georgepds

Reclassifying Diabetes: is it Time for an Expanded Definition?

8 posts in this topic

http://www.diabetesincontrol.com/reclassifying-diabetes-is-it-time-for-an-expanded-definition/

 

For those of who who seem to fall through the cracks...

 

 

"If we start by asking a few questions, the need for a reclassification or enhanced definition of diabetes becomes more apparent.

Such as…

  •       Is a patient with type 1 diabetes immune to developing type 2 diabetes in their lifetime, or can they possess features of both, such as dysmetabolic syndrome?
  •       Is it possible for the patient with type 2 diabetes to progress to insulinopenia, become ketosis prone, or even possess immune markers during the course of their disease?
  •       Are there type 1 diabetic patients who never test positive for antibodies, and are thus non-autoimmune yet insulin dependent?
  •    ..."

 

...When a patient presents or progresses in their disease with characteristics beyond the current definition, A V+ for variance would be added to the T1 (Type 1) or T2 (Type 2) nomenclature.

 

...Then the modifier that the patient exhibits would be added to the variant. Such as Ab +/- for antibody status, K +/- for Ketosis prone, IR +/- for insulin resistance, P 1/2/3 for phenotypic featuresand in the future G typing for Genetic Allele expression.

adiantum and JuliaDay2013 like this

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Not necessarily. We've seen a couple of cases here where someone became diabetic due to pancreas damage but, because it was not autoimmune, was treated as an average T2 with the usual advice.

 

I can see how it could be helpful in differenting cases like that.

meyery2k likes this

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Not necessarily. We've seen a couple of cases here where someone became diabetic due to pancreas damage but, because it was not autoimmune, was treated as an average T2 with the usual advice.

 

I can see how it could be helpful in differenting cases like that.

 

However...we cannot even get the medical community to recognize that their recommended diet is outdated and dangerous.  I have little confidence that if they cannot even take a look at the hard data and change their stance on something so basic, they will ever make any drastic changes.

miketurco and OldTech like this

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Yep! Last week I went to the emergency room for mild chest pains and was kept overnight for observations and an NMR stress test (passed).

 

As I got my first meal it was obvious that they were following the ADA recommendations for diabetics.The meal consisted of a large (40%) helping of white rice, a thick beef stew, and a vegetable. They knew that I was diabetic so they included a 'Carbohydrate Count Alert' sticker along with a note to have a nurse observe what I ate so they could appropriately determine my insulin dosage (I'm not on insulin). I only ate the 3 chunks of beef in the stew and the vegetables hoping that I would not get too many carbs from the thick stew. 

 

All this is protocol and I suspect it will only change when heck freezes over. Studies simply do not matter. Protocol decisions are well above the decisions that staff and doctors are allowed to make so there is little point in discussing studies.

 

BTW: I did find the staff helpful (within limits) and that I was allowed to order the rest of my meals carte blanche.

Edited by OldTech

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Anything that presents with high blood sugars gets stuck under the heading of *diabetes.* And we know well that there are almost as many distinctions to the causes as there are people with them. Can't pigeonhole something like this. Needs to be looked at in a case by case way. Unfortunately, it's not going to happen anytime soon.

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I guess it bugs me a bit but mostly it is because the general public really has no clue about diabetes. I can't be too mad because I was clueless until I was diagnosed.

 

I got type 1 (autoimmune) at age thirty. I had no clue what hit me. My Grandmother had diabetes and it didn't seem like a big deal until I realized that it was different. I wish I had understood from the get go, how my life had changed. I might have been a little more prepared. I had five young kids with. I time for myself and I really didn't take diabetes seriously for years.

 

They really are two (or more) very different issues and not only do people around you not understand, you don't yourself understand until it happens to you.

 

So for that reason, it would be nice to differentiate between the different types of diabetes.

meyery2k likes this

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