Ever wonder why there is so much
confusion about whether some people are first a type 2 and then later
are reclassed as a type 1 person with diabetes. Even people
diagnosed with type 2 later in life do not fit into the mold as true
type 2 diabetes. Some persons with type 2 diabetes actually don't
fit the symptoms of type 2 because of how they became people with
diabetes. Back in March 2013, I became aware of the over
simplification when I wrote this blog.
Then in August, September, and October
of 2013, further information came to light in three more articles
that I blogged about. Now, in December 2103, even more researchers
and physicians are declaring that there is more involved in the
diagnosis of diabetes. “The current subdivision of cases into
type 1 or type 2 'is a gross simplification, and poorly describes the
true range of diabetes,' wrote Leif Groop, MD, PhD, of Lund
University in Sweden, and his co-authors online Dec. 4 in The
Lancet.”
Yet, in the United States, doctors are
becoming even more close-minded and want everything simplified so
they don't have to think. They refuse to accept that diabetes can
develop from several overlapping mechanisms that can be modified by
both genetic and environmental factors. I will not go so far as to
say this could be the reason they are abandoning support for
diabetes, but their over simplification could be a large part of
their treatment and greater desire to not support patient needs for
education and methods of treatment to help manage the different
subgroups of people with diabetes.
No one is yet positive that the growing
obesity epidemic is some areas of the world is the total cause, yet
doctors in the United States declare that type 2 diabetes is a
lifestyle disease and that it is progressive. Most doctors still
want to blame poor nutrition and sedentary lifestyles totally for
obesity.
When we read books by Dr. William Davis
about the effects of wheat on the body, many bloggers about low carb,
high fat nutrition and the results that are positive in reducing
obesity, we know that what we are being told by the U.S. Department
of Agriculture (USDA), registered dietitians, and doctors is not
correct.
Many patients with diabetes present
with features of two or more types. While this used to be young
adults between the ages of 20 and 40, recently more confusion was
added by youth presenting with forms of type 2 diabetes. Previously,
most youth were correctly diagnosed with type 1 diabetes. Now we
have many youth presenting with type 2 diabetes and even some with a
monogenic subset, maturity-onset of diabetes in the young (MODY).
Most doctors are confused by this and
not even aware of the changes happening. They do not know how to
test for the variances in our youth and up into the later ages of
adults. Many doctors have thrown up their hands in defeat because
they cannot keep up with the changing and complex research required
by diabetes. This may be another reason for the medical community
turning against people with diabetes as I covered in my blog here.
Obesity used to be a clue for the
presence of type 2 diabetes. Now with the rise in obesity and the
number of people who are not obese being classified with type 2
diabetes, this characteristic is less helpful as a diagnostic tool.
Other subtypes of diabetes in adults
include ketosis-prone diabetes in adults, a hybrid form of the
disease in which patients have features of both type 1 and type 2
diabetes. Then we come to latent autoimmune diabetes of adults
(LADA), in with patients tend to be younger, secrete less insulin
than those with type 2, have less evidence of metabolic syndrome, and
have faster progression to insulin dependency than antibody-negative
patients.
Don't expect the American Diabetes
Association to do anything about this as their classifications have
not changed in the 2014 guidelines. They will use a foreign study
when it suits them, but the study has to fit their needs.
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