When Ostracizing Type 2 Diabetes Became an Accepted Lifestyle

When it comes to Diabetes, and the messages being put out there in the media, it is really hard for myself and other folks not to become angry -- if not downright furious. I have to tell you, I generally look through articles, and skim through different headlines, and just tend to "cherry pick" whats going to be real news, and ignore and pass over the fluff. If I were to read it all, I might be en route to a heart attack in less time than you can say "duck fiabetes."

But on Wednesday, just having gotten home from a long, physically and mentally exhausting shift at work, I failed to listen to my own advise. A dear friend of mine shared a news article, in my "Living with Diabetes" Facebook group... and I just lost it. I dont think I have ever been so outraged by an article before. (Well, except maybe for Wendell Fowlers abusive tirade against little Type 1 Diabetic children having ice cream. OMG, how dare they! Thats almost as dangerous as Paula Deen having a cheeseburger! *snark, snark*) I was seeing so many shades of red, and purple, I just could not think straight. I said a bunch of things, in my group, about the article, and to my husband... went and kicked a few things around... flipped off Dr Oz on the TV... and then I felt like my head was going to explode. It was just too much.

Having taken at least, a few days, to calm down... I can probably now tell you what I really think about this piece, with a little more perspective. The piece is called "Curing Diabetes: How Type 2 Became an Accepted Lifestyle" (Yes, you are reading right... That IS the headline for this article), and it was written for The Atlantic, by reporter John-Manuel Andriote, who has supposedly been specializing in HIV/AIDS reporting since 1986. I guess, I would like to think that being exposed to such a world would have given Mr. Andriote some perspective, and a keener sense of tact, and to an extent it has... but, apparently, not enough to have helped him rethink such a terrible headline.

The article itself makes a few key mistakes, which well, to an outsider would not be as self evident. And why would they? Our current government, medical advisory agencies, and medical industry want to do all they can to pass blame onto the Type 2 patient, entirely, and take on NO responsibility themselves. Ive shared on this, before, many times. Especially, the deep denial of how multi-faceted the triggers are for Type 2 Diabetes, and the roles pollution and other medications, etc., have in the development of the disease. It is unfortunate that everyone in the industry quotes such poorly done research studies that do not take these complexities into account, or even consider to do so, to blanket claim that 80% of all Type 2 Diabetes is "largely preventable." These simplistic allegations lead to discrimination, misunderstanding of a very complex disease, denial of health management resources and tools by the insurance industry, and uneducated reporting that often leads to societal abuse, bullying, and further discrimination.

Still, there is some good, among the bad, to be found in this article. I do feel that, had the author taken some time to meet with members of the diabetic online community, this article could have really shed some light more adequately, on a lot of issues that affect our community, without contributing so much to the problems it so tries to address.


The Good in this Article: 

• Right off the bat, the article addresses the issue that the medical industry does not like to discuss with patients, or at least seldom does, the idea that they can manage their diabetes without medications, much less what Diabetes even IS. This is, indeed, a struggle we have right now. But it is a deep, and complex problem involving a lot of ethical concerns which affect almost every aspect of the health industry, including the American Diabetes Association itself (its probably not an accident that they recommend diabetics keep their blood glucose levels at or below 180 mg/dL -- a very high, and potentially long term dangerous, blood glucose level), as well as other diabetes medical guideline agencies. The fact is, many medical professionals receive kick backs and incentives from the pharmaceutical industry -- large kickbacks and benefits -- and its in their pocketbooks best interests to keep as many of their patients taking certain medications. This is not something exclusive to the diabetes industry, though. I am sure this is one of the prime reasons why there are now, commercials on mainstream media, for prescription only medications. Its BIG business, and theres no better salesman out there than your doctor. 
• Andriote does some thinking outside the box, which is helpful: Chronic illness, particularly obesity and diabetes, are multi-faceted diseases which do not have just one contributing factor to them (though at times he seems to suggest they do) and thus, will need a multi-sector response. He speaks about our sedentary jobs, and a poor transit system, and the lure of the food industry, and how addicting high fat/high sugar/high salt/food combinations can be... and the supposed "myth" that healthy foods cost more than unhealthy foods. He even quotes an article from someone who supposedly "destroyed" this myth. What is perhaps not understood by people who claim that healthy food is cheaper than fast food is that most dedicated Type 2 diabetics dont consider healthy food what they consider healthy food, and they have to cut back on carbohydrates in order to control blood glucose, and not rely solely on their medications for control. Id like to see Andriote actually trying to live a lower carbohydrate lifestyle, at a grocery store, with a maximum of $350 for 2 people, for a month worth of groceries, and not being able to eat as many starches, grains, and other foods which ARE the cheaper foods, for their value and how far they go. Living on lean proteins, and veggies, and cutting back on all those starches and breads, and grains is NOT cheap. Also, per the fast food cost example he uses, if one assumes poor people buy value meals at fast food joints to feed all of their family members, one might be very, very naive: there is such a thing as a dollar menu, or less, at these places... And people KNOW this. How can you beat $2 for two double cheeseburgers at McDonalds??? It costs me $2.88 a lb alone, for chicken! (And its cheaper in Iowa, than in many places...) 
• Andriote talks about the need for balance in media industry reporting (Surprisingly): On the one hand, you dont want people dismissing diabetes as not serious enough, but on the other, you dont want to create a public backlash for patients. "When the media do focus on type 2 diabetes, said Sarah Gollust, assistant professor at the University of Minnesota School of Public Health, they give twice as much coverage to the behavioral risks for it than any of the other factors that contribute. But this over-emphasis on personal responsibility tends to blame and stigmatize people with type 2 diabetes or who are obese. Those living with the disease may feel its their fault if they cant always maintain the ideal blood sugar level. Worst of all, said Gollust, public support could erode as people are expected to cover the costs, however they can, of a medical condition its believed they brought on themselves ... Public support for addressing diabetes is imperative when you consider the tremendous amount of money it costs to manage the disease." This is a very important reality that we, as Type 2 Diabetes patients face as we strive to manage this disease. We NEED support, and we cant succeed without it. However, many of the undercutting remarks Andriote makes, including his headline, are FAR from being fair and balanced, and certainly not supportive! On page 2, Andriote has a "listing" of facts, and goes on to say that "Although there is a genetic predisposition for type 2 diabetes, the vast number of cases are the outcome of poor diet, obesity, and a sedentary lifestyle." Of course, this is contradictory... because ALL cases are of genetic predisposition. If not, then ALL obese persons would have diabetes -- and this is simply not the case. (I wont even go into his usage of the phrase "people of color" to talk about African-Americans, Latinos, and other minorities...) 

The Bad in this Article: 

• Andriote, sort of, implies that most Type 2 Diabetics could manage their condition without the need for medications, if they just try a little hard, and then they would be cured. There is a BIG disconnect in here: 
• For one -- he fails to realize that by the time the average person is diagnosed with Type 2 Diabetes, their disease is so advanced, they have lost nearly 40-80% of their beta cell function, making it extremely challenging to near impossible to control blood glucose levels without the assistance of oral medications, or insulin. Again, being the multi-faceted disease that it is, diabetes NEEDS a more aggressive and aware medical community, as well as increasing efforts in continuous education FOR the medical professionals, as well as patients. A medical professional who cannot think diabetes, and catch all the symptoms and markers of diabetes, in an age when its being considered as an "epidemic," is a medical professional who will endanger lives, and contribute to the rising costs of the disease when it comes to complications that are not being caught on time. 
• Secondly -- The kind of lifestyle changes to achieve true remission and euglycemia, are a lot more stringent than what the ADA might tout. You *cannot* reach euglycemia -- true euglycemia -- while thinking that blood glucose numbers below 180 mg/dL are normal. True euglycemia are levels that are below 140 mg/dL or lower, after 2 hours of eating, and in fact, rarely exceed that. In fact, some might even say below 120 mg/dL at 2 hours, or less. Not everyone can achieve those levels -- especially, if they struggle with hypoglycemia, or  have other health related dietary considerations to make that might not allow them to easily cut back on carbohydrates, or increase certain levels of exercise, etc. I, for example, have to consume 80-100 grams of carbohydrate a day, at a MAXIMUM, in order to maintain my euglycemia. This is unrealistic to many people... and its not a character flaw! It is HARD, often unrealistic, work. 
• Thirdly, he goes on to claim that if folks worked hard at it, they could "cure themselves," and he uses an opinion paper, mind you, to try to back up his assertions. He even goes as far as claiming that this is the opinion of the American Diabetes Association (ADA), by claiming that the ADA says that "maintaining normal blood sugar without medication for at least a year could be considered a "complete remission,"" when in fact, the ADA specifically highlights a the end of the second paragraph, in that same opinion paper that "The opinions and recommendations expressed herein are those of the authors and not the official position of the American Diabetes Association." Moreover, the panel of those expressing their opinions recognized that they had clear conflicts of interest in the matter, and also, found it difficult to reach consensus considering the wide arrange of questions to be considered. The group does, though, make a very telling distinction between a cure, and a remission... which the author of this article seems to gloss over, quite nicely, to what he could take out of context, and better fit into his piece: "Medically, cure may be defined as restoration to good health, while remission is defined as abatement or disappearance of the signs and symptoms of a disease (3). Implicit in the latter is the possibility of recurrence of the disease. Many clinicians consider true cure to be limited to acute diseases. Infectious diseases could be seen as a model: acute bacterial pneumonia can be cured with antibiotics, but HIV infection, currently, can at best be stated to be in remission or converted to a chronic disease. The consensus group considered the history of childhood acute lymphoblastic leukemia, which evolved from a uniformly fatal disease to one that could be put into remission to one that can now often be considered cured (4). Conversely, chronic myelocytic leukemia is now considered to be in prolonged remission, but not cured, with therapies such as imatinib ... For a chronic illness such as diabetes, it may be more accurate to use the term remission than cure. Current or potential future therapies for type 1 or type 2 diabetes will likely always leave patients at risk for relapse, given underlying pathophysiologic abnormalities and/or genetic predisposition. However, terminology such as “prolonged remission” is probably less satisfactory to patients than use of the more hopeful and definitive term “cure” after some period of time has elapsed. Additionally, if cure means remission that lasts for a lifetime, then by definition a patient could never be considered cured while still alive. Hence, it may make sense operationally to consider prolonged remission of diabetes essentially equivalent to cure. This is analogous to certain cancers, where cure is defined as complete remission of sufficient duration that the future risk of recurrence is felt to be very low."

You see, it is one thing to call something a "cure," because it is more hopeful, and more satisfactory to a patient... than for that to be, actually, a cure. The likelihood might be low, but it is, in fact, not a cure. As a comparison to HIV made above, for example, people like Magic Johnson have had their HIV infection in remission for years, but would would we say that hes cured? Not in a million years. Just because I cant "infect you" with diabetes does not mean Im cured. This debate among colleagues does not equate to something actually being "officially" considered a cure. Obviously, operationally, we cannot treat presently uncontrolled diabetes in the same way as diabetes in tight control, or in remission... So DUH, it can be "operationally" a cure, but not in truth. Remission is remission. A cure, is a cure. This is truly, irresponsible journaling at its best. 

I would add that the amount of mental focus that is required in maintaining diet, food carbohydrate counts, exercise, and meal planning often borders on obsessive and unhealthy, and ends in many an eating disorder for many diabetes patients. The psychological ramifications of attaining euglycemia, at all costs, for many... have NOT been assessed, and yet, they are just as much a part of the disease as hyperglycemia and other markers. Diabetes is NOT just a disease of high blood glucose!  

• The author uses statistical scare tactics to put the fear of God in you: But he does not put them in perspective. Its one thing to discuss how the rate of diabetes will triple, or double, or whatever. Its quite another to not discuss the rate of population growth, right along with that. Obviously, people ARE reproducing, and diabetes isnt just happening in a vacuum where the rate is growing by leaps and bounds larger than what it is. Its hard to say, because what will the population be in 2050? Our population is EXPLODING to what are potentially unsustainable levels, and of course, thats going to make numbers for any disease seem scary high, without some perspective. What would the rate be in RELATION to total population at that time? THAT is what the question should truly be... In addition, the author wrongly states that the prevalence of obesity has been increasing, year after year, when the prevalence of obesity has remained STEADY for the last 12 years.  Could it change, tomorrow? Sure... but for now, I think we can say many folks are starting to be more conscious of obesity, and their health, even if they might not see themselves as overweight. Andriote fails to keep balance in the picture hes trying to paint.
• While Andriote wants to instill a sense of seriousness to diabetes, while claiming we need support, he attacks commercials with friendly faces and role models, claiming that persons who are fit, or joggers, or younger folks -- are not what most Type 2 Diabetics are like. Perhaps not (some) newly diagnosed Type 2 Diabetics, but is it wrong to have positive role models to aspire to? Is it wrong to see that some of us HAVE made changes, and CAN live a healthful life? Is it wrong for me to see another 35 year old I can relate to, on the tv? I fail to see just what he wants to accomplish, here. Does he want a fat, old Joe, sitting on a sofa, not able to move, and popping pills, or doing leg exercises from a chair, because he cant move? Would THAT be more appropriate? Or perhaps, he wants people with their limbs amputated, like the city of New Yorks shocking diabetes ad campaign? Im not sure whats the alternative hes looking for, here, and whats running through his mind. 

Of course, I cant end without discussing... that headline. "Curing Diabetes: How Type 2 Became an Accepted Lifestyle" ... Im guessing hes trying to say most people just "accept" and take the diagnosis as a given, that they will need to live with this disease, forever... and take pills forever. But boy, is it an uneducated headline. Yes, people can live pill free, for a while... and depending WHEN they were diagnosed, if it was late in life -- maybe they might never have to take any meds, ever. But no, its not a cure. Type 2 Diabetes IS a progressive illness, and the likelihood of a need for medications increases with the LENGTH of time weve had this disease -- and not exactly with how well weve taken care of it. Time goes by, and not in vain... our bodies DO age. Things break down. My father was in remission for years, yet he was never cured; diabetes still progressed, and still took his life. It happens.

Diabetes is not an "accepted lifestyle" anyone chose, anymore than people who got AIDS or HIV (by whatever method), CHOSE that as their lifestyle. I bet you $1,000,000 that this author would NEVER dream of writing "Curing HIV: How HIV Became an Accepted Lifestyle," merely because he read an opinion piece on how one can keep HIV in remission for YEARS. The headline even seems to sort of imply that we "coddle" people into being lazy about their care, and lazy about "curing themselves," so that we dont need to support them. Its not a disease, if you would, its a "lifestyle." Yes, because Type 2 Diabetes is sooooooo glamorous. Its the lifestyle of the fat, and sloppy, and just give me my Metformin, over here. Ill take it with a side of that value meal, please. 

Sadly, Andriote could have done SO MUCH to advocate and help our community, but instead he chose the low road of blame, and veiled vitriol in between his lines. How someone who has written for the AIDS community can be so close minded about the needs of another equally ostracized community is BEYOND me. 

6 Mistakes When Treating Yourself

6 Mistakes When Treating Yourself | In the midst of economic trouble, many people trying to take medication against itself (self medicine). Treating yourself is fine, as long as done properly and correctly.

Was delivered by Prof.. DR. dr. Rianto Setiabudy SpFK of the Department of Pharmacology Faculty of Medicine, University of Indonesia, in a discussion entitled Rational Use of Drugs "on Thursday (3/29/2012) in Jakarta.

"Treatment of myself would be very useful because it can save time and transport costs, reduce the cost of consulting a doctor, and some diseases in people classified as self-limiting disease that fast," he said.

Rianto explained that the disease may be treated by a layman, has a characteristic in which the disease is usually mild, it will heal itself within a short time and is not harmful. Disease such as cough and cold no more than 5 days, mild diarrhea for several days, mild headache, constipation and difficulty sleeping.

"But sometimes we have to be careful. Although fever is just one day but if seizures, should be immediately taken to the doctor, because its not cold," he said.

Rianto warned, there are a number of diseases that should not be treated solely by the layman. Characteristics, the disease tends to be heavy, do not heal themselves (though not painful). For example, hypertension, diarrhea, diabetes, cancer, kidney disease and heart.

Even so, Rianto confirmed not everyone is able to apply the practice of self-medication correctly. He said there are a few examples of common mistakes made ​​by people in self-medicate:

1. Treat colds, coughs, colds with antibiotics.

"Its very bad and there is no similar benefits sakali. No viruses that can be treated with antibiotics," he said.

2. Excessive use of vitamin

Rianto said the research results of the National Cancer Institute in the United States showed that people who daily consume more than 1 kind of multivitamin greater chance of developing prostate cancer. "Although the truth of these findings is still debated among scientists," he said.

3. Leaving the drug for "Next pain"

In some cases, Rianto observed, patients who do not spend a lot of prescription drugs in accordance with a predetermined time. For example, a drug that should be spent within a week, but only taken up to four days (because the body is feeling a little better), then the rest is stored and used when the disease relapsed.

4. Use the drug, which looks effective for others

"Do not they see friends or relatives can be cured by taking medicine from a doctor giving, then we went along to drink," he said. According Rianto, although the same diseases that we suffer with others, but not necessarily being the same. Due to the severity of the disease every person is different.

5. Buy hard drugs without a prescription

When compared with neighboring countries such as Malaysia, for access to medicines in Indonesia is still too easy. Even a drug that should only be purchased by prescription, can be easily obtained at drug stores. "In Malaysia, if you want to buy prescription drugs antibiotic should be used. But if in Indonesia, never asked a prescription. It was in vain we cry to combat resistance to the drug if the system still like this," he explained.

6. Treat yourself malignancies

Until now, there are still some people who believe in traditional medicine is more than going to the doctor, especially in treating dangerous diseases such as cancer, diabetes, heart.

Things to consider When Buying Home go Equipments

There are a hundred lots of home cut equipment nowadays that are open in the sell. Do not make the mistake esteem buying something and since regretting why you bought it after a allotment or two. home pass equipments vary also you should always have one good reason to buy it. Don't believe on item commercials tell you about the equipment. Some equipment may seem slight to use on television but n fact will not altogether work for you. Try to cross-examine yourself peerless of these questions before you grasp your wallet and buy that equipment.

Do you need it? The equipment should suit your interests and needs. The activities that you will do with that equipment should be challenging and salient to enjoy on. Buying equipment is never a guarantee that you will interest it especially if it is something new that makes authentic harder to gravy train. Make sure that you already realize the equipment and that it is exigent that you already objective in a fitness club. perform from buying small equipments that are level to your interests.

Can you afford it? Don't be fooled stifle the perception that you consign be forced to use something because you spent too glaringly money whereas firm. Expensive equipments are never an assurance that you will use them or that they are effective for you. Always swallow how much are you distinct to bread for certain equipment. Also ask yourself iif it is worth it. Always comply on the quality before you buy equipment. The price may be too low but presume true that the quality can besides act for low. Or it may emblematize of value but then the quality is not that desired. You can stab choosing on cheaper alternatives but not sacrificing the temperament of the equipment.

You may also want to check out for some used equipments. Most of the time, this is where you find a better deal. You can even find equipments that get done not seem to opine been used at a excessively low degree. Or you can pride the equipment 3 months expired but the price is almost half the original.

Do you have enough space for it? This is often what buyers forget to hold. Try to consider first locality to live a treadmill before buying it. Before you agree something, make decided you know where you will place perceptible. Your place may not accommodate the equipment. Plan head and make certain that the equipment can represent placed in your home gone astray causing any hassle.

Is it safe for you? If you have existing conditions, be sure to check with your cherish to make actual that the equipment cede speak for inoffensive for you. Some equipment may be painful to use further might cause injure to your body. So introduce sure to try it first substitute fore you buy it.

It also suggested that you capital opine if a gym near you already has that equipment. You can save money by just registering to that gym and use that device compared the price you will spend if you will buy that product.

Buying fitness equipments should be bought with consideration. resolve not buy by punch. Always challenge the opinion of a licensed gym instructor before you stand together something.

Have Knee Pain When Walking Up or Down Stairs Learn About Chrondromalacia and Knee Pain Treatment

If you have knee pain when you walk up or down stairs, you might be suffering from chrondromalacia. Also known as patellafemoral pain syndrome, chrondromalacia often occurs without a specific traumatic event. The pain of chrondromalacia is sometimes compared to a toothache and it is often present when you stand up after sitting in a chair for a while.

Chrondromalacia of the patella is a common cause of knee pain, especially among women. While it sometimes happens following some type of traumatic event involving a hard hit to the knee, more typically, it happens over time when the kneecap becomes agitated or starts to wear out.

Knee pain treatments for those suffering from chrondromalacia does not typically involve surgery. The preferred approach for addressing patellofemoral pain is physical therapy combined with the use of shoe orthotics that provide stable support for the arches and feet.

Because the knee pain caused by chrondromalacia is often caused by body geometry that places increased pressure on the kneecap which over time leads to knee pain, the treatment focuses on altering the position of the leg to lessen the pressure on the knees.

While foot positioning is corrected by orthotics, strengthening exercises are also recommended for the muscles around the knees, especially those near the kneecap on the inner thigh.

Closed chain exercises, or exercises where a persons foot moves in a predetermined space so that it does not shift around, is helpful. Examples of closed chain exercises include activities like bike riding, mini squats and leg presses. A trained physical therapist can provide an exercise regimen that includes a variety of closed chain exercises to help strengthen the hips, legs, and knees in order to treat the condition.

Surgery is sometimes recommended by an orthopaedic surgeon to treat chrondromalacia in order to clean the undersurface of the patella or kneecap. This type of orthopaedic surgery can be conveniently done as an outpatient procedure using an arthroscope. Knee replacement surgery may be recommended in more extreme situations when damage to the undersurface of the patella has progressed to the point where the cartilage is worn out and exposed bone is evident.

Typically if you are suffering from knee pain including chrondromalacia or an ACL injury, you can find a successful knee pain treatment by consulting your orthopaedic physician. In many cases, before considering knee surgery, there are a number of non-surgical treatment options for you to consider. Often a combination of exercises, physical therapy, and orthotics will provide effective knee pain treatment.

Article by : Stacie L. Grossfeld, MD

Article Source : Have Knee Pain When Walking Up or Down Stairs? Learn About Chrondromalacia and Knee Pain Treatment

Cotton Bud When Danger Ear Cleaning

Health for human | Not a few people who choose to clean their ears using a cotton bud. Unfortunately, if not careful, it could cause harm, such as ringing in the ears or around the facial nerve paralysis.

According to a recent study, more than 50 percent of patients who come to a specialist Ear Nose and Throat (ENT) often use a cotton bud to scrape dirt in the ear. Although the tip is made of cotton, these tools are still at risk of damaging the eardrum. Apparently not secure a cotton bud ya hehehe

hearing loss commonly experienced by users of a cotton bud is tinnitus or ringing in the ears. While the hard-driven face is a symptom of nerve damage are also induced damage to the eardrum.

Fortunately, recent research conducted by Dr. Ilaaf Darrat, ENT specialist at Henry Ford Hospital, showed that 97 percent damage to the eardrum can heal itself in time average of 2 months. Surgery is only needed if the impact on surrounding facial nerve paralysis.

Research presented at the Combined Otolaryngological Spring Meeting in Chicago included 1540 patients who suffered damage to the eardrum between the years 2001-2010.

Then how do I clean the dirt right ear?

As reported by detikhealth, a function of earwax protect the ear from damage and infection, so do not need to be cleaned too often. But earwax is also sometimes disrupt the hearing.

The skin on the outer ear canal has special glands that produce earwax - known as cerumen. Each person has a different cerumen. There is a liquid, solid or in the form of dry skin. The color also varies depending on the composition.

Most of the ear canal can clean itself, by way of lining the ear canal skin migrates from the eardrum to the outer ear opening. Old earwax will continue to be transported from the deeper regions of the ear canal toward the exit, usually dry, flake and fall. But when too much earwax, thus forming block the ear canal and disrupt the hearing, then thats when earwax needs to be cleaned.

People will try to use a cotton bud or ear drops earwax when too hard. The use of cotton bud well done when the state of liquid wax and not a little hard. Because if the hard ear wax, then use a cotton bud will actually make the dirt deeper into the ear.

For those who use ear drops, it is important to know in advance that your ear has not been perforated (leaking) eardrum. Using state of ear drops with perforated eardrum can cause infections of the middle ear, and if accompanied by pain, pain or rash, use of eye drops should be discontinued.

At times like this, your doctor may need to clean out the ear wax (known as lavage), with a vacuum, or even clean it with special instruments. To maintain the health and cleanliness of the ear, it helps if you visit a health professional to clean the ear every six months.