@MrWebster @exindy @soryang @MrWebster @Lookout

responsive to all of you. My mother was a healthy, slim woman who ate a conservative, healthy, nutrition oriented diet her entire life. She had a pregnancy a bit late in life and afterwards was diabetic, in fact, she was a "brittle diabetic", hair trigger, fully insulin dependent. Her daughter, my much, much, much younger sister had early onset crohn's disease and had a very restricted and limited diet. Somewhere in her forties she caught some mystery virus, like an influenza, that hospitalized her for a while, and when she was released, she too was diabetic out of the blue sky, like her mom.

Back when type 1 was "childhood diabetes" they both would've been "type 2" even though diet wasn't a factor and they were totally insulin dependent becausse they weren't producing any insulin on their own. The old type 1 or type 2 distinction is going in the toilet, there are a huge number of different types, which is one reason not to leave it up to ye average GP as MWebster had suggested could be possible. what we don't know about this condition and how it and the various treatments interacts with all of the body's other processes and organs is vast, far greater than what we do know. My little sis has a small team that includes an endocrinologist, FWIW, who, as specialists can keep up with all of the latest.

Here's a kicker - my mom had an unknown gut disorder as a wee child that sounds in retrospect like something on the Inflammatory Bowel Disease spectrum, and they didn't think she'd live, or so I've been told. I'm not a diabetic but I've got long-term chronic UCS. I had a flare last year that lasted from early fall into spring of this year. While they got me through it they studied all the options and gave me a ton of tests, including mailing some of my blood off to a mystery lab in SoCal, San Diego iirc. I get copies of all my test results. So, weeks after all the results from one battery of tests I get the information from said outside lab - something like "Subject has two copies of the genespeak allele which means that they cannot process chemicals of the following 4 families and accordingly cannot have medications based on chemspeak 1 through 3". Two of those medications are being used and promoted for treating a variety of conditions including IBD. So it occurred to me that without their massive due diligence I could've easily been given one of those drugs on the traditional "well, let's try this one" basis. Then it occurred to me that some 20 years ago when my sister caught that virus they almost certainly weren't doing that kind of testing and she might have the same genetic problem and might've been given some chemical from one of those families and it trashed her pancreas. Pure speculation but nobody has, of yet, come up with any guesses.

So this is intended to be illustrative of how crazy wild the depth of the problem is and can be; humans and all quasi-unique and we still don't really have the science to deal with it. My provided has a subgroup of gastroenterologists that specializes in IBD and who work with a team of dedicated pharmacologists who work only with them. That's where we should be with a whole boatload of chronic conditions, and we're not even close.

As an, aside both my sis and I are empiricists, so we observe and monitor shit ()pun not intended, but ...), especially where there are conflicting experts or simply vague ones. We react differently to say wheat bread, rye bread, potatoes and corn, no big surprise, but also to sweet corn versus corn tortillas to tamales to polenta. Carbs ain't carbs, the term is a vast oversimplification, and a flood of experts, dieticians, diet authors and talk shows generally has a lot of the populace going off half cocked on a lot of dietary regimes and that includes a lot of our type 2 thru type 450 or whatever, which is how it is that people can be on "book healthy" diets and not get better. So, if a given regime can cure 50% of type two, that is fantastic and eyond wonderful, but what about the others. What if they really aren't classic type 2s at all, or what if they've got mystery genetic issues. We sort of need to look into that given the size of the population.

be well and have a good one

edit - assorted clean-up and fixes

Read a very good series on diabetes in NYC from NYTimes awhile back. One hospital created a sort of diabetes health clinic. The purpose was to have diabetics suffering from complications like kidney problems to stay with the hospital. In this way, they could make their money treating the complications.

One bizarre thing which maybe I misread was that in NYC there were not enough endocrinologists to treat diabetes. Not sure why an endocrinologist was needed when a GP could easily handle standard treatments.

I wouldn't have known it was World diabetes day. I guess it made me reflect on my father's experience with type 1. I know it was a hardship for him. His diet and eating schedule had to be strictly maintained or he could go into shock.

He was a chemical engineer who worked for a big pharma company. He always used to use the expression "ethical drugs," and "ethical drug manufacturers." I don't think anyone pretends US drug companies are necessarily "ethical" anymore. He introduced me to concept of drug labeling when I was old enough to understand it. Later by chance, I wrote a thesis on medical products liability litigation which was an eye opener. Became familiar with FDA regs and procedures at the time. I got stuck with the topic because it was the only one left to choose from because I had delayed selecting my topic. It was the least favorite topic among the law students. My thesis was well received, and helped me later when some friends wanted me to assist in office managing some medical products liability cases. That only lasted a couple of years or so.

My father lived to be ninety. He managed his diabetes well, although I did see him go into insulin shock a few times. This usually happened when he was outside of his normal routine for eating due to circumstances not under his control. I'm sure his expertise in chemistry was a factor in his ability to manage his disease. I think I indirectly benefitted from the family diet regimen when I was young, and still eat sensibly (thanks mostly to my wife) although I don't expect to live that long. I'm glad that none of my other family members (including me) seem to have inherited the disease thus far.

I remember meeting other type I diabetes persons over the years who didn't fair quite as well as my father. I was always moved by their condition. @enhydra lutris Thanks for bringing up this important subject. I had buried memories of these experiences for some time.

The cost of insulin is an outrage.

#2.2 but I am afraid that its significance will not be registered or might be overlooked. This malady is very complicated and complicated even more by all the anecdotal evidence. There are quite a few different kinds of diabetes, each requiring a different treatment to be generally effective. Some treatments will overlap, others won't. It takes a very good medical Dr to identify the differences. Unfortunately medical education is probably the most deficient disease that needs treatment. Profit is the primary goal of anything in our society.

Well, back to the subject at hand, adding my anecdote to the mix.

I have been diagnosed as insulin dependent type 2. I had originally fallen into the diabetes realm during the mid 90s. The first treatment was drugs to force my pancreas to produce more insulin. Didn't really do much. Metabolism looked at the increaaed insulin and said: "what is this crap, give me the good stuff." Some type 2's are resistant to some insulins, sometimes to the one their pancreas produces. Like mine.

In the late 90s I started on insulin, 2 kinds mixed in the syringe, twice a day. I found over the next 10 years that of the couple different brands that were tried, like the pen with the 2 kinds premixed, they were ineffective. So back to the syringe and mixed in the plunger.

And there I am, close to 30 years into it. As I said, I had a very good dr. I was able to talk with him and we discussed the disease. These were the early days and there were a lot of hypotheses running around, lots of confusions.

I have also found that there are different kinds of carbs that are vital to bodily functions. The processed foods show carbs in the nutrition list but I found that what they measure might be carbs but they aren't the kind that my body insists on. It wants the real stuff... sugar. I guess that 3 million years of evolution affected me a lot. Some lab in Japan that shoved in a chemical to convert corn to sugar might work great for profit but don't do much for me. I usually find the bad stuff during the night when my blood sugar level drops into the 50s. That's when I grab for the real sugar and start the yoyo. On the bright side it helps me sleep until my body stabilizes.

Along this journey as I said, I am very thankful for starting it with drs who went thru med school before the business school of medicine decided what was more important.

Sorry for the rant. This topic hits very close to home. If I might offer some advice... take care when faced with anecdotal evidence. There are many factors in play when dealing with this disease.

#2.2
https://www.youtube.com/watch?v=XyB-UNjt_V0
@ the 14 min mark

So everyone isn't cured but if we could cure half of the T2 diabetes in the US/world that would be terrific.

@Bring Back Civics

be spread especially to the medicos.

be well and have a good one

My brother’s neighbor, a former rural rodeo queen and barrel racer, had a horrific fall off of a horse that left her blind and destroyed her pancreas and kidneys as a teenager. For a couple of years, she had to take insulin daily and regular dialysis.

Her doctor put her on the list for a kidney transplant, and after a couple of years she was notified that a kidney was available. She was also notified that the same donor had a compatible pancreas. She received both the kidney and the pancreas, and for the next 20+ years she was neither a diabetic nor needed dialysis.

After 20+ years, her new kidney and her pancreas began to fail. She ended up getting another kidney, but no new pancreas. She is now a diabetic again and must take insulin every day.

Both my aunt and my best friend from college were Type-1 diabetics, which they contracted in connection with childhood diseases when they were four or five years old. I asked them whether anyone had ever discussed with them the possibility of a pancreas transplant and told them about my brother’s neighbor. Despite being lifelong diabetics, they had never even heard that such a transplant was possible. My subsequent research suggested that a pancreas transplant is not difficult and relatively safe.

It made me wonder how many perfectly good pancreas(es) are simply thrown away. It sure seems to me that 20+ years of not having to inject insulin and all of the related medical care and complications could cost even more than a pancreas transplant. In any event, it was a shock to me that my college buddy, who came from a very wealthy family, had never even heard of the possibility of a pancreas transplant. I spread the word whenever I can.

@on the cusp

We're too quick to generalize in the medical/biological realm, using a simplistic understanding of the way physics and chem are supposed to work as our reference models, but biology doesn't work that way and, what they are finally beginning to learn under the heading of "epigenetics" is proof and partial explanation. The totally discredited Lamarck (sp?) wasn't 100% wrong it seems and starting with the boomers, we've all been guinea pigs in a vast horde of unintended unplanned uncontrolled experiments that we've never understood to be such. The effects, especially the combined cumulative effects are unknown, unexplored and unanalyzed, but they shit for sure aren't uniform across the population.

be well and have a good one

(loss of legs) to Metformin miracle cure not approved for the condition.
My husband had a blood test showing he was sort of nearing pre-diabetic. So, we watched a video presentation by a dr. saying high fat content meat was the magic solution. The next video that came up was a video saying the worst thing a pre-diabetic could possibly eat was high fat content meat. And so on.
To all who have problems, and memories or realities of family with problems, my heart goes out to you. I tend to think everyone is unique, and treatment should not be dictated by an insurance chart, and thinking in broad categories where overlap to specific conditions is just wrong. And this is not just diabetes. It is copd, and high cholesterol, it is heart palpitations, it is fatty liver.
Last year, it took the fifth doctor to figure out what I had, and the 6th dr. to actually treat it properly.