Category Archives: economics

Diabetes is not a myth -so why do we pretend it is???


So funny to me how there is still a lack of acknowledgment as well as a bit of head in the sand when it comes to this massive diabetes epidemic. WE seem to think we are all fairies in a fairy tale and bad things will never happen to us despite our bad behaviour.

We are currently in a pickle. A sticky soup mess of diabetes by the gazillions and yet you see no REAL action. Why?

Confusing really.

Especially problematic to have this many children “suffering” mostly silently from undiagnosed disease.

So much knowledge available and yet so little interest even.

Until the day it hits you or your family. In terms of type 2 especially in children there is so much we can do as well as reverse this if found early. So why are we not going out and actively diagnosing it?

Unfortunately in type 1 in children through no fault of their own, their bodies have attacked their pancreas and essentially killed the pancreas. And without insulin they would die.

More awareness, less scaremongering, less head in the sand, more action. More at least attempt to slow the log curve of growth. Why don’t we at least try to slow the log.

type2 chilrdrentype2kids.jpg

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What is a cough and what is a cold?


The definition of a cough : Middle English: of imitative origin; related to Dutch kuchen ‘to cough’ and German keuchen ‘to pant’, Expel air from the lungs with a sudden sharp sound, kuchen : cough, hack, kuch: fit of coughing,.

A cough is a sound we make that has a deeper cause, like a post-nasal drip, a pneumonia or a bronchitis (blockage in the passageways), a problem with the nerve supplying the lining of the lung, asthma, smoking, a lung tumour, gastric reflux etc. So in my humble opinion cough syrup as such is a little bit like using an antibiotic to treat a viral infection. One needs to treat the cause of the cough. Once one gets to the root of the problem and treats that the kuchen will go away.

🙂

What is a cold? A cold usually implies a viral infection of milder intensity that the “flu”. So many people say I have the flu please give me an antibiotic. Well! Antibiotics DO NOT touch viruses for starters and “the flu” is not the common cold or a bacterial infection like a sinusitis or a bronchitis.

Cold viruses :

  • human parainfluenza virus.
  • Human metapneumovirus.
  • coronaviruses adenovirus.
  • human respiratory syncytial virus.
  • enteroviruses.

A virus is a tiny little living thing of genetic material that infects you. It is vastly different to a bacteria.

(yes do not confuse your google search with 27 years of study…)

Cold viruses generally do not kill you.

However the flu viruses of which there are also many amongst them swine flu and the influenza virus CAN kill you. So that is why we have a flu vaccine. It is so that you don’t get one of the virulent viruses that can kill you. Yes you may still get a cold virus or a bacteria (that is not part of the flu vaccine) …but it will NOT KILL you. Get it???

New insulins


Is it not a joy and a delight to be able to know that these days we can prescribe an insulin that is far more predictable and sticks to the rules than ever before.

If you are not a type 1 diabetic or parent of one you will never understand how easy it is to either over or under dose on this medication. Add to the fact that sometimes 10 u behaves a certain way and other days it behaves in another way.

So to have both Toujeo and Tresiba – true long acting analogues with SMOOTH delivery available in SA at a price that is competitive fills my whole being with delight. I can prescribe knowing that what I am hoping the insulin to do will ACTUALLY happen 🙂

By the way this lovely awesome cellist is also a type1 – no-one can deny his talent and poise. Just saying ! Type 1’s ROCK!!!!

Diabetic feet …


So what a hugely ignored region of the body feet are. The very base of us. The very instrument of motion. Disregarded at large by most. Diabetic and non-diabetic.

Why do some diabetics have problems ? The long and the short is that largely this area can be protected, well taken care of as well as preserved.

Diabetes is a systemic disease that affects the whole body, including the feet. The blood vessels and nerves going to the feet are tiny calibre vessels, easily damaged. Think of coke rushing through your arteries and veins and what stickiness that would cause?

An ulcer on a foot is a serious thing. In fact any break in the skin is something that has to be dealt with asap. The thing with diabetic feet is that often the nerves are damaged first and there is no proper feeling and damage occurs much more easily and worse damage due to no feeling.

The human body is an amazing thing and can do spectacular processes of healing.

There are so many awesome wound treatments these days, no amputations should be taking place if the correct care at the correct time takes place.

If in doubt ask a caring practitioner to take a look.

Don’t leave a foot injury even for one day.

0832898351

2 Quarry road

Eva Mackenzie : Prins Alfred street and in hilton

Toujeo or not to jeo?


Yes folks we have a new insulin and the best best news is that it is priced affordable – R590 SEP for a long acting insulin that almost guarantees NO hypos!!!

What great great news !!!

I can barely contain my excitement as I scribble out scripts for gazillions of patients for whom this means a huge leap up in quality of life living with type 1 diabetes or diabetes that requires insulin injection.

What is it? Toujeo – or insulin glargine U300 – lots to figure out. In a nutshell it is the same as lantus/optisulin BUT squashed smaller. What does that mean?

Science is “fucking” wonderful – sorry I had to – I LOVE !!! science. When you make a molecule smaller you decrease the surface area and thus slow the absorption rate right down. So now you have a more concentrated molecule (U300 vs U100) that is “dissolving” or releasing much more slowly and predictably and yes you guessed it all you insulin boffins out there – no stacking of insulin, which means no HYPOS !!

Simple yet brilliant, don’t you think – or am I just a proper nerd.

Once daily dosing – truly once daily.

No hypos, predictable.

Need I say more

Toujeo or not to je o ??

😉

Children with type2 diabetes


In the last month I have diagnosed 2 children with type 2 diabetes. This is a first for me and greatly concerning. The prediction was there but I guess I hoped I would never see it.

What does this mean?

Type 2 diabetes is where you “run out” of b cells – the ones that make insulin and run high sugars due to a bad match between carbs (too many) and insulin (too little).

This was previously only seen in adults really towards the age of 40. To see this in children is a wake-up call.

We have an epidemic of logarithmic proportions and it needs to be tackled in a multifaceted way. By governments – providing funding and facilities as well as knowledge sharing. By health practitioners – early diagnosis and implementation of turning the tide for both individuals and population groups. By society – recognition of poor eating and not enough exercise – ditch the device across the board. Go outside more often/daily for physical activity. By you and by you, yes you.

Newer insulins


Are they any better ?

Yes, yes and yes, if I needed insulin I would only be on the newest latest of them. Are they for everyone?

I certainly believe individualisation is the key here. We now have so many tools in the armament of diabetes and to this end they require to be prescribed for the greatest benefit for the individual.

So, when it comes to what we call basal insulin – background insulin. The insulin that controls your sugar before a meal and overnight and in the back ground so to speak (out side of meals). We now have a lot to choose from : protophane, other long acting basals, analogue basals like : glargine, detemir, newer ultra-long acting like degludec.

In terms of the choice it needs to match the needs of the patient.

If a patient wishes to only inject twice a day we have an option for that.

If a patient prefers an insulin pump we have an option for that.

If a patient is wanting ultimate control above all else there are choices for that.

What is critical is aiming for an A1c of 7 with very little variability. I am always happy to sacrifice A1c for less variability and my most important criteria is no hypos! or as few as possible. They are “Kak” for both brain and patient.