Friday, June 28, 2019

Retrospective #132: Why I Despair for the Type 2 Diabetic Patient

Chatting with an MD Internist friend of mine, my hopes for the medical care of his Type 2 diabetic patients sunk to an abysmal low. Admittedly it was a social situation, and in fairness my friend did not express much interest as I proselytized about my Very Low Carb, Type 2, self-treatment regimen. However, I felt despair as he referred to how he treats his Type 2 patients. When he used the terms “good diet” and “under control,” I rudely interrupted him as I was sure he and I had totally different concepts of their meaning. I must have seemed insufferable to him.
This is an immense and important problem. Until the entire public health and medical establishment comes to see these two terms differently, I fear that the world-wide epidemic of obesity and diabetes (“diabesity”) will continue to worsen. But small-town practitioners are not the problem. They just follow what they have been taught and continue to learn on an on-going basis from their medical societies. And the patient accepts the scripts his or her doctor writes, as well as the assurances he or she gives the patient, because it conforms to the messaging from the corrupt Government/Big Pharma/Agribusiness/Media consortium. Just follow the money.
I challenged “good diet” when my Internist friend mentioned it since I was sure he meant a “balanced” low-fat diet, specifically the one-size-fits-all diet that government advocates: 60% carbohydrate, 30% fat, and 10% protein. It’s on the HHS/USDAs Nutrition Facts label on processed and packaged “food.” The fat category subdivides into saturated fat (bad), trans fats (worse), and unsaturated fat, which they advocate. “These unsaturated “vegetable” oils (corn and soybean) are unstable and inflammatory. See Retrospective #21. They are not healthy for anyone.
Under control” is the other phrase over which I became exercised. By this point my friend was backing away from the conversation (LOL) so I didn’t get a chance to ask whether he was referring to an A1c of 7.0% (the ADA standard), or 6.5% which is the standard of the AACE, the endocrinologist’s society. If I had had the opportunity, I would have mentioned that Dr. Ralph DeFronzo, MD, stated in his Banting Award lecture at the 2008 ADA convention in San Francisco, that “good control” should be defined as an A1c <6.0%.
Even better, an A1c of 5.6% (the “normal non-diabetic range), is achievable and can be maintained by a “good diet” alone, as I would have it defined it: to wit, a Very Low Carbohydrate or perhaps even just a Low Carb diet.
And Dr. Richard K. Bernstein, himself a Type 1, holds that diabetes patients (Type 1s and Type2s) should be entitled to “normal” A1c’s, in the 4.0% to 5.0% range. Remember, heart disease risk rises steadily with an A1c above 5.5%. 
“Good Control,” of course, from a doctor’s perspective, means controlled with medications, either oral or injected. And good control as defined by the associations (ADA and AACE) assures that the patient will take progressively more and more of these medication as the disease “progresses.” Type 2 diabetes is defined as a “progressive disease,” DUE ENTIRELY TO THE TREATMENT REGIMEN THAT MEDICAL ASSOCIATIONS ADVOCATE. Why is that?
“That’s a very hard question to answer,” replied Jay Wortman, MD, a Canadian activist and low-carb blogger, to Andreas Eenfeldt, MD, the Swedish doctor who founded the very successful, in a 2013 interview:
Wortman: “I think there’s a multiple answer to that question. I think there’re a lot of people in organizations and positions that are funded by the drug industry, and the drug industry doesn’t want people doing this [“a simple dietary change”]. They’d get off the drug.” Eenfeldt: “Bad for Business?” Wortman: “Yeah. Bad for business – totally bad for business. And these big organizations [ADA, AHA, etc.] depend on drug industry funding.” Wortman, later in the interview: “The other problem is there’s nothing to patent there. There’s nobody going to get wealthy from patenting this [a simple dietary change]. Our system runs on something that can be patented and marketed, and turn a profit, and that’s how the funding goes through the system in terms of both the research agenda and also how recommendations are generated, and there’s nothing to patent.” Eenfeldt: “Right. It’s all free information, right?” Wortman: “It’s freely available.” Folks, think about that for a moment, please…

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