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Re: [IP] in-law newly dxed type 2

In a message dated 1/7/00 11:11:48 AM US Eastern Standard Time, 
email @ redacted writes:

<< It seems that older doctors were actually
 taught that type 2 is a "mild" form of diabetes and that "keeping it under
 200" is the proper goal. >>

I'm a "book-a-holic" and I happen to have a book on DM with a copyright date 
of 1923. (It includes, as almost an afterthought, a chapter on insulin. It 
was a new discovery, you see, and they weren't quite sure what to do with it 

At any rate, it describes the different types of diabetes. If you get it 
while you're young, it's a "severe" case. In middle age, DM is "moderate" and 
elderly people have a "mild" case. That made sense in 1923, when the young 
ones (with type 1) died without insulin and the middle-aged type 2s had more 
time to get complications than elderly people.

However, this is 2000 and we now know how insulin works. There are home 
blood-glucose testing meters. There are a variety of oral medications to help 
type 2s control their BGs. There have been studies that prove tight control 
-- for both major types of DM -- helps reduce complications. The old thoughts 
and methods are -- or should be -- history. 

However, I don't agree totally that the new generation of docs will think any 
differently. Why? They're being trained by the old generation. Here where I 
live, there is a family practice residency program. The director was 
surprised to learn that the pump is not surgically implanted. My PCP, who is 
relatively young, believes that a BP of 140/90 is a bit on the high side of 
normal, but OK. (Which would make me happy if I didn't know that type 2s are 
more prone to cardiovascular disease and should keep their BP down. I had to 
practically order him to start adjusting my meds.) 

To all you health care folks on the list, I don't mean this as a 
generalization of all. But, seriously, how much did you know about DM before 
you or your child was DX'd? Do you know more now? Do you have a better 
understanding now of how it works (or doesn't work)?

In the meantime, I'm in search of another PCP and am very grateful that I 
have a wonderful endo who cares -- and who double-checks on my PCP. lol

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