Viewing a single comment thread. View all comments

lame-borghini t1_j1e1l63 wrote

Advancements in science, technology, and medicine are meaningless when the barriers are too high for the average person to access them, color me shocked!


killcat t1_j1gjvvm wrote

Also people in lower socioeconomic groups are far more likely to have co-morbidity, obesity, poor diet etc


Reep1611 t1_j1h2zsi wrote

Which is down to the same reason, if you have little money, you cannot afford a healthy diet easily. Because good fresh food is behind the same monetary hurdle and cheep unhealthy processed food is much more affordable.


Excusemytootie t1_j1ihtxg wrote

You can eat healthy on a budget. I know it’s not possible everywhere but I think the problem has more to do with education and understanding nutrition. So many people, especially if they only have a high school diploma or less, aren’t taught a single thing about nutrition. On top of that, people in the US were given the opposite of nutrition education with that old food pyramid that recommended 5-6 servings of “whole grains” which is often interpreted as “bread, cereal, baked goods, etc”. What a mess, it’s no wonder we have this health crisis.


tasteothewild t1_j1h1594 wrote

No, they had access! To be included in the study you had to be on insulin. The point of this study is the complex issues related to adequate glycemic control in the-face-of using exogenous insulin. Yes, correct dosing and timing of insulin administration could be a factor since based on the population studied these are almost certainly type 2 diabetes patients who are, by definition, “insulin-resistant”. Therefore, other factors are huge; such as co-morbidities, health literacy, diet, exercise, etc.


Elfin_842 t1_j1i6ox9 wrote

Admittedly, I haven't read the article, but from the headline they have to have access to some insulin. That doesn't mean they have access to all of the advancements. Insulin pumps and CGMs are expensive, but they make a world of difference. In addition to this, type 2 diabetics don't usually have a CGM. The mindset difference that I've seen between type 1 treatment and type 2 is crazy. Most of the type 2 diabetics I've known haven't cared a lot about their blood sugar as long as they got reasonable A1C results.

The last thing I'm interested to know is how insulin use was done. Insulin is expensive and some people ration their supply.

I agree that those other factors you mentioned are important, but I wouldn't assume that these people have all of the means needed to fully support themselves.


strizzl t1_j1e3mrq wrote

Diabetes in 90% of type 2s is completely manageable with diet. Access and education to appropriate foods and poor impulse control is what drives the majority of uncontrolled diabetes. I do not fault majority of patients for this either: they didn’t create the crappy education system, lobby to the government to create a “food pyramid” that promotes carbohydrates, or elevate the costs of transport of fresh fruit and vegetables. That was all failure of our system. The fix is too complicated for a public entity with no incentive to address so it’s up to individuals to take care of themselves unfortunately.

It is a systemic problem but I just don’t see help coming from the government


bobbi21 t1_j1ebbgl wrote

If caught early possibly but thats absolutely not true once it gets going. I have type 2 diabetic patients admitted to hospital and literally not eating any food for days due to multiple factors. They still need insulin. That is the vast majority of type 2 diabetics i see.


nowlistenhereboy t1_j1fyq2t wrote

Yes but that is not the majority of type 2 diabetics, that's just the worst 'end-stage' cases. Even later on in the disease diet and exercise can majorly improve A1c and reduce reliance on meds. Exercise causes insulin-independent insertion of glut-4 transporters in muscle cells.

Just because DM2 can't be totally cured doesn't mean we should discount the value of lifestyle changes. Yea it's hard for the patient to maintain those habits but we need to find ways to help them do it.


ph1294 t1_j1ghl22 wrote

Not eating for 3 days with type 2 exacerbates the issue. You’re going to induce hypoglycemia, which isn’t a risk for non diabetics.

You diet control type 2 by eating a healthy portion of low glycemic index food on a regular basis until your body can readjust to the absence of glucose spikes caused by sugary foods and drinks.