Thursday, February 9, 2012

Camarillo, California. February 9, 2012. Post # 2: Caveats, apologies and exceptions
In this second blog, I want to set the stage; detail  the caveats, apologies ,exceptions and share the difficulty of resolving this disease.
Coming off my Book – At the Precipice and my Doctor’s comments that what he  and I were doing as well as all the behavior and data logged that apparently did not follow his play book and guide to the Doctor, it became readily apparent much more research and comment was necessary, needed and important.
Not withstanding  ones perspective, this disease is exploding out of control and some say it is exploding world wide with numbers of increase that suggest 200 to 300 percent. I do not care who you are, numbers like that even if my numbers are 50 percent too high are still ridiculously too high and throw into question the aspect of what medicine and the cures are really doing and their effectiveness and force us to ask why are we not making progress here.
First off, and thankfully in medical science and in most fields, there are incredible research gains, cures, drugs, and improvements in technical tools every day. That said, type 2 diabetes seems totally stalled in the dark ages with people and their bodies rotting out with apparent little progress on the horizon. That said, tons of money is being poured into “research” with what seems apparent little definitive progress.
Taking a break from medicine and hoping into a field I have had in-depth experience in;  is advanced digital microprocessor electronics and networking. When I started in this field many moons ago, a multi meter and oscilloscope were mostly what was needed to design, debug , and correct these systems. As the complexity and speed shot up and complex integrated circuits took over, increasingly more sophisticated test and data capture tools that could capture multichannel signals and thousands of samples over time that enabled one to debug the behavior and actually get visibility of the problem. Guessing and swapping out Integrated circuits on a hunch readily became a crapshoot, wrong and inefficient.
Today’s tools for type 2 diabetes seem to resemble this same problem where presently there are  no adequate tools with a total lack of quick visibility.  Single shot lab tests, finger prick machines and if your lucky a continuous glucose monitor( – a step up from finger prick machine) are simply inadequate debugging a multi-hormone, multi-organ  human digestion system consisting of stomach, liver, kidneys, pancreas, intestine, thyroid etc.; quickly and efficiently. Quite frankly, not to rip off appropriate metaphors and apologies to the Start Trek Movies and Dr. McCoy, we really need the 23rd century medical tools and the computers on the deck of the Starship Enterprise crunching the data down to help the Doctor get a patient back on track. I envision a loaner pack one wears for a few days to get a multi-day 24/7 picture of a patient’s body and what is really happening. We have the technology but no tools presently available!

Unlike a broken bone, bad hip, a virus or bacteriological infection that can be targeted quickly and easily and patched up; type 2 diabetes does not lend itself to the best of our battlefield medical skills and experience. This is a problem all rolled up with medical failures and problems, diet/carbs control – energy balance , exercise and aging – a multiphase problem that cannot be shot a single bug-issue at a time and in fact must be attacked on multiple fronts with extensive data availability of the hormones and organs involved. Single shot lab tests while a good place to start simply do not give us the 24/7 visibility to watch the interaction and parse out the failure issues.
Trying to solve this mess one problem at a time is like the old days of early multi-gun(three) CRT units which required one to adjust magnets on back of set to try an optimize the picture alignment. As one who has been there; one always got 3 corners of the tube in and left with one out. All one could do was get the best as one could and when adjusted the bad corner, the other three would be thrown out. Simply no joy.
Type Two Diabetes is like that, needing a multiphase approach of attacking medical problems, diet/carbs control and exercise as a complete whole to pull body back into the proper operating point. This also means a team of Doctors, Dietitians, Diabetes Trainers, Exercise consultants will be needed to arrest this problem promptly, effectively and keeping costs under control. A fifteen  minute visit with Doctor and taking pills when you get home and call me in the morning will not simply cut it on this disease.
Right now due to any lack of consistent fast, accurate visibility and data, Doctors are reduced to educated guesses, experience , the wand of Merlin and much praying. This same problem of lack of fast accurate visibility facilitates a battling  cluster  of contending theories and ideas along with a host of supposed theories how the body works that more resembles a medieval science/medical text. Frankly this claptrap  is neither helpful, useful nor gives a type 2 patient any idea how one can help save her/ his body by working with his Doctor/team. We are starting to see glimmers of light as powerful tools like magnetic resonance spectography tools are going where we never have gone  before,  and no dissection needed to get inside the cell to get  data. In fact dissection cannot get one there.
Please do not throw rocks, stale buns etc. at your Doctor, as he like you is trying to do his best. In addition, due to quality and legal reasons he must follow the approved treatments his medical society has deemed correct and worthy and signed up for.
It is at this point where I need to tackle I believe is the one aspect of this mess namely lobbyists. They know who they are. These groups raise huge pots of money, lock in bad ideas and poor , bad, or misdirected philosophies which result in massive extra costs in care to the type 2 diabetics and in my opinion and mind stall out critically needed advances in medicine on type 2 diabetes. Simply put, a barrel of 50 test strips for a finger prick machine should not cost $ 77.00 at the local pharmacy off the shelf. These lobbyists have the dollars and clout to fix that immediately. Today, advanced research and new ideas are like the Holy Grail of an Indiana Jones Movie ; where these items sit locked in a box in a government warehouse out of sight helping no one.
When our American System works well including the lobbyists; we have a system and results that are second to none and we got to moon and Mars. If it gets off the rails, my opinion is we end up with the American atomic energy industry (with apologies);  with costs blown out to the stratosphere with everybody with their hand out taking their “share”.  In that case we end up with a situation where we spend more than any other country out there for a service and get far less for the money spent compared to those countries. Type 2 Diabetes does not look good from where I sit.
I believe we are At The Precipice like my book where we have incredible technology and a desperate need to make progress; and I believe we will see an explosion in new research and thinking. As we get further down the road; we will be like Dr. McCoy of Start Trek Fame of the Star Trek Movie – The Voyage Home; when Dr. McCoy runs into the aged lady sitting in the hall of a 20th Century Hospital in San Francisco and Dr. McCoy says “what the devil are you doing here? She says – Kidney Dialysis. Dr. McCoy shakes his head and says – What is this – the dark ages?. Dr. McCoy hands the lady a pill and says call me if any problems!. A few scenes later, we see the lady being wheeled out -  all healed - ecstatic.
Once the darkness has been pulled back by light, we will also stand in horror looking back at what we were doing then in the 20th and 21st centuries on type 2 diabetes as well as amazed at what  a lot of pioneers that were  trying to resolve this mess without the exotic tools I believe are around the corner and yet at that time pioneering diets and addressing energy balance issues.
In the blogs ahead;  I want to discuss the following issues:
1. The role of the Hunter Gatherer digestion Gene System and what genetics did include and what was left out.
2. Science and Agriculture and availability of 24/7 high performance refined foods and grains.
3. Key role of body energy balance that helps prevent rot and the role for the human.
4. Exercise is critical. Insulin does not burn off glucose; only exercise and process does.
5. Insulin efficiency versus glucose saturation. Human Blood system regulation relies on insulin from pancreas causing transfer of glucose from blood system to available space in temporary glucose stores of skeletal muscles and fat cells. As long as room in temporary glucose stores of fat and skeletal muscle cells; blood system will remain regulated.
6. Alternate theory on how the liver, pancreas, and skeletal muscles form a servo system to  set the fasting glucose set point on the body and why type 2 diabetes progresses worse when one ages. ( From an electronics/survivor person)  Why are we ignoring leaky livers?
Thank you for your time and interest and best wishes for good health. 
Jim Snell

2 Comments:

At January 16, 2013 at 12:51 PM , OpenID resolvingthecontroversies said...

So true! I'll be interested in reading your continuing blogs.

I'm especially interested in items 1, ie your take on the genetic influence, and 6, why T2 gets worse as we age.

- Dan

 
At February 28, 2013 at 3:00 PM , Blogger jim snell said...

Dan:

My read on genetics is they yes obviously are important and I believe play a roll in direct detected medical failing issues and aging issues.

Over all, my suspicion is that the huge increase in numbers of T2 and world wide is more do to with the impressive miracles in science and agriculture improving quality and yields of modern grains, rice, and corn that has helped to stop starvation and acerbated type 2 diabetes.

In addition , modern science has found out how to create tons of high fructose corn sugar at pennies on the ton converting starches to sugar.

Lastly, we have reduced human energy burn by all the labour saving/couch potato tools and computers, video games, wide screen TV that completely acerbates the mess on the ole unmodified ancient gene digestion system optimized to burn low grad gruel with intermittent supply. It was not optimized to run on our 24/7 availability of excellent and refined foods. This ole body was designed to prevent starvation by grabbing every calorie of glucose it can haul out from ingested food and stuffing it in the blood system.

The upshot today is that the old advice as kids was to clean up our plates or we would starve is no longer applicable.

If the human system would only bypass excess glucose over the side when body is topped off, type 2 diabetes would not be such an issue.

For me this meant metformin to keep liver in check, dropping diet to 1200 calories and upping exercise to 2 miles walking.

Aging is an extension of this where by we are slowing down, organs aging and dropping their output of basil and bolus ( background insulin and meal insulin) and the liver responds by upping the liver glucose release making matters worse.

In my mind genetics may be a bigger factor here as genes get hammered, age and changed and body overall performance drops. One may need some insulin and thyroid help to overcome these issues.

The unfortunate riot here is that the human needs to externally and manually monitor his energy balance - input versus burn and mnake sure to keep in balance.

Unfortunately there is no warning light on one's Star Trek dash that lights up to say - your fuel tanks are full and you need to cut back. Only the nasty type 2 diabetes aspect and conditions rears its nasty head silently, quietly and gets worse as time progresses.

 

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