Thursday, February 7, 2008

Physiologists-come back-all is forgiven

Google this story.....Diabetes Study Partially Halted After Deaths

Published: February 7, 2008 New York Times

...and you will be amazed. Apparently lowering blood sugar in Type II diabetics (90% of the diabetic population have Type II) increases your chance of dying. It was supposed to be the other way around. This is a quick post so I'll get to the point. Perhaps the physiology of the diabetic patient is fundamentally different to that of a non-diabetic? This is not a radical statement, nor a novel one, but the pharmaceutical profession do tend to think of a diseased individual as a person having 'normal' physiology with an 'abnormal' disease superimposed on it. So, we just add drugs, or drug cocktails, to 'fix' all the abnormal bits (for eg the high sugar, or the high cholesterol). Most drugs are assessed by their effects on receptors and organs rather than whole systems as they go through drug development. They are marketing in the same manner. No wonder we tend to pile up the meds to counter all the deviant aspects of a person's physiology rather than stepping back to assess the overall picture. The 'overall picture' is a scary concept. Modern medicine doesn't give us the tools to assess nor treat it.
In the current age of high profile drug cocktail-related deaths such as the recent passing of Heath Ledger, and Ann Nicole Smith, perhaps it is time for those of us in the health professions to think of how we can begin to see the human as an ever evolving system over the years, that becomes fundamentally changed as we reach the tipping point for various disease states (diabetes is only one--dementia, autoimmune disorders, depression, anxiety etc, etc are others). When we do become diabetic, depressed, etc, our baselines have changed. And, because we are an interconnected mess of tissues and cells, these baselines affect every aspect of our being from our response to drugs to our mental view of the world. We can't just keep throwing on more meds until the blood sugar is low enough, or we feel calm and serene enough to get back to work. It's time we spent more time looking at the heart of our diseases and the dynamic physiology that underpins them; that complex backdrop that determines our unique response to everything that interacts with us, natural or imposed.
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