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Permalink Reply by jims on May 7, 2012 at 7:09am

finally, some intelligent response working the issue of the flood and 200 and 300 per ent increase in type 2 diabetes.

Since I do not see this report listed in the ADA forecast magazine, ADA albiet listed for credit in this report must be holding its midievil nose as usual and pretending nothing is wrong. Just keep rotting out.

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Permalink Reply by BadMoonT2 on May 7, 2012 at 11:24am

The report is long and complicated but I agree it does seem to indicate some progress in the thinking about T2. I do question their reliance on the ACCORD study for some of their conclusions. Here's an article that questions the conclusions many have drawn from this study.

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Permalink Reply by Brian (bsc) on May 7, 2012 at 11:29am

I pretty much see this report a repetition of the same old, same old, but worse. They have loosened blood sugar targets, they still have the same stepwise algorithm focused on making sure that T2s have totally burned out their poor pooped out pancreas before starting insulin. About the only good thing is that they added some of the newer medications.

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Permalink Reply by jims on May 7, 2012 at 12:48pm

Thank you for taking time to review and checkout. I was not able to review all that either. Sometimes we see what we want to.

The points that I found were most curious:

Some key comments:

Patience centered approach

Evidence-based advice depends on the existence of primary source evidence.

A energy balance mentality rather than fat/weight causes this!
Any rise in glycemia is the net result of glucose influx exceeding glucose outflow from the plasma compartment. In the fasting state, hyperglycemia is directly related to increased hepatic glucose production.
In the postprandial state, further glucose excursions result from the combination of insufficient suppression of this glucose output and defective insulin stimulation of glucose disposal in target tissues, mainly
skeletal muscle.

Metformin is most widely used first-line type 2 diabetes drug; its mechanism of action predominately involves reducing hepatic (liver) glucose production (54,55). No kidding! Finally an accurate answer.

If I wasted anybodie's time - my apologies.

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