Will, in my career, I worked in the lab of a major medical center in Chicago. As I ran hundreds of blood tests each day, I'd look at the diagnoses that the ER entered in the computer. They sometimes put a direct quote of what the patient told them. A number of times I saw, "ran out of" or "can't afford" insulin. Who knows if these people…
Will, in my career, I worked in the lab of a major medical center in Chicago. As I ran hundreds of blood tests each day, I'd look at the diagnoses that the ER entered in the computer. They sometimes put a direct quote of what the patient told them. A number of times I saw, "ran out of" or "can't afford" insulin. Who knows if these people had insurance, but I would see the astronomical glucose levels and figure that they weren't going home that day. The lack of affordable medicine lead to EXACTLY the type of situations you talked about! Which in the long run, increased costs for ALL of us.
I might also mention that diabetes often leads to renal failure. Renal failure leads to dialysis---I believe (someone help me here?) that is one of the biggest expenses to Medicare/Medicaid. Also, big business, as John Oliver had a segment a few years back about the dialysis industry which was eye opening.
A former co-worker of mine was borderline diabetic for most of his career. He retired from the SO and went to work for one of the casinos managing their security team. He ended up having to retire from that when he (due to diabetic neuropathy) could no longer walk. His ultimate "last walk" went from digital amputation on one foot, followed in short order by amputation below, then above the knee, then a double amputation above the knee, and a very difficult recovery due to both renal and heart issues and ultimately resulted in his death from a heart attack at age 60. He could never afford the treatments he was offered as the more "preventative" ones were not covered by insurance.
And generally dialysis, yes, for renal failure, is poorly tolerated by diabetic individuals, which makes prevention by proper early treatment true life extension, and it's far less expensive than the treatments needed for all the complications detailed in your and Wil's notes. But if companies only see their bottom line and ignore everything else, and if half crazed lunatics in our House of Representatives only see political advantage, things would never change. We must stay woke. For woke means awakened to injustice.
Not only does long-standing, poorly controlled diabetes cause renal failure, it puts you at high risk for infection, metabolic syndrome (heart disease/stroke/diabetes), heart failure (CV disease), retinopathy (vision damage), puts you at higher risk for developing Alzheimer's disease, foot complications due to neuropathy as stated below and depression! I am a nurse practitioner who works on a critical care unit and see the devastating effects of on a daily basis. We need physicians, physician assistants and nurse practitioners, who work in primary care to be trained in 'lifestyle medicine' to educate these sick folks about the 6 domains (see below) to healthier living in order to reverse or at least tame this disease, to use health coaches
(make sure insurance companies cover coaching) and YES, provide insulin at little to no cost! We must address this problem holistically (whole food plant-based diet, physical activity, restorative sleep, avoiding risky substances and promoting positive social connections.
Don't know where you are but your nursing philosophy is spot on. It's why I spoke to a large conference of NP's about 25 years ago and told them that I believed, as a primary care internist, that eventually there would be few primary care docs and most primary care would be done by nurse practitioners. Of course, I had special education as I was and still am married to a now retired ARNP.
Thank you for dedicating your career to primary care, we need more of you! My dear friend is also a primary care internist in rural PA (my home state) and he would agree with you. I became a member of the American College of Lifestyle Medicine (ACLM) and got certified in Lifestyle Medicine as a Health Coach during the pandemic. I have lectured about Lifestyle Medicine and the Blue Zones and it's positive affect on health and well being. The ACLM is an ever-growing society of health professionals on a mission to reverse chronic disease. I am currently working as an ICU NP in San Francisco but will be launching a LM course that specifically focuses on women's health (perimenopause and menopause). Lifestyle Medicine is evidence-based and research shows this is the future of healthcare! I highly recommend checking their website out, lots of good resources to point friends and family to that need help getting healthier!
More power to you. Your experiences doing that would be of interest to a journal like Menopause, I bet, in which Ellen Mitchell and Nancy Woods, U of Washington, published many things about the menopausal transition which they studied for about 25 years. Stuff that women really want to know about how long the transition to FMP will last and what symptoms tend to be exaggerated or changed by the transition. Somehow, we have all made the transition to retirement together, but it was a great fun ride!
Once upon a time there were nutrition courses, obligatory in public schools. Does anyone remember “the basic seven”? Nutrition studies have advanced since then, but the rash of diabetes is a tribute to corporate America’s pushing sugar: colas, sweet snacks. At a recent check-up I was twice asked if I have diabetes. It’s expected of people of “a certain age.” It’s time for really thorough “health” courses in public schools, particularly before Florida can take over truth.
We are a nation of drugs over exercise. It may well be our undoing. Once public schools had vigorous sports programs for everyone (how well I remember being the last chosen for a side playing softball - astigmatic, I couldn’t catch or hit a ball), not just the “athletes.” What happened?
There has been a suggestion(out "there") that a moratorium on law suits be provided for dieticians and the medical community in regard to current protocols for the treatment of T2d, type 2 diabetes. There is a huge online community of motivated diabetics. Over the years, the medical community has agreed to a pharmaceutical answer to all of T2d. There is evidence the SAD(Standard American Diet) promotes metabolic syndrome. There are alternatives. Capitalism shows us it is not the economic vehicle to provide community health and wellness. ...plenty of stuff, yes. Be safe. Be well.
Agreed. It is expensive to eat healthy. In the long term though it is cheaper if you can avoid the health problems that co m e from the SAD.
Think of the food deserts and people buying good at dollar stores. I sometimes watch a YouTube channel where they do "southern" cooking. She has done a few shows where she buys all the ingredients at one of them. I was horrified at the fat/sodium laden canned junk she threw together, but I realized that is all many of her viewers can afford. Very sad.
Will, in my career, I worked in the lab of a major medical center in Chicago. As I ran hundreds of blood tests each day, I'd look at the diagnoses that the ER entered in the computer. They sometimes put a direct quote of what the patient told them. A number of times I saw, "ran out of" or "can't afford" insulin. Who knows if these people had insurance, but I would see the astronomical glucose levels and figure that they weren't going home that day. The lack of affordable medicine lead to EXACTLY the type of situations you talked about! Which in the long run, increased costs for ALL of us.
I might also mention that diabetes often leads to renal failure. Renal failure leads to dialysis---I believe (someone help me here?) that is one of the biggest expenses to Medicare/Medicaid. Also, big business, as John Oliver had a segment a few years back about the dialysis industry which was eye opening.
A former co-worker of mine was borderline diabetic for most of his career. He retired from the SO and went to work for one of the casinos managing their security team. He ended up having to retire from that when he (due to diabetic neuropathy) could no longer walk. His ultimate "last walk" went from digital amputation on one foot, followed in short order by amputation below, then above the knee, then a double amputation above the knee, and a very difficult recovery due to both renal and heart issues and ultimately resulted in his death from a heart attack at age 60. He could never afford the treatments he was offered as the more "preventative" ones were not covered by insurance.
And generally dialysis, yes, for renal failure, is poorly tolerated by diabetic individuals, which makes prevention by proper early treatment true life extension, and it's far less expensive than the treatments needed for all the complications detailed in your and Wil's notes. But if companies only see their bottom line and ignore everything else, and if half crazed lunatics in our House of Representatives only see political advantage, things would never change. We must stay woke. For woke means awakened to injustice.
Not only does long-standing, poorly controlled diabetes cause renal failure, it puts you at high risk for infection, metabolic syndrome (heart disease/stroke/diabetes), heart failure (CV disease), retinopathy (vision damage), puts you at higher risk for developing Alzheimer's disease, foot complications due to neuropathy as stated below and depression! I am a nurse practitioner who works on a critical care unit and see the devastating effects of on a daily basis. We need physicians, physician assistants and nurse practitioners, who work in primary care to be trained in 'lifestyle medicine' to educate these sick folks about the 6 domains (see below) to healthier living in order to reverse or at least tame this disease, to use health coaches
(make sure insurance companies cover coaching) and YES, provide insulin at little to no cost! We must address this problem holistically (whole food plant-based diet, physical activity, restorative sleep, avoiding risky substances and promoting positive social connections.
Don't know where you are but your nursing philosophy is spot on. It's why I spoke to a large conference of NP's about 25 years ago and told them that I believed, as a primary care internist, that eventually there would be few primary care docs and most primary care would be done by nurse practitioners. Of course, I had special education as I was and still am married to a now retired ARNP.
Thank you for dedicating your career to primary care, we need more of you! My dear friend is also a primary care internist in rural PA (my home state) and he would agree with you. I became a member of the American College of Lifestyle Medicine (ACLM) and got certified in Lifestyle Medicine as a Health Coach during the pandemic. I have lectured about Lifestyle Medicine and the Blue Zones and it's positive affect on health and well being. The ACLM is an ever-growing society of health professionals on a mission to reverse chronic disease. I am currently working as an ICU NP in San Francisco but will be launching a LM course that specifically focuses on women's health (perimenopause and menopause). Lifestyle Medicine is evidence-based and research shows this is the future of healthcare! I highly recommend checking their website out, lots of good resources to point friends and family to that need help getting healthier!
More power to you. Your experiences doing that would be of interest to a journal like Menopause, I bet, in which Ellen Mitchell and Nancy Woods, U of Washington, published many things about the menopausal transition which they studied for about 25 years. Stuff that women really want to know about how long the transition to FMP will last and what symptoms tend to be exaggerated or changed by the transition. Somehow, we have all made the transition to retirement together, but it was a great fun ride!
Thank you for the reference to the Menopause journal, I will definitely look into that! Enjoy your retirement, I am getting close!
Please add education in every school on Adverse Childhood Events.
https://www.cdc.gov/violenceprevention/aces/fastfact.html
Once upon a time there were nutrition courses, obligatory in public schools. Does anyone remember “the basic seven”? Nutrition studies have advanced since then, but the rash of diabetes is a tribute to corporate America’s pushing sugar: colas, sweet snacks. At a recent check-up I was twice asked if I have diabetes. It’s expected of people of “a certain age.” It’s time for really thorough “health” courses in public schools, particularly before Florida can take over truth.
We are a nation of drugs over exercise. It may well be our undoing. Once public schools had vigorous sports programs for everyone (how well I remember being the last chosen for a side playing softball - astigmatic, I couldn’t catch or hit a ball), not just the “athletes.” What happened?
There has been a suggestion(out "there") that a moratorium on law suits be provided for dieticians and the medical community in regard to current protocols for the treatment of T2d, type 2 diabetes. There is a huge online community of motivated diabetics. Over the years, the medical community has agreed to a pharmaceutical answer to all of T2d. There is evidence the SAD(Standard American Diet) promotes metabolic syndrome. There are alternatives. Capitalism shows us it is not the economic vehicle to provide community health and wellness. ...plenty of stuff, yes. Be safe. Be well.
Agreed. It is expensive to eat healthy. In the long term though it is cheaper if you can avoid the health problems that co m e from the SAD.
Think of the food deserts and people buying good at dollar stores. I sometimes watch a YouTube channel where they do "southern" cooking. She has done a few shows where she buys all the ingredients at one of them. I was horrified at the fat/sodium laden canned junk she threw together, but I realized that is all many of her viewers can afford. Very sad.