Category Archives: economics

Myths around diabetes


November is diabetes month – awareness around what it is and treatment etc. There is actually quite a lot of strange information that circulates, “fake-news” so to speak regarding diabetes at large.

So let’s dispel some myths.

1.) Diabetes is caused by poor diet : firstly type 1 has nothing to do with diet and is bad luck essentially. It seems to be an auto-immune disease and essentially destroys the b cells of the pancreas creating an absolute lack of insulin.

Type 2 diabetes is a lifestyle related as well as genetic disease and even more complex in nature.

Insulin resistance is a condition more and more prevalent due to lifestyle as well as stress – a big factor. More about this another time.

2.) IF you eat properly you will get better : well firstly type 1 diabetes, without insulin – you die, children in the era before 1921 died. Only since 1921 and Banting and Best’s discovery do type 1 ‘s survive with normal life expectancies.

Concerning type 2 diet is critical and important (as it is with type 1) carbs are key and obviously healthy eating and exercising are key but eating 100% correctly will unfortunately not bring back b cells that have died.

3.) Type 1 diabetics should never eat carbs : whilst one should be mindful of the type and quantity of carb and dose the insulin accordingly it is by no means advised that type 1’s exclude all carbs. This is a tricky one and best discussed in consultation with a dietician.

 

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Diabetes and governments


Why is this not a more pressing issue? The diabesity epidemic threatens to ruin the whole world and yet so much of silence?

The log curve that shows no even inkling of abating rises like a tsunami and we are all “thula-msindo” – zulu for not saying a word.

Urgent action is required, yes I said action. Urgent.

Alternatively we can go with the tsunami of medical costs that are unsustainable, ill populations, knock effect to the economy due to loss of income, knock on due to high costs (medical) etc etc. It is a disaster and yet we look on.

Wake-up oh sleeper!

Now is the time to do something, its fast becoming too late.

 

Tidal wave required


Ok so life is interesting in south africa. I would like the kind of money that Manyi  has, 450 million? was it. I would use it to “fund” my patients needs.

Diabetics, type 1’s in particular have many needs. Most of these are not taken care of by their medical aids and despite the fact that patients pay a LOT of money for the privilege of being on one.

Type 1’s require tight control of glucose above a certain range and below a certain range and everything including the weather impacts on blood sugar. Thus continuous monitoring is a tool that can make a very very big difference in a patient’s life – it can also make such a difference that the medical aid is spared costs of admissions for highs and lows, for amputation, renal dialysis, heart attacks as well as costs attached to being blind.

However medical aids at large do not seem the slightest bit interested in saving themselves money.

Far rather milk the patient for all they are worth and at the same time provide the minimum service and complain about any request made by the health care provider who has studied long and hard and has a passion to save the medical aid costs.

Yes I am angry, perhaps at this time of day I am even h”angry”.

I am tired of begging, pleading for minimum standards of care.

I am tired that overseas things get “accepted” years before they do in south africa. Are we really 3 rd world? Despite having the “Manyi’s” ???

We require a tidal wave of protest in the form of intelligent debate with the stakeholders that matter in the realm of diabetes. I am just so tired of fighting.

Please from far and wide across  this beautiful country we call home join me, join the debate, write to your medical aid. Email me : drleethegp@gmail.com.

Please.

Continous monitoring is available in 4 forms in south africa : dexcom G5 and G4, libre flash abbott, medtronic standalone CGM and most new to the scene : ever sense.

Coming in at the lower end is the abbott flash R990 once off and R990 every 2 weeks. Dexcom is a cost upfront more than about 25k and then monthly around 4 k, medtronic around 15 and 2k per month and ever sense brand new so not too sure but in the ball park for the last 2 mentioned.

What is boils down to is MARD and quite frankly this is the bottom line with CGM is accuracy. The lower the MARD the more accurate. There are really only 2 in the market that a great on MARD : dexcom G5 and ever sense, however for the cost the libre is actually a very good value for money.

The other thing that helps me as a practitioner is a trend and all of the devices are good for this.

What we need is for the medical aids to realise that CGM is a tool they their patients can NOT afford to be without! FOR THEIR own sakes – the medical aid’s sakes.

Please tsunami arrive and let’s flood the medical aids with the truth.

Alternatively could the guptas or the Manyi’s or maybe Grace Mugage give me 450 million to spend on my very deserving patients.

Thanks ;).

Libre flash monitoring


The patient driven and marketed libre has arrived in south africa.

R990 for a reader once off which is a meter for both glucose and ketones.

R990 for a sensor that lasts 2 weeks and so i.e. cost per month if worn every day is R990 x2

You scan your button and get a reading every 5 minutes. The device has functions like worked out a1c (3 month average) as well as about 100 more. See the website.

https://www.freestylelibre.co.uk/libre

You need to fill in a form, pay the amount and it gets couriered to you.

Contact me for forms

26 hilton avenue 033 343 1826

😉libre.jpg

Diabetes still on the rise


Whilst the world (rightly so) is horrified at the current state of zuma/zupta/corruption in south africa to the absolutely insane attacks in the UK but ALSO the ongoing terrible and unacceptable carnage in syria, iraq, afghanistan (this list is way longer and way worse than most of what the “west” has seen).

I would like to bring all of your attention to something that is “silently” killing way more people. Diabetes. Don’t believe me – look at the horrendous stats. They do speak for themselves. In both the west as well as the east as well as the poorest of the poor.

Diabetes is a scurge that is on the surge. And with no even small little sign of stopping.

What is type 2 ? A disease of wealth but also of abnormal eating. There is no reason to get type 2 diabetes unless you have actually “abused” your body OR if you have had cancer or a tumour of your pancreas.

It is a disease of too much sugar into the body. Too many simple carbs stuffed into a single body and the pancreas says ok well enough is enough and all of a sudden once you have lost 50% of them pancreas cells you find yourself diabetic.

Type 1 however is a different story. This is a case of severely unfair dishing out of disease. Mostly children and young adults who out of the blue have total pancreas failure. And become dependant (i.e. you die without it) on insulin.

Type 1 is NOT avoidable by anything you do or do not do.

Type 1’s rely on insulin, without it they die.

Diabetes is killing and causing loss of quality of life for many many people.

Educate yourself and be aware of what you say. Prevent yourself from getting type 2 and help others understand the difference.

Coxsackie,yuppie flu, post viral fatigue


Anybody who has not witnessed firsthand or experienced this evil is willy-nilly able to say that this vile vulgar viral disease is “all in your head”. I can tell you that there is no-one on this green earth who voluntarily goes through the ordeal that comes with this virus. It literally flattens you in more ways than one.

I have seen countless patients afflicted with it and whilst “science” on many levels questions this disease (instead of getting on with more accurate diagnosis) it is a disease that no-one wants and is more than happy to get rid of the day it leaves their bodies.

I have to ask though why the medical profession at large is sceptical and ridiculously pathetic when it comes to diagnosis as well as treatment (of which there is little). And once again in my mind it goes back to something similar to semelweiss. The washing of hands idea disdained by so many pompous egotistical physicians turned out to be one of the most important discoveries of science and prevention of transmission of disease. Why are we so arrogant? Who gave us this “god” complex?

When we don’t fully understand something or don’t know we simply say it must not/can not exist and therefore the patient themselves must be “mad” ????????????

Surely surely we have gone past this aged way of thinking ?

No, alas it seems we have not. We will not admit we don’t know. Rather make it the patients added problem.

I think it is sad and poor.

I only hope that none of these arrogant physicians ever actually come down with it as they may lose their egos in the process.viruss

Google the semelweiss history – it’s interesting and very very sad. Sad because why can we not drop ego and rather try to understand what the very truth of the matter indeed may be.

Pump for me or not for me?


Report back : We had a marvellous discussion about pumps on wednesday evening. Highly enjoyable and informative, even our pump patient learnt something.

JOIn us today : On wednesday night 530 pm in Hilton Pietermaritzburg we will be holding an informal hour discussion about pumps -insulin pump therapy. What is pump therapy ? Who “qualifies”? What is the benefit. Is it for everyone who injects insulin?

Feel free to join us for free for an hour to explore the “pump market” in south africa and get first hand feedback from “pump” patients 😉