I address a huge missing gap in clinical Medicine, as currently practiced.
With specialization in multiple disciplines in Medicine, blood sugar and diabetes mellitus come to the fore only if discovered accidently or through major complications in eye, kidney, brain, heart, or peripheral nerves or if declared / confessed by the patients at the time of Hospital Admission to Institutions or infectious complications such as tuberculosis
How many patients are being missed by a fasting blood sugar or HBA1c levels -- that are commonly ignored up to 7.0 with advancing age?
We, therapists, are not proactive in assiduously searching for diabetes mellitus.
Denial of disease is also inbuilt in humans, particularly the male subset.
As a rule, all patients past 50 years admitted to the Hospital worldwide, must undergo a PP blood sugar evaluation after a monitored carbohydrate-heavy meal or 75 g glucose-drink.
As a completely treatable disorder in its early stages, type I one or type II, no complacency in detecting diabetes mellitus is acceptable in clinical Hospital or Private practice. IDDM also has a spectrum of clinical presentations.
Doctors are not placebos -- designed to please patients or to assist them to deny disease, but to face harsh realities of life and living and of the science of Medicine.
I will use this discussion to present 50 years of my experience with detecting and managing diabetes mellitus, the master masquerader and deceptor in science of Medicine. My residency in 1977-78 was in Endocrinology, and I have built on that clinical exposure.
This evolution of scientific concepts is extremely valuable for research. All of data accumulated in all fields of Medicine regarding associations is fallacious and misleading as diabetes mellitus was never excluded properly, whether in retrospective epidemiologic or prospective studies. Missing out a huge pool of diabetes mellitus patients confounds all clinical estimates.
For example, the link between migraine and diabetes mellitus can never evolve satisfactorily unless the 1-hr and 2-hr glucose challenge test is performed.
Discussions on Insulin will follow.
As a prelude, I attach the link to published article of complicated diabetes mellitus.
file:///C:/Users/ANJALI%20SHAKILA%20GUPTA/Downloads/GUPTA-NEPHRON-OCCULTSARCOIDOSIS11.pdf
Https://www.orcid.org/0000-0002-6770-5916
I am NOT a doctor but know this disease well.
A few reasons why hospitalization may be beneficial:
1. Medical evaluation and management: Hospitalization allows for a comprehensive evaluation of the individual's overall health, including the management of their diabetes. During hospitalization, healthcare professionals can assess blood sugar control, adjust medication regimens, and address any acute or chronic complications related to diabetes.
2. Glycemic control optimization: Hospitalization provides an opportunity to closely monitor blood sugar levels and make necessary adjustments to achieve optimal glycemic control. Even without routine post-prandial blood sugar estimation, healthcare professionals can use other methods such as fasting blood sugar levels and continuous glucose monitoring to guide treatment decisions and medication adjustments.
3. Education and self-management training: Hospitalization can be an opportunity to provide education and training on diabetes self-management. This includes teaching individuals about proper nutrition, medication adherence, blood sugar monitoring, and lifestyle modifications. Education during hospitalization can empower individuals to better manage their diabetes after discharge.
4. Evaluation of comorbidities: Hospitalization allows for a comprehensive evaluation of any comorbidities or complications associated with diabetes. This may include assessing cardiovascular health, kidney function, diabetic neuropathy, or other conditions that commonly coexist with diabetes. Identifying and addressing these comorbidities is crucial for comprehensive diabetes management.
5. Multidisciplinary care and support: Hospitalization provides an environment where individuals with diabetes can receive care and support from a multidisciplinary team of healthcare professionals, including physicians, nurses, dietitians, and diabetes educators. This collaborative approach can enhance the overall management and support for individuals with diabetes.
Hope it helps:credit AI
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