Preface Flashcards
Failure to diagnose diabetes damage.
In the absence of personal exposure to autopsy pathology of type 2 diabetes, clinicians and clinical investigators, including those from distinguished institutions, continue to fail to connect the pathology of diabetes with the earliest diagnosis of diabetes and its clinical pathogenesis, e.g. athero-arteriosclerosis.
athero-arteriosclerosis
Arteriosclerosis vs. … Arteriosclerosis and atherosclerosis are different conditions. Arteriosclerosis is the stiffening or hardening of the artery walls. Atherosclerosis is the narrowing of the artery because of plaque build-up.
Autopsy - lost art
Since 1970, the autopsy-with the exception of forensic requirements-has virtually become obsolete to the detriment of clinical medicine.
Cardiovascular disease conferences fail to address the pathogenesis of arteriosclerosis.
Cardiovascular disease conferences are legion. They excel in addressing clinical management and life saving advances. The conferences, irrespective of sponsorship and faculty, fail to address the hyperinsulinemia, (insulin resistant) pathogenesis of arteriosclerosis. In this relative absence of significant autopsy experience or exposure, the conferences reflect a collective lack of understanding of the vascular autopsy pathology of type 1 and type 2 diabetes. The type 1 diabetic by receiving exogenous insulin over their lifetime becomes hyperinsulinemic (insulin resistant). The pathology of type 1 diabetes is now indistinguishable from hyperinsulinemic (insulin resistant) pathology of type 2 diabetes.
Repeat for emphasis:
The type 1 diabetic by receiving exogenous insulin over their lifetime becomes hyperinsulinemic (insulin resistant). The pathology of type 1 diabetes is now indistinguishable from hyperinsulinemic (insulin resistant) pathology of type 2 diabetes.
Risk factors are not risk factors, they are the pathology!
Cardiovascular conferences designate cardiovascular disease as a risk factor for diabetes. The predominate pathologies of hyperinsulinemia, type 2 diabetes are athero-arteriosclerosis, cardiovascular disease, cerebral vascular disease, hypertension, nephropathy, retinopathy, peripheral and central neuropathy, and penile erectile dysfunction. They have their beginning when the blood sugars are normal. (See Chapter 14.) The pathologies of diabetes are not risk factors for diabetes. They are the clinical pathology of diabetes! If you have any of the pathologies of diabetes, you are diabetic irrespective of your glucose status!
Undiagnosed diabetes can be discovered by its pathologies.
In the undiagnosed with any of the clinical pathologies noted above, especially those with normal fasting blood sugars, the insulin assay with oral glucose tolerance will confirm the diabetes diagnosis. Insulin deficiency (hypoinsulinemia) is the prima facie of type 1 diabetes. Direct measurements of insulin determining normal, increased (hyperinsulin) and decreased (hypoinsulin) have been established by insulin assay with oral glucose tolerance and is the basis for this text. (See Chapter 12.) Hypoinsulinemia per se with diabetes mellitus glucose tolerance (DMGT) identifies type 1 diabetes, hyperglycemia phase. Hypoinsulin (low insulin) remains the sine qua non of type 1 diabetes. With the IGT and the NGT, hypoinsulin identifies type 1 diabetes in-situ (occult diabetes), prehyperglycemia. Type 1 diabetes and Type 2 diabetes have their beginning when the blood sugars are normal.
