcher Barbara V. Howard, PhD, tells WebMD.

Both treatment groups also had far fewer heart attacks and strokes
than would have been expected without treatment.

But no advantage was seen for aggressive lowering of LDL and SBP in
terms of heart attack and stroke incidence.  And patients treated to
lower SBP targets experienced more side effects related to their blood
pressure medications.

Howard tells WebMD that the study’s relatively small sample size and
short duration of follow-up may explain the failure to demonstrate a
difference in outcomes among the two groups.

"My educated guess is that we will see a difference when we continue
to follow these patients," she says. "Our study suggests that these
lower targets could bring benefits, but we need more research to
really understand the risks vs. benefits of this strategy."

How Low Should You Go?
These findings appear certain to add to the debate within preventive
cardiology about how low to go in reducing cardiovascular risk factors
like high blood pressure, LDL cholesterol, and high blood sugar in
diabetic and other high-risk populations.

The debate hit the front pages of the nation’s newspapers early in
February when findings from the 10,000-person ACCORD study suggested
that rather than reducing heart attack and stroke deaths, intensive
blood sugar lowering may increase such risks among people with type 2
diabetes.

"We have basically taken as gospel that if we change risk factors
[like LDL, blood pressure, and blood sugar] good things will happen,"
Duke University Medical Center cardiologist Eric D. Peterson, MD,
tells WebMD. "Studies like ACCORD and this one suggest that modifying
risk factors alone may not ensure better outcomes."

In an editorial accompanying the study by Howard and colleagues,
Peterson writes that the findings should give ammunition to both sides
of the debate.

"For the true believers, the study confirms that aggressive lipid and
hypertension treatment has a favorable effect on proven ‘early
markers’ of disease," he writes. "Thus, with longer duration of follow-
up the study would most assuredly demonstrate improved patient
outcomes."

But for those he terms the "therapeutic nihilists" the findings once
again fail to show a clear advantage for very aggressive treatment.

So what is the message to patients and their physicians about
aggressive treatment?

Peterson tells WebMD that there appears to be little downside to
lowering LDL cholesterol to very low levels with statins, but the jury
is still out on aggressive blood pressure lowering.

"We really do have good data showing the benefits of aggressive
cholesterol lowering with statins," he says. "It’s a safe assumption
that the benefits are great and the risks are low. But that isn’t
clear yet with aggressive blood pressure lowering. We can’t say that
the benefits outweigh the risks."

SOURCES:
Howard, B.V. The Journal of the American Medical Association, April 9,
2008; vol 299: pp 1678-1689.

Barbara V. Howard, PhD, MedStar Research Institute, Hyattsville, Md.

Eric D. Peterson, MD, MPH, Duke Clinical Research Institute, Duke
University Medical Center, Durham, N.C.

******* end article excerpt ********

Comment:

It remains smarter to go for the cure by simply eating less, down to
the right amount:

http://HeartMDPhD.com/BeSmart

Here is a simple parable given in hopes of promoting greater
understanding:

http://HeartMDPhD.com/Parable

Be hungry… be healthy… be hungrier… be euglycemic:

http://TheWellnessFoundation.com/BeHealthier

Prayerfully in the infinite power and might of the Holy Spirit,

Andrew <><

Andrew B. Chung, MD/PhD
Lawful steward of http://EmoryCardiology.com
A latter-day disciple of the KING of kings and LORD of lords.
http://HeartMDPhD.com/HolySpirit/DiscipleNow

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Daily Spirit-guided health tip for 04/20/08.

http://ABChung.LiveJournal.com/116860.html

May dear neighbors, friends, and brethren have a blessedly wonderful
2008th year since the birth of our LORD Jesus Christ as the Son of
Man …

… by being hungrier:

http://TruthRUS.org/KnowingGOD

Hunger is wonderful:

http://HeartMDPhD.com/Hunger

It’s how we know what GOD wants, which is what is good.

Yes, hunger is our knowledge of good versus evil that Adam and Eve
paid for with their and our immortal lives.

Those who suffer from the powerful delusion predicted by the prophecy
of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! )
forever …

http://HeartMDPhD.com/Convicts/CrazyOne

http://HeartMDPhD.com/Convicts/CrazyTwo

http://HeartMDPhD.com/Convicts/CrazyThree

http://HeartMDPhD.com/Convicts/CrazyFour

http://HeartMDPhD.com/Convicts/Bob

… gone:

http://YouTube.com/watch?v=Qb6d_z5C35E

Such will be the demise of all those who refuse to know **and** love
the truth, Who is LORD Jesus Christ:

http://HeartMDPhD.com/Love/TheTruth

Be hungry… be healthy… be hungrier… be blessed:

http://HeartMDPhD.com/HolySpirit/BeBlessed

"Blessed are you who hunger NOW…

… for you will be satisfied." — LORD Jesus Christ (Luke 6:21)

Amen.

http://HeartMDPhD.com/HolySpirit/Luke6_21

A simple parable for the wise and discerning:

http://HeartMDPhD.com/Parable

Be hungry… be healthy… be hungrier… be euglycemic:

http://TheWellnessFoundation.com/BeHealthier

Prayerfully in the infinite power and might of the Holy Spirit,

Andrew <><

Andrew B. Chung, MD/PhD
Lawful steward of http://EmoryCardiology.com
A latter-day disciple of the KING of kings and LORD of lords.
http://HeartMDPhD.com/HolySpirit/DiscipleNow

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NASH Social Network Web 2.0

I ve just open a NASH Social Network Web 2.0

All are wellcome

www.nashion.ning.com

Thanks

Gustavo

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