Re: Type 1 diabetes: New drugs?

From: Hillary Israeli (hillary_at_hillary.net)
Date: 01/26/05 

Date: Wed, 26 Jan 2005 17:34:24 +0000 (UTC)

In <rwPJd.6114$YD5.5454@newsread3.news.pas.earthlink.net>,
Todd Gastaldo <tgastaldo@earthlink.net> wrote:

*>
*> Well, I think that if you're talking about insulin resistance and "early"
*> disease, you aren't talking about diabetes.
*
*It is the MD's pronouncement (diagnosis) that makes the disease?

No, of course not. If the diagnostic criteria for diabetes mellitus are
met, then the disease is (IMO) present. If they are not, it is not. Seems
pretty simple. There's a continuum.

*> If in fact the situation has
*> advanced such that the patient receives a diagnosis of diabetes,
*
*What? A disease is only a "situation" until the MD steps in and saves the
*day with his pronouncement (diagnosis)?

Nobody except you had made that proclamation, actually.

*
*The disease called "d. mellitus, Type 2" is defined in Dorland's Illustrated
*Medical Dictionary [29th ed. 2000] as "...gradual onset...no need for
*exogenous insulin..."

Dorland's is an excellent dictionary, but hardly my first choice for an
endocrinology textbook. Type II diabetes is characterized by peripheral
insulin resistance as well as a secretory defect OF VARYING SEVERITY.
Some Type II patients *will* need exogenous insulin. Often a distinction
is made between type I patients being "insu8lin dependent," in that they
will enter a ketoacidotic state if they stop taking insulin, vs type II
patients having an "insulin requirement" but not a "dependence," because
they do not, in general, become ketoacidotic if they stop taking insulin,
even if insulin is required to keep their sugar within a normal range.
Personally, if it were my body on the line, if I were unable to control my
blood sugar tightly within the normal range without exogenous insulin,
regardless of my official diagnostis, I would take the insulin.

*I had not heard that new drugs had been developed which help Type 1
*diabetics increase natural body production of insulin.

There are drugs which promote insulin secretion, but generally speaking
the diagnosis of type I diabetes isn't made until there are too few beta
cells left to produce enough insulin to sustain life, regardless of what
drugs you may throw at them. 

-- 
			  Hillary Israeli, VMD
		      Lafayette Hill/PA/USA/Earth
"Outside of a dog, a book is a man's best friend. Inside of a dog, it is 
                  too dark to read." --Groucho Marx

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