I subscribe to regular notifications from academia.edu, and while many of these articles aren’t of any particular interest to me, the lead article from today’s email was indeed an interesting one. Some researchers conducted a study among diabetics in certain demographic groups, low income and minority populations, to assess their understanding of diabetes, and it was found by the researchers to be quite lacking.
So I thought, I should look at this to see how they define lacking, which I assumed would just mean out of step with what the medical profession believes, or perhaps it really was lacking, as in things like you can catch diabetes from someone who has it or the like.
In any case, I thought it should be plenty interesting. The objective of the study was to assess the patients’ knowledge about the disease and about medications that could hinder optimal disease management.
So they certainly set the bar high here, optimal disease management? Already I’m thinking, optimal disease management to them surely means short term A1C control, and sadly that’s the prevailing belief among the medical profession, but this does not manage the disease at all as it turns out, let alone do so optimally.
So they asked the participants a number of questions, with the first one being whether or not they think that blood sugar of less than 200 mg/dl is normal. Of course that’s way off the truth, although interestingly enough, at the rate we’re going, that might be the case some day, where this would at least be the mean, which normal is generally derived from.
A more interesting way of asking this would be to ask them if they considered blood sugar of less than 200 to be acceptable, and you could actually make a pretty good argument that it would be. Even the ADA deems blood sugar of less than 180 to be acceptable, and if one medicates down to this or lower, that has been shown to be a bad idea if you’re not looking to increase your mortality rate that is.
From the evidence we have, below 200 might even be too tight, and in fact if we look deeper at the mechanisms and effects of artificially lowering blood sugar with medications, this may only be a good idea to save someone life should they get diabetic ketoacidosis.
I(t’s actually pretty funny to reflect on the alleged benefits of tighter control, and correlation is indeed the hobgoblin of small minds, and when it comes to medical correlations, it’s halloween all year round.
So they start with looking at rates of complications among people with high blood sugar, and not surprisingly, we see this correlated. The mistake they make though is assuming that it’s the high blood sugar that causes it, and it actually does contribute, but the higher insulin levels that you get with high blood sugar is an even bigger problem.
You just can’t compare someone whose natural blood sugar is lower with someone who is made lower with medications, as the two situations are different. So they end up wanting to increase insulin levels further, the blood sugar comes down, but people start dying more, and oops, we’ve made things worse, but no matter, let’s just keep doing it and we can pretend this stuff doesn’t happen.
29% of respondents believed that their doctor will cure them of diabetes, and that’s actually 29% who are clearly misguided. Even the doctors would not claim that though. I would have liked this to be asked as to what percentage of people think their doctors will improve their condition, and anyone who answers yes would be misguided, although the expected answer would be yes.
For those who think that they do help, we can just ask, where’s the evidence of that? It’s not in short term blood sugar control. What about the long term affects of this? Well they score terribly here, their treatment even fails to control blood sugar well in the end, and that’s not treating the disease anyway, which is actually an even bigger deal.
They don’t even know what diabetes even is, let alone know how to treat it. It is not high blood sugar, that’s just one of the effects, no more than a fever is the disease when someone gets an infection. If you just treat the symptom, the fever, that’s pretty stupid, but stupid is allowed in conventional medicine, it’s actually expected and required.
23% said that there is no need to take their diabetic medications when their blood sugar is normal. I guess the idea here is to suggest otherwise, but if someone is on medication and their blood sugar is normal, at the very least they are being overmedicated, and this is aside from the question of whether people should be taking these medications in the first place.
Lowering blood sugar is always a risk and reward thing even if you believe that lowering blood sugar with medication is actually ever a reward, which it actually never is. So even if the assumptions that they are making were true, that it’s just all about blood sugar, and high blood sugar is the sole enemy, there are risks involved with medications and at some point the risks outweigh even the most trumped up benefits, so a balance must be sought.
This balance is not normal blood sugar, and this is why some doctors actually become alarmed when people report even only slightly elevated blood sugar, even when it is achieved without medication, although there’s never risks in that. The excessive risks of medicating to these normal or near normal levels are ones that are even evident to these practitioners.
12% responded that they only have diabetes when their glucose levels are high. This is how these people define the disease though, and if you get screened for diabetes you will only be said to have it if your blood sugar is high enough.
If that’s the definition, then it logically follows that anyone who is outside this range does not have diabetes, and the 12% would be right here. What happens though is that if you’ve ever been that high, they put blood on your door and sentence you to life with this disease, which of course excludes the possibility of ever getting better in itself.
It makes sense to at least make the distinction here of one having non diabetic blood sugar on their own, versus those who are below the threshold by way of medication, at least if diabetes is to be understood as high blood sugar. If we really want bonus points here we can look at hormonal levels to see how one is doing, such as insulin and glucagon, requiring these plus blood sugar to be normal before we can say one is not currently a diabetic.
If these levels are normal, where is the pathology anyway? Well there wouldn’t be one, at least as far as diabetes goes. Of course we rarely test for insulin levels and never really test for glucagon, so how would we know where our patients are at with this anyway? Certainly not just with blood sugar.
We don’t want to damn them either, but damning them is very convenient for those who want to milk us for life. Not everyone wants to be on this farm though.
The researchers need to do this survey themselves, only with the questions asked a little differently, to look to expose their own misconceptions, which are considerable.