Gale wrote that it is "widely appreciated" that type 2 diabetes isn't a uniform disease and it lacks a definable cause, mechanism, and treatment. In other words, he said, it is a "ragbag" of conditions "all wrapped up into one definition - which is fair enough, except that people forget it."
"We then talk about type 2 diabetes as if it were an actual well-defined, formulated disease," Gale told The Lancet TV. "And the moment we start talking about it as a disease, we assume that this is a disease which has got a cause, which has got a specific mechanism, for which there are specific treatments and for which there may be prevention and cure."
Rather, clinicians should think about type 2 diabetes as a spectrum of diseases, since it often goes hand-in-hand with other metabolic complications -- although not always.
I think this is an important editorial. We discussed this last week. I wish my doctors had a better understanding of the complexity of diabetes. Most don't really understand that T2 is diagnosed by exclusion and simply skip the exclusion step as well as the whole thing about it being a spectrum.
I agree. Either you are type 1 and everything else is type 2.
Problem really is that type 2 seems to arise over excess glucose and saturation of back half of system from a grab bag of liver, pancreas, kidneys, intestines, thyroid multiple organs and a huge bag of hormones that depending what is off.
We are finally begining to accept liver leakage as well have now some new hormone drugs to tune up system but no one as I can tell see this as a complex system with many variables and hormonal influence. We do not yet accept glucose saturation of the skeletal muscles nor how a distributed skeletal muscle/fat system all with their own temporary glucose storage actually function and do flow control to prevent poisoning the muscle/fat cells with excess glucose.
Clearly glucose can backup and we are stuck on the term insulin resistance as being some mal function issue rather than a result of a proper flow control and is dynamic.
