What Is the Best Way to Treat Diabetes?
Medical controversies last a long time and are often bitter not only because science gives provisional rather then definitive answers to most questions, any of which answers may soon be overturned by further evidence, but because science by itself provides no means of deciding between incommensurable results according to a single criterion of value. Besides, everyone likes a good intellectual argument and wants to keep it going as long as possible.
An editorial in a recent edition of the New England Journal of Medicine claims that the long-running controversy over whether surgery or angioplasty is better for diabetic patients with ischaemic heart disease has now been decisively resolved in favor of the former, thanks to a paper published in the same edition. The matter is not a small one: in the United States alone 175,000 diabetic patients were treated last year either with surgery or angioplasty, and the figure is likely to rise as the number of diabetics grows.
The paper described a trial in which 947 diabetic patients with ischaemic heart disease underwent surgery and 953 underwent angioplasty (there were no untreated controls). At five years, mortality in the angiolasty group was 16.3 percent as against 10.9 percent in the surgical group; in total 26.6 percent of those treated with angioplasty had either died or had had a stroke or heart attack, as against 18.7 percent of the surgical group.
You might think, as the writer of the editorial evidently thinks, that the matter is now settled once and for all: surgery is best. But I noticed something implicit in the figures to which the authors did not fully draw attention. Patients who underwent surgery were twice as likely to have strokes as people who had angioplasty, and furthermore the strokes that they had were twice as likely to be incapacitating as those suffered by the angioplasty group. If my arithmetic serves me (which it may not), there were about 10 more patients in the surgery group with incapacitating strokes than in the angioplasty group. On the other hand, about 50 lives would have been saved by the surgery by comparison with angioplasty.
How does one compare the worth of five lives saved at the cost of one incapacitating stroke? To make an informed decision, a patient must know both the absolute and relative risks of good and bad outcomes of the procedure to which he is giving consent, and to make that decision at a time when he is probably not feeling at his best. Even the doctor advising him may not have all the evidence at his fingertips, or understand its meaning: such a thing has been known. Besides, according to the new medical ethics, the doctor is no longer an adviser, which is paternalist and therefore bad: he simply lays the scientific evidence before the patient in as neutral and objective a fashion as possible, and lets the patient decide. Perhaps diabetic patients with ischaemic heart disease will have to be given a copy of this paper. I wish them luck.
There is one more question to which the paper does not address itself, but is not without a certain importance. Many or most of the patients treated were approaching the age when their cognitive reserve had shrunk. Surgery is often associated with an irreversible decline in cognitive functioning, sometimes a very marked one. If, then, there were a difference in outcome between the procedures from the point of view of the patient’s cognitive capacity afterwards, it would be important for him to know it: that is, if Man is a rational animal and mere survival not his highest good.
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Images courtesy shutterstock / mayamaya / Miriam Doerr
More from Dr. Dalrymple at PJ Lifestyle:
The Worldwide Evolution of Life Expectancy
The Sleep-Deprived Doctor Saving Your Life
As Life Expectancy Increases Will the Elderly Become a Greater ‘Burden on Society’?
Should Doctors Lie to Their Patients About Their Survival Chances?
How Doctors Turn Their Patients into Drug Addicts
BREAKING NEWS: Study Confirms Natural Disasters Make People Unhappy
Er, is this really about treating diabetes?
That aside, though, it’s a good point — how do you decide? I’m pretty medically sophisticated for a non-MD, and I’m certainly more mathematically sophisticated than 99 percent of the population, and basically it appears the question is between X probability of infarct — really two probabilities, X_1 probability given angioplasty, and X_2 given surgery — but with Y probability of a serious stroke and Z probability of pumphead given surgery.
Having just watched my mother die of congestive heart failure leading to multiple organ failure post-MI, that doesn’t look like fun at all. On the other hand, a stroke sounds kinda horrible too, and I’ve got friends with pumphead that really don’t like it.
I can write out a mathematical expression for this; the only problem is how to estimate the relative utility of being a cardiac invalid versus being a stroke basket case.
are you stoned or just stupid
The best part about writing here is the quality of comments.
time I have encountered a snarky post of yours. You need to go out there, find your rock & crawl back under it, never to be seen or heard from again.
Your late brother Peter would be very ashamed of you.
Most “outcome” studies are done using Quality Adjusted Life Years, or QALYS. Determining the quality, is of course, the hardest part but there are methods to do this. A study without such methodology is not of much use. “Pumphead” can be avoided with “beating heart” surgery, not always possible. I had such a procedure myself about 15 months ago and, being a former heart surgeon, I was pleased it was an option. I haven’t read the study but would also caution that the options available to older patients with co-morbidities like diabetes, are going to be increasingly controlled by cost, not QALY.
Er, what Charlie said! Better than I can.
Most importantly, DIABETICS OFTEN DO NOT EXPERIENCE “CLASSIC” SYMPTOMS OF A HEART ATTACK!
Because of nerve issues associated with diabetes, you likely won’t get that “discomfort in the chest” or “tightness in the jaw,” etc. that warn people of a heart attack.
You may experience shortness of breath, you may suddenly lose stamina, won’t be able to walk as far as you once did, you may cough uncontrollably, especially when you lay down, because there is fluid building in your lungs…
Don’t be in denial. Seek help. Your kids and grandkids will be so happy that you did.
Hm, it is even more complicated than this… “stroke” can be anything from a droopy lip to being unable to communicate.
I see way too many studies out there that are just statistics without thought. Yes, there are differences in outcomes between surgery and angioplasty, but are all the differences caused by the treeatments or are there other things that might cause you to choose a particular treatment that also might cause the different outcome… ie if doctors tended to recommend surgery for patients who were over a particular weight, or if people who had already had strokes would tend to pick one treatment over the other.
Then we have the tendency to switch cause and effect, such as the study that shows that people who drink diet sodas tend to be overweight and concludes that artificial sweeteners cause obesity instead of considering that the only people likely to consistently drink diet sodas are people who are either already overweight or have a reason to believe they will become overweight.
I hardly ever drink sodas of any kind.
What’s wrong with water, coffee, and tea?
Maybe if the dietary advice given to diabetics wasn’t so wrong, many of those operations could be avoided. Low carbs as in less than 30gm carbs and those carbs from green vegetables will go a long way here.
Regards the ‘we only have limited amount of operating theatres and surgeons and money’ that is communist arithmetic — those people believe that humanity is limited in everything which is why they ban and ration things instead of building them.
Don’t forget, there are two types of diabetes: Type I and Type II.
You’re thinking of the more common Type II, which has risk factors like obesity and poor diet, and is usually acquired later in life.
But there is the other type, Type I (juvenile) diabetes, which some children are born with or acquire as young children. A friend of mine was born diabetic. So was Elena Kagan, the Supreme Court justice.
For these folks, diet won’t control their diabetes because their pancreas never functioned. They have to be on insulin for their entire lives–unless they get a pancreas transplant.
You are wrong on a couple of points.
Type 1 diabetes is known as “juvenile” diabetes. However, I am one and presented at the age of 33. I passed all my military physicals with flying colors; The first thing they check for is sugar in the urine.
It is unknown why I became a Type 1 diabetic. Some doctors think it has to do with the extreme rise in white blood cell count when undergoing stress or an infection, with the white blood cells recognizing the platelet cells in the pancreas (those are the cells that produce insulin) as invaders and killing them, thus over time eventually destroying the pancreas’s ability to control blood sugar.
In any case, it’s a real drag but, thankfully, living in today’s age, insulin is largely produced through synthetic means, thanks to the efforts of many people, I can live an essentially normal life.
However, obamacare terrifies me because of the very real possibility that when I retire, it will just not be financially feasible to keep me alive. Insulin is expensive and after 65, I will be of no use to my company and will have to retire. Just as well for the encroaching communism that it’s embracing is already annoying.
On a side note, if you know anyone with diabetes, give them a lot of latitude. They are struggling every day just to keep the numbers in balance and it can affect their moods or even their personality to some extent. If they are less diligent, you will notice odd behavior. Try not to be judgmental. Personally, I check my blood sugar constantly and make adjustments to my insulin or dietary intake as well. However, many factors affect the level of blood sugar to include stress, diet, exercise, sleep, etc. I put stress first because that is the one the diabetic cannot control.
Outside forces such as management treating the employee like crap can affect the blood sugar very negatively. It’s also important for the management of the company to be aware of the many facets that diabetes entails. I was once told by one of my ***hole managers, “Well, heh, you’d better get it taken care of because we can’t afford having you pi** off our other employees”. This conversation was based on the fact that I had a blood sugar low previously that day and one of the after-effects is that I’m a bit snarky and negative for a bit. Maybe it’s due to a lack of character on my part but I have certainly done a great deal of soul-searching to that effect.
Not wanting anyone to have cause to blame me is important so I take my diabetes very seriously. When everything is under control, I’m fine but I fully expect very little help or understanding from my management should I have an episode while at work. They just don’t get it and have never bothered to take the time to listen to me explain it to them.
However, they are very tolerant of gays, muslims and the like in the workplace. But because I’m a white Christian male who otherwise seems “normal”(IOW I’m not in a wheelchair or have any obvious medical challenges), they take it upon themselves to assume my diabetes is of no consequence and luxuriate in their apathy towards me about it. The conversations have been rude and very telling at the same time when they dictate to me.
I didn’t mean to go on about myself but it’s quite revealing how willfully ignorant those who claim to be “tolerant” truly are; Not even taking the time to read the articles and educational material I have provided them.
So, among the many challenges I have as a diabetic, my employer is also one of them.
Oh..and point two: Pancreas transplants don’t take. They have enjoyed minor successes here and there but ultimately, it’s far from a “regular” thing like, say a heart transplant.
It’s worse.
There exist several ways to cure Type 1 diabetes, but they have to go through the FDA, and none of them can be patented. Dr. Faustman (Harvard and U Mass Med.)in the middle of the last decade found 2 protein that people normally produce, but most Type 1 diabetics do not. One protein is secreted by new tissues when attacked by a white blood cell, before that white blood cell has time to label the tissue as foreign for the rest of the immune system. The other picks up cell surface proteins from new tissue, carts them off to the spleen, and tells the immune system, “These are the good guys, so don’t attack them”. The treatment is one shot of each, 24 hours apart.
In spite of these being produced every day of the year in normal humans, the FDA required the full 3-phase human trials work. The average cost for those trials is now $840 million. No, it is not patentable, so it is sitting.
Faustman also found that an older tuberculosis vaccine (first approved in 1909) called BGC can, in higher doses, get 4 out of 5 non-obese diabetic mice to be cured by also resetting the immune system. She has been allowed to get to phase 1 trials on this, but estimates that given the regulatory and financials hurdles it will take another 8-10 years to get through the FDA’s hoops.
So, there are cures out there, but you can bet that with Obamacare they will get to Type 1s like us slower.
I presnted at 49 and your absolutly right, I am a “type 2″ but as one health care worker said I am really type 1 as i must take insulin for the rest of my life.
Decades ago I read an article by a doctor that claimed the sugar disease (Diabetes)
was the root of all disease and the yers have seemed to prove him right. We need to change our food production methods to return to a better functional diet.I too know the workplace disregard from supervisors and coworkers, myy sugar level doesn’t run on the companies break schedule and I have often been given short shrift when it comes to my medical needs. your post is right on target.
I’ll go ya one better, Bill.
While temporarily underemployed due to cutbacks, I went and worked at a Staples store. The manager was a good guy, understood my disease and occasionally helped me out when I had troubles with it. He understood.
However, we got a new shift manager who let the whole store go eat with just me and him on the floor for an hour. I told him I was having a low and needed to eat. He told me that he needed me on the floor. I told him, “You don’t understand, I need to eat NOW..I told you this when you started working here and you said, ‘no problem’. Now I need your help. Let me grab a candy-bar or my glucose tablets or something so my sugar doesn’t crash and I pass out.”
He said I can’t have food while I’m on the floor, company rules.
So I left and went across the street to get something to eat. Never worked there again. I came close to writing a letter to Staples but it was a menial job that was simply filling my gas tank. I had a place to live, etc and no bills so I just let it go. The overall store manager wanted me to come back, as did all the other employees but the one shift puke didn’t so that made it a no-sale.
I probably saved that clown’s job because had I passed out, ended up in the hospital and then explained to Staples corporate that he wouldn’t let me take care of my urgent medical needs, then he’d have been fired. I doubt he had the depth to understand the mechanics of it.
Shortly thereafter I found work in my field again and was back on track. But I wonder how many times such things happen and which result in difficulty or tragedy for the employee.
One more reason Staples is going down the tubes. (Sorry, Mitt! LOL…)
By ALL accounts, Staples’ customer service is abysmal, mostly because of how they treat their sales staff.
There are three types of diabetes: Type 1, 1.5, and 2. Think of each category as a broad umbrella term to cover the wide spectrum of sypmtoms peculiar to each person. Type 1.5 is a combination of 1 & 2 and at its root cause(like Type 1) is the presence of autoantibodies. I am 1.5 and my own body is killing itself by destroying the beta cells that produce insulin. Right now I am on metformin but soon enough I will be on insulin. Testing for autoantibodies is the only way to confirm the differences.
My mother and brother both had/have diabetes. I am 59, 5’7″, 145 lbs and thought I had escaped this curse. I was wrong. I am hoping that my autoimmunity is mild and that I will die before I have to go on insulin or have any severe consequences such as blindness, loss of limb, nerve damage, organ damage etc., etc. My mom went blind in one eye and her death was ugly.
If you are diabetic I suggest that you read “The Diabetes Solution” by Dr. Bernstein. This is the most comprehensive and instructional book and far better than what even my endocronologist knows. Dr. Bernstein is a lifelong Type 1 individual. I also suggest that in addition to having your A1c monitored you add the glyco-mark test. The combination of the two makes for a better diagnostic and montioring tool.
I also suggest the paleo diet. I eat less than 40-50 carbs a day and all of those come from vegetables. I feel great but I know that I am fighting a slow war of attrition. It feels as though I am caught in the middle of a forest fire and I am running around the edge trying to keep the fire at bay and watching it slowly encroach upon my life.
If you are not diabetic, do not rely on a once a year glucose fasting test. Insist on having an A1c and glyco-mark test. If your fasting glucose is 90+ you are on your way to trouble. You should be in the mid 80′s with an A1c of 4.5 or lower. I would also check to see if autoantibodies are present in your blood.
Flagra, I feel your pain, truly. I am tired of explaining to friends why I can’t eat this or that. I don’t want to be a bother to people so I’ve stopped going out and socializing. It’s too much of a hassle. I am getting close to retirement and hope that it comes before my daily battle becomes an anchor around my neck at work.
Here’s another recommendation for Dr.Bernstein’s “The Diabetes Solution”.
My wife has Type 2 Diabetes and since reading this book and eating as he recommends, her blood sugar is lower and a lot more stable. She has many fewer episodes of high or low blood sugar problems.
I have been on the low carb diet with her and at my most recent medical exam my blood sugar, which had been creeping up every year, was exactly normal. My blood pressure is down, my triglycerides are down, my low density lipids are down and my high density lipids are up. I’ve also lost about twenty pounds and feel a lot better.
Glad to see so many people mentioning Richard K. Bernstein, M.D. Per our local VA hospital, the normal A1C range is 4.2 – 5.6%. For diabetics, Dr. Bernstein recommends an A1C of 4.2 – 4.6%.
If you are any kind of diabetic, you should read everything Dr. Bernstein ever wrote. Or at least read “Blood Sugar 101″ by Jenny Ruhl. She runs a web site by the same name but wrote a book w/ the basics for those who felt overwhelmed by all that info. She was thrilled to get kudos from Dr. Bernstein on her little book.
There actually is a finite number of physicians, OR’s, OR staff and time in the day for surgical procedures. I
This kind of ideologically rigid but ignorant “opinion” doesn’t help anything. I work in the OR and my facility is lucky enough to face a significant backlog of elective procedures in an age of declining Obamacare reimbursements. However, one reason we face that backlog is because of limited personnel. Not everything is a communist plot.
“Everything is not a communist plot.”
So, they have you fooled too.
I like the simplictiy of earth clinic here:http://www.earthclinic.com/CURES/heart_disease.html
Im 61 and have flesh body of 20 year old so I must be doing something right. learn from other people’s mistakes on how they treat their flesh body so you do not become elderly before your time I say. The poor Paramahansa Yogananda drop dead at 59 because he had to eat all the fat meat food his worshipers bring to him and I learn from this prepare for the holidays how to say NO to fat meat food and stay serve the adoring people.
But death is not so bad for the Paramahansa as he came to me yesterday as a beauty swan in the 6th heaven 7th angel sanctuary to enter the Great Solomon’s temple in the 11 heaven and then to go to the 1st heaven cleansing of the priests to complete my mission for God
Of course I just made all the demons get frisky and say: Look we caught waxwing boasting, gather an army and we turn him into old man in no time. ” But I command the snow to fall and I go top 2nd heaven light the fires in my stone stove in the enchanted forest and burn away the demons and i see the rest run away with tail between the legs
I find fear and doubts destroy your flesh immune system so gain confidence and turn your fat meat into muscle I say but take your time if the damage is as serious as it was for the Great Paramahansa Yogananda
I formerly was on close terms with a family who had been in Yogananda’s inner circle.
He was a complete fraud.
We’ve been eating the flaxseed oil/cottage cheese blend that Dr. Budwig developed way back in the 50s. It helps prevent all manner of problems like cancer, heart attacks and strokes. It’s healed a pre-cancer skin condition that I had and (though I didn’t plan on it) re-grown hair on the top of my head. You’ve never heard of it because it’s impossible to make a profit off of.
I’d not heard of Dr. Budwig, but googled his simple formula and see that yogurt can substitute for cottage cheese.
I make breakfast smoothies with flaxseed, yogurt, any/all kinds of fruit & fruit juice, spiru-tein protein powder. Flaxseed gets ground up along w/everything else in blender. Can toss in anything, like wheat germ.
I am not a proponent of no fat (or even particularly low fat) foods as some fat is absolutely critical (for example, cell integrity) and think fat in general has gotten a bad rap, altho’ meat fat is obviously worse than avocado fat etc.
“Ischaemic heart disease” at wikipedia doesn’t mention the most important aspect of “prevention”…exercise. In diabetes, too, for what insulin/glucose uptake is still functioning in the cells.
I hope this isn’t too “inside baseball” for a reply. The yogurt use is unfortunately not true nor part of Dr. Budwig’s plan. You can use cottage cheese or quark but not yogurt. I know that the yogurt recipe is out there but it’s wrong. The cottage cheese emulsifies the flaxseed oil so your body soaks it up easily. The answer for reinvigorating the cells is fat. Who’d a thunk it? Our whole lives, I’m 54, we’ve heard about protein ad nauseam but the key is the fat. Flaxseed oil just happens to be constructed of a very beneficial chain of fatty acids that is easily emulsified by the cottage cheese (quark). My father-in-law eats the Budwig Muesli too and it turned his white hair black again. He’s happy. We know nothing of this cure because there’s no way to bottle it or package it or make a profit off of it. If they could put it in bottles and charge 100 times the cost of making it, it would be prescribed by every doctor out there.
“….according to the new medical ethics, the doctor is no longer an adviser, which is paternalist and therefore bad: he simply lays the scientific evidence before the patient in as neutral and objective a fashion as possible, and lets the patient decide.”
Yeah. Sure. Try being a patient with inoperable cancer. There’s not one doctor in a hundred who will lay out the facts — unless of course their brother-in-law has a clinic or hospice. Excepting also the butchers who just want to slash away despite what outcome statistics show from around the world.
Doctors are rarely better than a good computer “expert system”, and when they’re challanged, they always revert to the “Medicine Is An Art” BS. Well it isn’t an “art”. It’s supposed to be a science. LOL.
In reference to comment 7. The first two years of med school train physicians to be scientists. The second two years train physicians to be clinicians. They are supposed to be both. The most a physician can do is to apply the best science (studies and bench work) to the clinical situation with a goal to do what is best for their patient. The science advances and changes but the patient never does. The 13th century farmer asking his physician why his children died is no different from the patient with inoperable cancer at the Mayo Clinic. They both look for an answer and compassion from their doctor. The answers may change over time but the compassion should not. Health and illness are ill defined, complex and intertwined. The conflicts in Medicine reflect the interplay between science and humanity.
From what I learned over the course of my nursing career, the best way to treat diabetes is on an individual basis. The major objective is to keep the blood sugar level under control; it is also the major challenge, particularly in cases of type 1 diabetes. Poorly controlled blood sugar levels is the major thing that leads to deleterious health consequences (high blood pressure, cardiovascular disease, renal insufficiency, renal failure, etc.)
By all means, not allowing a diabetic to eat whenever necessary is like grabbing a cripple’s cane & smacking him in his bad leg with it.
Was there a 3rd group or control group, no surgery or angioplasty? Put me in the neither group please.
If the study was conducted with the evidence-based-outcome model, there would be no need for the 3rd group you describe.
Also missing is a discussion of the 2 groups equivalency. It is almost certain that the 2 groups were not otherwise equivalent (general health pre proceedure). Generally, surgical candidates are in better health. This may bias the outcome of the study if not controlled for.
Based on the synopsis presented here, my first question is whether the patients in the two groups (surgery v. angioplasty) were comparable? That is, were they similar in terms of age, sex, degree of illness? Unless the patients were randomly assigned to a treatment group (and try getting *that* study past your institution’s human-investigation committee), it may be that the patients undergoing surgery were regarded as a better risk for a more invasive procedure, because they were healthier: which means that they would likelier to survive longer, all else being equal.
This is an interesting study, but I’d hardly say that it’s the last word on the subject.
How ’bout this for a way to treat diabetes: Do everything in your power to avoid getting it! It’s mostly a lifestyle disease, and if you follow the government’s food pyramid advice, you’re MORE likely to end up diabetic.
That’s at best only true of Type II diabetes. Type I looks more and more like an autoimmune disease, or possibly a viral disease, with a genetic component.
Of course there’s also some reason to suspect a genetic aspect to Type II.
There are also many drugs that drive sugar levels berserk. One is prednisone and its more powerful buddies. Another family is anti-rejection drugs like Prograf.
Now, I REALLY like my new kidney, and dealing with insulin in this very convenient age has proven not so hard, after all.
I will point a few things out:
The most important decsisions you make about your health are your choice of physicians. You should find a genius internist and then go to the people he recommends ONLY. These people will talk with each other and constatntly compare notes, and your life dealing with a really serious problem, will be far, far better. Miscommunication and sheer incompetence are your enemies when you are really sick. This must all be set in place BEFORE you need, say, a kidney transplant. If you have been so lucky as to have this organised before you are really sick, your outcones will be far better.
There are many foolish doctors (the bell curve spares no man), unfortunately, and the path to less foolish ones always lies with the basic internist.
THE FACT THAT THE DOCTOR IS CLOSE TO YOUR ABODE SHOULD NEVER EVEN BE CONSIDERED!
Unless, of course, you’d like to die young.
Remember, there are even crappy doctors at Mt Sinai and Columbia Prebyterian. Not many, but some.
Not true of Type 2 either, actually. The propensity for insulin resistance appears to be strongly genetic (stronger than for Type 1).
And, of course, if you’re prone to insulin resistance to begin with, eating “right” according to government recommendations, media advice, and most doctors’ demands will decrease your insulin sensitivity faster. Repeated dieting will make it worse, since the body interprets this as cyclic famine and responds by decreasing insulin sensitivity in order to lay down fat stores for the periodic hard times that the dieting has told the body it should prepare for.
Then your doctor will tell you that you must be lying about how much you eat, your relatives will tell you that your blood sugar problems must be your own fault, and the IPAB will tell you that you’re worth less because you have obviously created your own illness through sinful eating. Sigh.
Since I didn’t read the study my question is what form of angioplasty was used for the study? If it was just balloon angioplasty then it’s not a huge surprise there was sufficient restenosis to cause problems down the road. It would be more interesting to me if the study used excimer laser angioplasty. Seeing some of the pictures from studies of diabetics with black tissue of the toe and foot turn back into healthy pink skin after excimer laser peripheral angioplasty I’d be surprised if laser angioplasty didn’t result in better outcomes than getting sliced open.
As Charlie asked, is this really about diabetes? I’m just a civilian but I thought I’d read the same kind of reevaluation of angioplasty and specifically stents, as opposed to surgery, over the past few years.
Kind of falls into the no silver bullets category, medical science has a long way to go, and I suppose even then everybody will still die.
J.
Dr. Joel Fuhrman,author of the NY Times Bestseller “Eat to Live”, recently authored “The End of Diabetes”, which is now available at Amazon.com. I know personally of individuals who have REVERSED diabetes and no longer require insulin. PLEASE take the time to investigate the excellent — and palatable — and life-changing — alternative presented by Dr. Fuhrman.
My wife, a hospice nurse of many years tenure, informs me that this still is so.
Yes, Virginia, we do certainly all die. It’s merely a matter of “when”. And “how”.
Some better than others. Some die with a smile on their face; some die with visions of snakes in their mind. When they see snakes, the Caribbean Nurses’ Aides always open the windows, be it 10 degrees out, in order to “let out the bad spirits”. Noone scoffs. They wait several minutes to finally close the windows.
May God have Mercy on all our souls.
I’m sorry.I meant this as a reply to Josh.
“she spoke again, in a timid voice — almost in a whisper. ‘And can all the flowers talk?’
‘As well as you can,’ said the Tiger-lily. ‘And a great deal louder.’ ”
I recall I light the candle in the 3rd angel sanctuary in the enchanted forest then leave to visit the rest of the 7 angels. When i got back there was the beauty snake right below the candle: “How dare you enter my world” I say back then.
But after that I saw only very wise messages from snake must be reformed since the great fall in the Garden of Eden who know how long this took but why get into details
Such a universe fleeing the dying human being blind for what feels like eternity this is good to open a window and give permission to find peace
I was diagnosed with Type 2 diabetes on Novemer 1, 2010 and quickly thereafter obtained Dr. Neal Barnard’s book on his program for reversing diabetes. (I later bought other books and a DVD by Dr Barnard.). His premise is that excess dietary fat leads to insulin resistance, and so he favors a low-fat diet based on four food groups, with preference given to foods having a low glycemic index.
Using this program, my reversal of Type 2 diabetes was rapid and permanent. Within a few weeks I was off insulin. By late January 2011, my hemoglobin A1c was under 5 (normal) and has remained under 5 to this day.
As for Dr . Joel Fuhrman, I have not read his book on diabetes but I read one of his other books and was favorably impressed.
I have diabetes and had an angioplasty done 10 years ago when I was 57. This was just before they switched to the drug-eluting stent that has caused problems. Mine still works fine.
I meant this reply as a reply to Josh.
I’m sorry if I screwed this up.
I lost 50 pounds last year on a low-carb diet. As a result, the Dr. says my diabetes is cured. I’m sure that weight loss is important but I don’t think it is necessary to endure surgery that could kill to get there.
While I don’t work directly with the cardiovascular system, my specialty requires a lot of care for people who suffer the complications of the procedures mentioned. I made my mind up a long time ago that it would be surgery for me. The higher stroke rate in surgical patients can at least in part be attributed to the fact that stent patients have to be on long term anticoagulant therapy, and if the stroke isn’t due to atherosclerosis, it will be suffered after a post-surgical patient develops an arrhythmia such as atrial fibrillation at some point and may have an embolism of clot from the atrium prior to diagnosis of the arrhythmia. At any rate, the complications I see from bleeding after stenting and the number of repeat procedures stent patients suffer through (all with great benefit to the cardiologists wallet, mind you) have convinced me that surgery is the way to go.
From the article: “Surgery is often associated with an irreversible decline in cognitive functioning, sometimes a very marked one. “
At the signing of the Declaration of Independence Americans ate, on average, 9 pounds of sugar a year. We now consume over 150 pounds of sugar a year.
Gee. I wonder how we can solve the diabetes problem in this country?
The best treatment for Diabetes (type II) is to change one’s diet early or even before being reaching that point. Low carb (not necessarily no carb) seems to be the best way to go. To that end, several of my diabetic friends have begun using our Visalus protein powder in the morning for breakfast to start their day off. Some, especially those who are extremely over-weight or obese, will even add a second protein shake later in their day at meal time. Their sugar levels seem to stablilize and avoid the roller coaster effect. Some have even had their physicians lower or end some or all of their medications. My own sister who is a physician herself, was recently diagnosed with type II and has begun to consume the shakes with positive effects.
For those who are unaware of utiizing a more liquid diet, imagine a high quality protein shake as a high-tech food completely formulated to give a body exactly what it needs to perform to its fullest potential. Here’s the nutritional info http://samanddawn.myvi.net/Resource/DbFile/?f=Vi-Shape_Ingredients.pdf
** Full disclosure, I am a distributor **
But first and foremost, I’m a dedicated consumer who was attracted to the product in the hopes of bringing my diet into line and avoiding a type II diagnosis in the future. Since August 1st, my wife and I have each lost over 50 lbs (my original weight was 285 lbs) and our doctors are thrilled with our success on the Visalus products. You can read about my and my wife’s story here http://samschaos.blogspot.com/2012/10/rising-dawn-90-day-challenge-story.html
http://www.youtube.com/watch?v=vIhNyX3pRrk
Watch it twice.
PREVENTION is the answer.
#1 cause of the rapid increase of diabetes in this country: obesity. So how about everyone just eats a lot less food. How’s that for a cheap idea?
And it’s amazing the amount of pseudo-science that’s thrown around.
As Milo once said to Opus (Bloom County – years ago): “Eat less. Exercise more. “
Let me add that flaxseed oil (or linen seed oil is a very good base for paint.