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In a message dated 1/9/2006 6:58:51 P.M. Eastern Standard Time,

whimsy2@... writes:

Much better to place type 2s on

insulin if there is clear evidence that pills and/or diet/exercise are

not working adequately.

I am type 2 but I am getting tingles in my arm.

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I read it this morning and thought it was a very good part 1, although

pretty depressing. I did write a letter to the editor, which I'll paste

on here. Wonder if they'll print it?

Here's the letter:

Congratulations on your series about the diabetes " epidemic " and its

social consequences. I would like to point out that all is not as

hopeless as it seems. Change can happen - but it will have to start at

the very top, institutions such as our medical schools, insurance

companies and the American Diabetes Association.

The medical schools need to revise their curriculum to reflect, among

other things, the latest findings such as the use of the glycemic index

for diabetic control. This index quantifies how carbohydrates are

metabolized in the diabetic's body. High GI carbs, such as the

" whites, " -- breads and in fact, anything made with grains, including

pastas and cereals, rice and root vegetables, cause high blood glucose.

Eliminating these foods from a diabetic diet helps keep BGs in the

non-diabetic range. And frequent glucose testing with meters needs to

be encouraged.

Insurance companies need to expand the number of permitted test strips,

which are very expensive. At the beginning, at least, new diabetics

need to learn how different foods affect their blood glucose and then

eliminate those foods from their diet. Diabetes is not a

" one-size-fits-all " disease, but up till now, it has been treated thus.

Far too few doctors understand that this is the true purpose of blood

glucose testing with meters.

It's probably too much to ask drug manufacturers to reduce the cost of

test strips to make them more affordable. However, insurance companies

could certainly revise their guidelines to allow for more than 2 or 4

tests per day. In the long run, this will save millions of dollars

because more diabetics will be able to afford to test more frequently,

avoid the foods that cause high BGs and thus avoid diabetic-related

complications.

Further, far too many doctors rely on the American Diabetic Association

recommendations, which encourage high GI food consumption. So the ADA

needs to redefine its teachings. At this point, following the ADA

" diabetic diet " truly does cause high BGs and diabetic related

complications.

Medical schools should have a specialty in diabetics, not merely as an

adjunct to endocrinology. They also need to have more classes on

psychology and the psychology of motivation, to get diabetics to test

more. Unlike many other chronic conditions, diabetes is best managed by

the educated diabetic

Medical schools also need to teach doctors how to prescribe insulin

properly. Most doctors prescribe a " set dose " of insulin one or two

times a day, which rarely works, since the amount of carbohydrates one

eats in a day varies widely. Much more efficient is basing insulin

dosage on the amount of carbs eaten, as those on insulin pumps do.

Further, they need to recommend the use of newer, faster-acting insulins

instead of the old NPH and regular insulin, which have irregular action

curves and often cause unexpected and dangerous hypoglycemic episodes.

I would point out that there are other categories of diabetes besides

type 1 and 2. There is LADA, latent autoimmune diabetes in adults, which

is essentially type 1 diabetes occurring after age 35 and caused by the

same autoimmune process that causes type 1 diabetes in children. Too

often doctors assume that if a patient is adult at onset of diabetes,

it's type 2. This is clearly not true. My own LADA diagnosis was made

at age 60, 8 years ago.

In this case, misdiagnosis can be dangerous and cause diabetic related

complications because after a short while the traditional type 2

remedies -- diet and exercise or pills will not work. Insulin is the

only appropriate and proper treatment for LADA, as it is for type 1.

I have been managing my LADA successfully since diagnosis and have no

diabetic related complications and my plan is to reach a ripe old age

with all my parts in excellent working order.

Lastly, I would point out the excellent support available with online

diabetic groups. I would especially refer people to Dr. K.

Bernstein's website. Dr. Bernstein is an MD, author and type 1 diabetic

who successfully reversed his diabetes-related complications through the

use of insulin and a lower carbohydrate diet.

The successful management of diabetes is complex but it is, indeed

possible. Unlike many other diseases, the patient can actually control

his/her diabetes. But it's not going to happen unless all the above

changes take place. I'm rather pessimistic about it happening in my own

lifetime. But one can hope.

Vicki Abbott

Portland, Oregon

Times series

> The lead story in the New York Times today is the diabetes epidemic. I

> guess

> the prevalence in New York City is the highest in the nation. They're

> doing

> a 4-part series, Monday through Thursday, with more stuff and feedback

> online. This might be a good chance to spread the word about the

> benefits of

> good control.

>

> Gretchen

>

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Vicki, I sure hope they do print your letter. It was beautifully written and

covers all the important things. Lots of good luck.

Lou

whimsy2 wrote:

> I read it this morning and thought it was a very good part 1, although

> pretty depressing. I did write a letter to the editor, which I'll paste

> on here. Wonder if they'll print it?

>

>

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Very well written Vicki, I hope they print it.

Bev Thoman

-- Re: Times series

I read it this morning and thought it was a very good part 1, although

pretty depressing. I did write a letter to the editor, which I'll paste

on here. Wonder if they'll print it?

Here's the letter:...

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Just realized I forgot to mention in that letter that doctors need to

place type 2s on insulin far earlier than they have been. Once the

complications are there, it is too late. Much better to place type 2s on

insulin if there is clear evidence that pills and/or diet/exercise are

not working adequately.

O well.

Vicki

Re: Times series

> An excellent letter, Vicki, written with clarity and authority.

>

> Paice

> www.dapaice.com

> " Click on Potpourri for diabetes tests. "

>

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> I read it this morning and thought it was a very good part 1, although

> pretty depressing.

I was pleased to see that they pointed out that a lot of overweight couch

potatoes *don't* get diabetes and that type 2 can be delayed " and possibly

prevented " by lifestyle changes. This is a big change from the usual blaming

the patient and saying that type 2 can be prevented with " simple lifestyle

changes. "

> I did write a letter to the editor, which I'll paste

> on here. Wonder if they'll print it?

If they don't, you could post something to the Web site.

You might want to wait until the end of the series to send the letter, if

it's not too late.

It's a good letter, but if you could shorten it a bit, you'll increase the

chance that they'll use it.

Gretchen

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An excellent letter, Vicki!

I hope they do print it.

Hugs, Dianne

__________________________________________

Yahoo! DSL – Something to write home about.

Just $16.99/mo. or less.

dsl.yahoo.com

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In a message dated 1/9/2006 8:09:31 PM Eastern Standard Time,

gretchen@... writes:

> It's a good letter, but if you could shorten it a bit, you'll increase the

> chance that they'll use it.

That's great advice, Gretchen. The letters I've had published were short and

controversial. Unfortunately, non were about diabetes . . . yet!

Paice

www.dapaice.com

" Click on Potpourri for diabetes tests. "

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I've just finished part 2 of the series. It's good, but they made a

major error, and I wrote them about it, as follows:

<<

There's a glaring error in your otherwise excellent series on Diabetes,

part 2, in today's paper:

You stated,

" Type 1, which comprises only 5 percent to 10 percent of diabetes cases,

is not associated with behavior, and is believed to stem almost entirely

from genetic factors. "

Type 1 in fact stems almost entirely from AUTOIMMUNE factors. Genetic

factors are almost purely coincidental.

I hope you will correct this, either by printing this letter or by a

sidebar.

<<

They haven't printed any of the Letters on the subject yet -- maybe

tomorrow -- but I'm sure mine was too long. I did post it on their

Forum section in a somewhat edited form -- it was too long for that

venue also. It's an interesting discussion, though. This is the link:

http://forums.nytimes.com/top/opinion/readersopinions/forums/health/thediabetesc\

risis/index.html?page=recent

There was also an excellent and related article in the Health section

about the connection between diabetes and heart disease:

http://www.nytimes.com/2006/01/10/health/10hear.html

Vicki

Re: Times series

> In a message dated 1/9/2006 8:09:31 PM Eastern Standard Time,

> gretchen@... writes:

>

>> It's a good letter, but if you could shorten it a bit, you'll

>> increase the

>> chance that they'll use it.

>

> That's great advice, Gretchen. The letters I've had published were

> short and

> controversial. Unfortunately, non were about diabetes . . . yet!

>

> Paice

> www.dapaice.com

> " Click on Potpourri for diabetes tests. "

>

>

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I started to write or email the Times yesterday, but then decided it

was futile. I get so sick and tired of reading how type 2 diabetes

is " caused " by obesity. They don't seem to get it that just because

there is a correlation between the two, that doesn't mean you can

draw that conclusion. In my case, and in others I'm aware of, I'm

certain that the slow onset of diabetes was responsible for my weight

gain and not the other way around. Three years prior to diagnosis,

my doctor mentioned an elevated glucose level, but since he kind of

blew it off I didn't worry about it. By the time I was diagnosed I

had a fasting BG of 338 and an A1c of 10.7. I had also gained about

45 pounds. As soon as I got my BG under control, I dropped those

extra pounds with no effort. It makes sense to me that if you have

increased IR, you have both insulin and glucose building up in your

system, and from what I've read, it will cause you to store the

excess as fat. So as I became increasingly IR, I gained weight. I

also lost energy and became tired easily, so my activity level went

down. Once I got back to normal BG levels, my energy level shot back

up. I did not " cause " my diabetes. My father died from

complications of diabetes, and it is also prevalent on my mother's

side. None of the diabetics on either side are particularly

overweight, and some are downright skinny. I wasn't morbidly obese

at 45 pounds over even at my highest weight. Some of my family

members who do have weight problems are NOT diabetic. For me, it was

a strong genetic predisposition. Oddly, we have both T1s and T2s in

my family tree.

Christy

-- In diabetes_int , " whimsy2 " wrote:

>

> I've just finished part 2 of the series. It's good, but they made

a

> major error, and I wrote them about it, as follows:

> <<

> There's a glaring error in your otherwise excellent series on

Diabetes,

> part 2, in today's paper:

>

> You stated,

>

> " Type 1, which comprises only 5 percent to 10 percent of diabetes

cases,

> is not associated with behavior, and is believed to stem almost

entirely

> from genetic factors. "

>

> Type 1 in fact stems almost entirely from AUTOIMMUNE factors.

Genetic

> factors are almost purely coincidental.

>

> I hope you will correct this, either by printing this letter or by

a

> sidebar.

> <<

>

> They haven't printed any of the Letters on the subject yet -- maybe

> tomorrow -- but I'm sure mine was too long. I did post it on their

> Forum section in a somewhat edited form -- it was too long for that

> venue also. It's an interesting discussion, though. This is the

link:

>

>

http://forums.nytimes.com/top/opinion/readersopinions/forums/health/th

ediabetescrisis/index.html?page=recent

>

> There was also an excellent and related article in the Health

section

> about the connection between diabetes and heart disease:

>

> http://www.nytimes.com/2006/01/10/health/10hear.html

>

> Vicki

>

>

> Re: Times series

>

>

> > In a message dated 1/9/2006 8:09:31 PM Eastern Standard Time,

> > gretchen@s... writes:

> >

> >> It's a good letter, but if you could shorten it a bit, you'll

> >> increase the

> >> chance that they'll use it.

> >

> > That's great advice, Gretchen. The letters I've had published

were

> > short and

> > controversial. Unfortunately, non were about diabetes . . . yet!

> >

> > Paice

> > www.dapaice.com

> > " Click on Potpourri for diabetes tests. "

> >

> >

>

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This would help to explain why I was GAINING weight the last month before I

was DX'd. and I was trying to be " good " with my eating. mind you I am not on

any meds - and hopefully won't need to. but I am gaining control over my

BG's now. so hopefully the weight will come off (and take a few " friends "

with it too!) :-)

Shauna :-)

_____

I started to write or email the Times yesterday, but then decided it

was futile. I get so sick and tired of reading how type 2 diabetes

is " caused " by obesity. They don't seem to get it that just because

there is a correlation between the two, that doesn't mean you can

draw that conclusion. In my case, and in others I'm aware of, I'm

certain that the slow onset of diabetes was responsible for my weight

gain and not the other way around. Three years prior to diagnosis,

my doctor mentioned an elevated glucose level, but since he kind of

blew it off I didn't worry about it. By the time I was diagnosed I

had a fasting BG of 338 and an A1c of 10.7. I had also gained about

45 pounds. As soon as I got my BG under control, I dropped those

extra pounds with no effort. It makes sense to me that if you have

increased IR, you have both insulin and glucose building up in your

system, and from what I've read, it will cause you to store the

excess as fat. So as I became increasingly IR, I gained weight. I

also lost energy and became tired easily, so my activity level went

down. Once I got back to normal BG levels, my energy level shot back

up. I did not " cause " my diabetes. My father died from

complications of diabetes, and it is also prevalent on my mother's

side. None of the diabetics on either side are particularly

overweight, and some are downright skinny. I wasn't morbidly obese

at 45 pounds over even at my highest weight. Some of my family

members who do have weight problems are NOT diabetic. For me, it was

a strong genetic predisposition. Oddly, we have both T1s and T2s in

my family tree.

Christy

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The thing that strikes me about the Times series is how medicine and

the current health care " system " (or lack thereof) fails poor

people. Today's article was depressing as he**, and knowing that

those stories are repeated millions of times all over the country

doesn't help. Poverty is an emotional, spiritual, cultural and

physical condition. It seems to me that relying on free clinics or

emergency rooms are poor ways to get medical care, but often all that

are available to many poor people. Clearly, it's better to be rich,

thin, and live on the upper east side of Manhattan than to live in

Harlem. Gee, and this is news?

Culture is also an issue, one we are all probably familiar with when

we go to family affairs and are told to just have some this time, or

just have one bite so as not to insuln grandma.

Lack of money means no education or training. Many may bash the ADA

method of diabetes control, but clearly it would be an improvement

over what many people are doing right now.

Lack of money means it's harder to be high quaility food.

Lack of money and insurance means it's harder to afford strips and

medications. Getting through the medicaid morass isn't easy.

Lack of follow up care means no help when a diabetic gets weary or

frustrated.

Sure, computer groups help, but, to me, they're a third tier thing.

First tier being lack of decent healthcare to begin with, second tier

being lack of money for decent food. There's so much more that could

be done before we get to the idea that computer and internet access

should be there for everyone.

More than anything, this series makes me want to do outreach work.

Not to convert people to my viewpoint on how to deal with diabetes,

but more to encourage people to believe that it's worth it to care

and take as good care of oneself as possible.

I will read the rest of the series, though I understand tomorrow will

be about prevention issues. That should be interesting, to say the

least.

Stacey

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>

> The thing that strikes me about the Times series is how medicine and

> the current health care " system " (or lack thereof) fails poor

> people. Today's article was depressing as he**, and knowing that

> those stories are repeated millions of times all over the country

> doesn't help.

does anyone have the link to today's article?

thanks!

kate

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Here you go!!

http://www.nytimes.com/2006/01/10/nyregion/nyregionspecial5/10diabetes.html?th

R.

-----Original Message-----

>

> The thing that strikes me about the Times series is how medicine and

> the current health care " system " (or lack thereof) fails poor

> people. Today's article was depressing as he**, and knowing that

> those stories are repeated millions of times all over the country

> doesn't help.

does anyone have the link to today's article?

thanks!

kate

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Stacey wrote:

>Lack of money means no education or training. Many may bash the ADA

>method of diabetes control, but clearly it would be an improvement

>over what many people are doing right now.

>

>Lack of money means it's harder to be high quaility food.

>

>Lack of money and insurance means it's harder to afford strips and

>medications. Getting through the medicaid morass isn't easy.

>

>Lack of follow up care means no help when a diabetic gets weary or

>frustrated.

>

>Sure, computer groups help, but, to me, they're a third tier thing.

>First tier being lack of decent healthcare to begin with, second tier

>being lack of money for decent food. There's so much more that could

>be done before we get to the idea that computer and internet access

>should be there for everyone.

>

>More than anything, this series makes me want to do outreach work.

>Not to convert people to my viewpoint on how to deal with diabetes,

>but more to encourage people to believe that it's worth it to care

>and take as good care of oneself as possible.

>

>

Hi Stacey

Couldn't agree with you more.

I'm in England so I don't see the NY Times, but I wonder how many of the

poor people get to read the articles as well?

I'm lucky in that I don't need insurance but because I am not working,

for other reasons than the diabetes, my diet is not the best. I can't

afford the supplements that would assist with this condition. I have had

to borrow some money to buy some multi-vitamins, luckily there was a

sale at the store so I got enough to last a year at one go, but now I

have to repay the debt also.

Have the articles been picked up by other newspapers in the states? Is

this information only available to those with computers or the money to

buy a copy of the Times in New York?

--

Rob

T2 Metformin; Multi Vits with Minerals; Soya Lecithin;

Effexor XL

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