1. If their program, policies and mis directed help were realling having some positive effect, the rate for type 2 diabetes insulin resistance diabetes would not be exploding here and around the world. If it was doing some good increases should be in the single digit per centages up or down. That is not the case.

2. Life style blame is bull shit and unacceptable lazy science. The ADA should no better.

3. Liver issues of excessive glucose release have been identified that in fact load up human body and cause type 2 diabetes. The ADA has done zero about this. I was almost dead from this and finally after being on “more insulin” both liquid and starlix, glyburide et all – 26 years to be exact, got off, found metformin taken properly on a timed basis shuts off liver dawn effect etc.

4. How much money of all funds spent on reserach are really spent on type 2 issues which constitue 80 per ecnt of the diabetics. Type 1only constitute 15 to 20 per cent.

5. ADA and its cheerleaders keep promoting the pancreas – its your insulin is not working correct when in fact a multiorgan set of liver, kidneys, gut/intestine, thyroid run this exoctic collection of organs and hormones etc. Yet the current thinking is locked on target like a heat seeking missle leading to rot out of the body.

6. While life style may or may not have causedones type 2 diabetes, given the latest knowlegde on human skeletal muscle cell operation and glucose storage, exercise and carbs control are key to ensure that the energy balance on a human body are close to a null so as not to overfill all the glucose storage of the body.

7, Hearty exercise is the onl,y thing that gets rid of the liquid energy glucose. Insulin does not. Insulin simpliy enables the storage of glucose into the liver, fat, skeletal muscle cells IF there is still room. WHen there is no room, Insulin resistance is turned on causing glucose to backup in the blood system as thete is no where to go.

8. Adding Actos and even more insulin hoping to stuff more glucose into the cell storage cites causes unbelievable trouble. Here Life style changes of regulating carbs and ensuring energy burn match up can help alleviate the situation. If though the liver is misbehaving and constantly stuffing in excess glucose, diets are meaningless at this point. I was on 1200 calorie tight diet, no sneaking snacks or booze and my weight climbed to 330 pounds till liver arrested and carefull monitoring by finger stick and later CGMS and preventing BG dropping below 100 so as liver kept idled on glucose add.

My book At the Precipice by Jim Snell details all of this in better detail.

I am fed up with the non science, mis information and nonsense peddled by those who should know better.

Why Type 2 Diabetes is such a mis understood poor boy of the medical business escapes me but this mess is going to get worse before it gets better.

As for studies showing that monitoring doesn’t benefit type 2s, it was just a matter of collecting data. If you just collect data and do nothing with it, it won’t help. The monitoring is NOT the problem, but failure to act on the the data.

I have consistently kept my A1C under 6% with minimal meds. By monitoring how different foods affect my blood sugar, I’ve discovered what I can eat and how much. One day I hope to get off my meds. In my interaction with other diabetics, I’ve discovered that foods affect people differently. What jacks up my blood sugar, may not jack up someone elses. The only way to know is to test and then act on what the data shows.

Of course, I’ve ditched the ADA diet since I’ve discovered it’s a guarentee of high blood sugar. The ADA just wants type 2s to blindly follow its diet and take their meds. With no monitoring, no one will know that the ADA approach isn’t working until they end up with nasty complications. The ADA lost all credibility with me a long time ago.

What does ADA rank and file members for – they got him?

Page 70

http://www.diabetes.org/uedocuments/2006_990.pdf

I’m not sure you said the speech was not about Type 1 with regard to technology, but if you did, I encourage you to write to him and say that. He will assure you that it was about Type 1.

T2 diabetics (in general) should be on low carb, low glycemic, low bad fats, and high fibre diets, which will automatically go a long way to keep their blood sugars stable. They should avoid all junk, processed, high fat, high glycemic, and high carb foods. I personally have never met a T2 not on insulin with severe swings in blood sugar. Most of the time, they stay fairly close to slightly above normal range, unless they eat something they shouldn’t, are stressed, or are ill. For the last two categories at least, it is true that testing is very important.

The fact is, the *vast majority* of T2′s gain very little from testing overall once they have made the proper lifestyle choices. I’ve read an article stating that one T2 knew to cut out his favorite candy snack after testing his blood sugar only to find it made his blood sugar shoot up. DOH! I mean if some people really ARE that dumb, OK. Give them a tester. But perhaps we should educate people to avoid those high glycemic foods 100% to both prevent and treat T2 diabetes in the first place.

It’s not that I think T2′s not on insulin should never test (of course not), but it is true that studies have shown that for most T2′s not on insulin, testing makes little difference on a daily basis. The exception to this would be adjusting meds for weight loss, exercise, illness, etc.

Sure maybe 20% of Type 2′s (including misdiagnosed LADA’s, MODY’s, thin and very active people with genetic insulin resistance, people who take steroids and other meds, those with other medical conditions, etc.)*should* test daily. But the point is that for the T2 diabetes epidemic as a whole, technology is NOT the answer.

It seems that Doctors, Diabetic Educators, et al, are ONLY “educated” by pharmaceutical companies and insurance companies. AND they seem to eat it up, thinking that “now” they know how to treat their patients better. Bah! Humbug!
Solution: Let’s develop a 5 or 7 point laminated list to distribute to EVERY medical person everywhere. The list would teach them how to question the “reps” that come to visit them on a daily basis. It would teach them to be cynical. It might go something like this:

To ALL medical personnel:

QUESTIONS TO ASK YOUR PHARMA REP WHEN THEY VISIT YOU:
1. How much does this cost the patient (assuming there is no insurance) per day / per month / per year?
2. Never let the rep. talk like every patient has good insurance, or any insurance at all.
3. Write their answers down on paper. Make a simple chart so they can see that you understand the real cost.
4. How many patients (T1? T2?) will WANT this product? Translation: How many patients feel this product will help control their diabetes. No, the pharma cos aren’t the best people to ask but believe me, they’ve done their research and the numbers will astound you (any maybe the rep).
5. If they don’t have the answers, show them the door and tell them to find the answers and don’t return until they have the answers. Also, tell them you will not be prescribing ANY of their products until they give you answers!
6. Verify their answers with real Diabetic patients. Use your own patients.

KEEP THIS LIST TAPED TO YOUR WALL WHERE YOU CAN SEE IT AT ALL TIMES, AND USE IT. DON’T BE INTIMIDATED BY PHARMACEUTICAL COMPANIES.

The cost to do this, though great, is minimal compared to the potential benefit. And don’t cope out by making it sound ‘nicer’, or sending it out in some throw-away mailing, or worse, a non-read email. It has to be a ‘keeper’. Hard plastic. Colorful. Small enough to fit on a desktop but big enough to see from 6 feet.

AND the insurance companies ALWAYS lag in accepting new technology so they don’t have to pay for it. I’ve been waiting for a continuous glucose monitor for 20 years (and I’m sure the technology was out there) but it’s only been available for a year or two. Now, the 7-day Dexcom is available but still considered (by my insurance) as experimental. Why? Because, obviously, the 3-day require twice as many replaceable parts (at $125 a shot) as the 7-day. And, is $125 even remotely related to reality? Yes, I want the pharmaceutical companies to make some profit but this is GOUGING and Greed. GREED. GREED!

Question: Surly, there must be some department in government (paid to protect citizen rights) that looks out for us. And fights for us. If the insurance syndicate and the pharmaceutical syndicate are the sole influence on capital hill, then where are the consumer advocate group?

For the record, this are my list of things that piss me off about the diabetic industry (read: suppliers and insurance; an unholy alliance if there ever was one):
1. cost of test strips
2. non-availability of generic insulin
3. lag in development/availability of CMG
4. influence of pharma cos on law/policy
5. influence of insurance cos on law/policy
6. lack of influence by T1 diabetic citizens on law/policy