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                         Diabetes - WEB Publication Forum  
           For Patients, Health Professionals, Interested Persons and Investors



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           World Diabetes Health Care Org.
                                 Charity Non-Profit Organization
 
                For The Best of Humans Worldwide

    To help Diabetes People worldwide to get The Information they need by One View
    or One Source to
better understand and manage it to have a happy Diabetes Life.
    Our aim is also to
create The Awareness For The Ongoing World Epidemic for the
    Political Parties,
Governments and Institutions to do what it need to improve the life
    of Diabetic People
and to avoid abuses of such as by Health Insurances or at Jobs
    or Careers, Etc. or
getting treated as 2nd Class People and instead to receive the
    preference status by
humanistic civilized ways to release some of the burden,
    problems and difficulties in
their daily life. 
    As world first and only we publish the Detailed Practical Therapies Approach by information’s
    as usually
only by Doctors in Diabetology - Endocrinology provided if they have enough time,
    for
the Diabetic People able By Self- Management to improve the HbA1c or A1C Values, Etc. 
    and To Reduce Any Risks for Associated Diseases such as Neuropathies, Retinopathies,
    Cardiovascular-,
Micro- Macro- Vascular- Disorders, Etc. Up-To Amputations To Avoid.

    Our Email Contact: WDHCO@outlook.com  
   
( We Don’t Sell Anything and Act without Sponsors to remain Neutral. We will also never cooperate with
      any Telemarketing Firms to get only 20% of the Donated Money as the ADA does. Resulting of what we
      receive to 98% gets into informative WEB Diabetes Care Publishing. Our Members work on Goodwill base.
)

    This is the World Only WEB-Site with Medical Advices to help Patients and Doctors !

   
At Forums or Communities or Magazines or Associations as seen, the Diabetic People cannot
    even
find anything of How to Improve the A1C, Etc., but find reiterated Poor Guidance- Norms
    and Attractions
for selling Products or Crossword Puzzles ( LoL ) or Confusions by some News
    as daily updated declared
.

      ( For example the Diabetes.co.uk is a good example of Fake Fooling just creating attractions to sell its Products. Where its Forum Members get hypocrite motivated to provide
      any Diabetic Advice or Support possible and when this naturally medically by best experiences made, the Posts as medically get Deleted and the Forum Members Get Banned !
      
Diabetes.co.uk declares themselves world’s leading support community for people with diabetes. Presently just too many like to do business with Diabetes. 
     Other WEB- Sites or Forums Have The Hypocrite Policy At Medical Topics Any Medical Advices Not Permitted. Resulting What For Such Sites ? ) 
    For Diabetics it’s frustrating to see how much is published in the Internet or what is ongoing
    and how little if any is really helpful and that’s where We Show The Difference Just To Help !! 

    We Change and Improve now of what the ADA and Followers during the last

    20 Years failed to do by the Diabetes Epidemic Resulting. Just creating some
    Press Releases at weekly base or So-Called Studies do not compensate this.


    Charitable we do this worldwide By Diabetes Related Keywords for by Google Search
    to see at any FrontPages to get the maximum of Clicks and
Interests as necessary.
    This is costly and therefore we would really appreciate any Donations to do it as

    good as necessary. 

    For this Please Donate to our Bank-Account: Swissquote Bank SA, IBAN Code: CH810 8781 0000 7014 5100
    with Beneficiary / Comment: WDHCO 

    If this is not been seen At Every FrontPages as necessary by just using one Keyword
    as for example "Diabetes", it would mean only that we
regrettably did not receive
    enough Companies- or Private- Donations for doing this.
    WDHCO Donation-Status Not Yet Sufficiently.
    ( WDHCO in June 2017 also with some Diabetics established at lowest costs as seen here. We are
    planning to do a nice WEB-Page with a WEB-Designer when we have the money for and doing place-
    reservations for the Pages 1 it need to
create the necessary awareness. This would need to be done
    by Advertisement
at Google AdWords for the Medical Field with $ 1.29 Costs Per Click.
    This only for all to know !

    All companies seen more at front, for a Preferred Status monthly pay to Google $ 4,000 - 8,000
    to be seen on the WEB. It's not just Clicks- Based and they call that helping. Google as known
    also applying some abusive tricks.

    If You A Diabetic and Really Care About Improvements of the Diabetics Situations, then you should
    Take That Chance Here To Get The Words Out And Donate even any small amount You Can Afford,
    because by the experiences
The Non-Diabetics Usually Don’t Care About As Long They Not Became
    Diabetics Themselves
and just concentrate on any other interests in days life.


     Diabetics expect Anything, but maybe not so willing to give Anything.

    According of WHO-World Health Organization we have now about 1.5 Billion
    of Diabetes affected People and this by increasing tendency as confirmed !

      Always November 14th Is The World Diabetes Day To Remember.

    This Site Will Be Continuously Further Completed And Updated To Aware.



    ADA – American Diabetes Association 2018 Standards 

        http://diabetesed.net/wp-content/uploads/2017/12/2018-ADA-Standards-of-Care.pdf
    General Topics http://care.diabetesjournals.org/content/41/Supplement_1  
    Instead considering this, it’s better to consider here the Topic “Objective Diabetes Standards & Guidelines” !

    DDG – DE Diabetes Gesellschaft 2017 Standards

        https://www.deutsche-diabetes-gesellschaft.de/leitlinien/praxisempfehlungen.html  

    Roche Diabetes Care – CGM & Insulin Pump Systems

        https://www.roche.de/en/diagnostics/diabetes-care-vision.html
        https://www.accu-chek.com/

    Novartis - Google Diabetes Care
        http://medicalfuturist.com/googles-amazing-digital-contact-lens-can-transform-diabetes-care/ 
        https://www.pharma.us.novartis.com/our-products  

    Abbott Diabetes Care - CGM System

        https://www.diabetescare.abbott/index.html https://www.diabetescare.abbott/products.html  

    Pfizer - Diabetes & Metabolic Disorders

        http://www.pfizer.com/health-wellness/diseases-conditions/diabetes-metabolic  

    Merck Diabetes Care

        http://www.merck.com/about/featured-stories/diabetes_care.html  

    Dexcom - CGM Glucose Monitoring

        https://www.dexcom.com/contact  

    Metronic - CGM & Insulin Pumps Systems

        https://www.medtronicdiabetes.com/home  

    Glooko - New FDA Approved Diabetes Management System

       https://www.glooko.com/

    Dual Insulin & Glucagon Pump Systems – Artificial Pancreas – Near Diabetes Future
     
https://www.nih.gov/news-events/news-releases/four-pivotal-nih-funded-artificial-pancreas-research-efforts-begin
        https://diatribe.org/introducing-beta-bionics-bringing-ilet-bionic-pancreas-market
         https://www.google.com/search?q=diabetes+dual+pump+system&client=firefox-b&tbm=isch&imgil=1rrc3XTvq9_UVM%253A%253BDnUjbQGB2af0PM%253Bhttp%25253A%25252F%25252Fwww.healthline.com%25252Fdiabetesmine%25252Fdouble-the-pump-chambers-double-the-diabetes-device-fun&source=iu&pf=m&fir=1rrc3XTvq9_UVM%253A%252CDnUjbQGB2af0PM%252C_&usg=__V0Fv-g6XwAa8MiuIf3g99dnJkYs%3D&biw=1347&bih=765&ved=0ahUKEwixyZyW57PUAhVGGZAKHdGJCbAQyjcIRA&ei=zyw8WfGlNsaywATRk6aACw#imgrc=GbLL9t_XPcMxUM



    Index Table of Topics
    - Introduction, Associations and Companies in the Diabetes Field.
    - Dual Insulin & Glucagon Pump Systems - Artificial Pancreas – Near Diabetes Future.
    - Objective Diabetes Standards & Guidelines
    - If You Have A Question or Problem Until Now Without Solution ?
    - 1. Diabetes-Related Microvascular and Macrovascular Diseases.
    - 2. HbA1c or A1C Values & Target Value.
    - 3. Diagnostic Standards.
    - 4. Diabetes Awareness & Precautions.
    - 5. The Simple Therapy Rules For At Any Diabetes Types To Apply.
    - 6. Swollen Feet’s & Higher Blood Pressure & Neuropathies Checking.
    - 7. When You Get A New Insulin-Pen To Use.
    - 8. Calibrations at CGM-Continuous Glucose Monitoring Systems.
    - 9. Important Information’s For Basal-Insulin Users And Patients. 
    - 10. Injection Technique / Basal-Insulin.
    - 10.A) At Rapid-Insulin Applications.
    - 10.B) Hypoglycemia - Hypos - Low Sugar - Cramps.
    - 10.C) Hyperglycemia - Hypers.
    - 10.D) Glucose Measuring - Lost Insulin Effect. 
    - 11. Metformin or Metformin Containing Medications - Type 2 + Type 1 Dosing.
    - 12. How to set the Basal-Insulin Dose as very important for the Necessary Base Effect.
    - 13. About Glucose mg/dl.
    - 14. About Diabetes Therapies In General.
    - 15. Beta-Cells Transplants or Beta-Cells-Therapies or Immune Therapies To Cure Type 1 ?
    - 16. Doctors Symptoms List.
    - 17. Healthy Nutrition Opportunity  & Supplements. ( Also about important Potassium, Aspirin, Etc. ! )
    - 18. Drinking Alcohol and Diabetes.
    - 19. Diabetics Erection Disorders.
    - 20. Misdiagnosed Diabetes Type 3c.
    - 21. Gene Mutation Causes MODY Diabetes.
    - 22. UKs Top 10 Priorities For Type 2.
    - 23. Smart Synthetic Beta-Cells Insulin T1D & T2D Patches Treatments ?
    - 24. The Brain Also Produces Insulin.
    - 25. Over Weight Problems & Type 2.
    - 26. Nov. 2017 Study Report - ADA Diabetics Fooling Masterpiece ?
    - 27. Nov. 30th - How Naïve To Reach Out To NIDDK !
    - 28. The ACCORD Study 2009 Should Never Been Made By Its Incomplete Conclusions !
    - 29. Diabetes and 30-40% Chronic Kidney Disease: an increasingly common multi-morbid disease
         in need of a paradigm shift in care !

    - 30. Diabetes & Potassium – Very Important For Heart & Health !
    - 31. ADA & Co. Keeps You Sick By Its Hugh Conflicts of Interests !!

    - 32. Type 2 Diabetes Can Be Reversed !
    - 33. HbA1c - A1C Diabetes And Cognitive Decline !

     This List gets continuously completed also by each Topic information
    getting improved, completed or up-dated as soon as New- or Better
    Know-How is available.




    Objective Diabetes Standards & Guidelines
    This purely scientifically, physically and practically made to handle the epidemic.
    ( It’s Not Made by Poker-Table ADA Set 12 People Only Committee, where world
    recommended Professors & Doctors in Diabetology - Endocrinology and General
    Medicine may missing. The present Diabetes Epidemic cannot be handled like this.
    Where are such as Prof. Dr. M. Donath or Prof. Dr. M.
B. Zimmermann, Etc. ?

    Presently worldwide registered T1D, T2D, LADA, MODY, Etc. Patients of about
    500 Million by the dark number for Pre-Diabetes of about 1 Billion.
    This by an Increasing Trend according of WHO - World Health Organization ! )

 
    Normal Healthy People
    Fasting Glucose less 100 mg/dl ( This also by ADA )  
    A1C max. 5.2 % or Average Glucose 88 - Max. 103 mg/dl ! ( This not made by ADA )
    This by world recommended Professors & Doctors in General-, Cardio-, Neuro-, Endocrine- Medicine
    since over 40 Years successfully applied and by NIH.Gov approved as seen here by its 2010 Link:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911067/  

 
    Pre-Diabetes
    Fasting Glucose 100 125 mg/dl ( Av. Glucose of 125 mg/dl = A1C 6 %. This also by ADA )
    A1C 5.3 - 5.9 % or Av. Glucose of 105 124 mg/dl. ( This not made by ADA )
    If Pre-Diabetes by Fasting Glucose is confirmed an OGTT 75g Test should been made with
    the 1 Hour-Result of 145mg/dl or higher as First Priority To Use by its better
sensitivity or
    reference To Detect Pre-Diabetes compare to the 2 Hour-Result of 130 mg/dl or higher ( This mg/dl not made by ADA ).  

    ( Continuous Glucose of 105 mg/dl known as beginning of Micro-Macro-Vascular Blood Circulation Disorders to see by the
    beginning of swollen Feet. As also seen here in the NIH.Gov 2010 Link, Pre-Diabetes of A1C 5.5 - 6 % compare to Healthy 5 %
    has already a Double-Risk for Heart-Failures and therefore should been treated by Therapies Medications & Lifestyle to get
    into the Average Glucose Range of 88 - Max. 103 mg/dl as for any Normal Healthy People. This not made by ADA )

    By ADA anyone with A1C of less 5.7 % is as healthy as someone with a Healthy A1C of 5 % - How Wrong They Are !
    ( ADA by high A1C Recommendations putting Diabetics at Heart- Etc.- Risks and resulting calling for Heart- Medications
    with Potential Cardio-Vascular and Heart- Health Benefits, But Which One ?It’s Unbelievable ! )

 
    Diabetes
    Fasting Glucose higher 125mg/dl ( This also by ADA ).
    A1C 6% or higher ( The new 6% has the ability to confirm diabetes as good as the OGTT can, it also means if any 6% A1C
    Result is achieved, that an OGTT 75g Dextrose Test should been made for reconfirmations ( The A1C 6% not made by ADA ).  

    OGTT 2 Hour-Result of 180 mg/dl or higher to confirm diabetes ( The New 180 mg/dl 10% lower not made by ADA ).
    ( Good Diabetes Therapies should allow to have the Glucose within the range of any Normal Healthy People ! This not made by ADA )
 

    Therapies Related Measures For Any Diabetes Types
    -- Any Basal-Medications as 24h Insulin- or Other- Long Acting Medications, Metformin, Etc. within
    the Daily 24 Hours Cycle At Lowest Fasting Glucose Set within 80 - 90 mg/dl to avoid Hypos but providing
    the best preconditions for A1Cs as of Normal Healthy People as following ! ( This not made by ADA )
    -- General Target HbA1c or A1C for Any Diabetes Type, Age, Gender:
    4.7 - 5.2 % or Average Glucose Range of 88 - 103 mg/dl ( This not made by ADA )

    -- The Simple Therapy Rules For At Any Diabetes Types To Apply:
    1. Fasting Glucose Value before or after any Meals 80 - 100 mg/dl !
    2. During any Meals Glucose Above 100 mg/dl for Max. 2 ½ Hours !
    ( By This Any A1C Will Also Improve. This not made by ADA )

    -- Metformin by lower D 3x dosing of Daily 375 - 750 mg to Support Therapies should been applied by Any
    Diabetes Types to improve A1C and also to reduce known Heart Failure Risks and for this also generally
    checking too low GLP-1 Hormone levels to possibly
supplementing it ! See also at Topic 11.
the use of
    simple Non-Hypogenic Therapies for much better and healthy overall results !
 ( This not made by ADA )
    -- Every 2nd Day, by one day pause, 1/2 Standard Aspirin Tablet combined with Daily Vitamin-E 600 - 800 mg
    and 3x Daily Slow-Release Prolonged Niacin 125 mg
to open Blood-Vessels. All this for improving Blood-Flow,
    reducing Blood-Pressure and resulting to reduce Heart Failure- and Neuropathic- Risks. ( This not made by ADA )  

    ( At any Operations, Aspirin stopped 10 Days before and Vitamin-E or Niacin
    stopped 2 Days before ! )
    -- Supplementing Potassium by daily 800 - 900 mg or eating 2 Bananas. See at Topic 17. ( This not made by ADA )
    -- Standard Normal Healthy A1C 5% for Diabetics able To Avoid or Reverse Neuropathic Symptoms !! ( This not made by ADA )
    -- Taking all Medications as required !
 

    By all of this, every Patient or Doctor can see how it is or suppose to be and
    can themselves decide about how much risks to accept.
 
    All above modifications are communicated with NIH.Gov to become the Standard also at ADA !





    If You Have A Question or Problem Until Now Without Solution ?
    By Email you can contact us and we will reply with the answer made
    by some leading Prof. Dr. in Diabetology - Endocrinology which
    you then should discuss with your Doctor in Diabetology.





    1. Diabetes-Related Microvascular and Macrovascular Diseases in the Physical Therapy Setting
    Here from NIH.Gov the Worlds Medical Reference !

         https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2579903/   
    The Basic-Cause of Neuropathy, Retinopathy, Kidney-Nephropathy, Bones-Osteopathy, Etc. of about
    20 Additional 
Diseases up to Amputations.   
    The Related Venous Capillary Netting: https://en.wikipedia.org/wiki/Capillary  

    Feet’s should never been swollen because if swollen it confirms Micro- Macro-

    Vascular Blood Circulation Disorders. To avoid swollen Feet’s it need the
    Average Glucose at Max. 97 mg/dl. When Feet’s swollen for a Week and
    the Average
Glucose is made to be in range of Max. 97 mg/dl then it can
    take
1 - 3 Months until the Capillary Netting Veins recover back to normal.

    To Reduce the Diabetes Typical Blood Circulation Problems with its Inflammation
    and Neuropathies Potentials.
    As known Every 2
Days take 1/2 of Standard Aspirin Tablet, means taking it and
    Pause for One Day then take it again, etc., this combined with Daily 600 - 800 mg
    natural Vitamin-E
!

    As known To Reduce the Inflammation Potentials, Every 2nd Day take 350 mcg of pure
    natural Selenium-Yeast without of any Magnesium-Stearate affecting the Selenium
    properties and bio-functionality, but micro-crystalline Cellulose it could contain ! 
    Selenium to preserve its Effect need to be taken 2 hours apart from any other

    Medications or Substances or Supplements.
    As known, the Aspirin will reduce the White-Blood-Bodies to stick together and the

    Vitamin-E as known will reduce the Red-Blood-Bodies to stick together and by that
    the Blood has an increased Flow-Capacity. As known Glucose is a sticky matter !
    ( As Important - 10 Days before of any Operations the Aspirin intake and 2 Days
    before the Vitamin-E intake needs to be
stopped ! ).
    The Selenium is very well known for its huge Inflammation- or Infects- Reducing properties
    and resulting is also reducing and eliminating Diabetic Pain !!

    If under the above procedure swollen Feet's do not disappear, then
you have to
    contact your Doctor, because possibly you have also some
Kidney, Liver, Heart,
    Lungs, Thyroid, Digestion Problems or some Medication Allergy to take care.

    At Acute Neuropathies reduce the A1C to 5 % Average Glucose of Max. 97 mg/dl

    and take Every Second Day the 350 mcg Selenium as above, but in-between take
    also only 250 mcg
Selenium to strengthen- and preserving- its Effect.
    By this in combination with above Aspirin & Vitamin-E plus daily Vitamin-B12 30 mcg
    and Vitamin-B6 10 mg with 3x Daily Slow-Release Prolonged Niacin 125 mg ( B3 )
to
    open Blood-Vessels, it’s possible to recover within 1 - 2 Years by the Feelings also
    returning again.

    About the Aspirin and other Supplements details and use have a look at Topic 17.
       ( For example Alpha Lipoic Acid provides too little recovery if any and is not solving the problems. )

    If like to get Neuropathies it’s easy, just follow the ADA Guidance of 80 - 180 mg/dl Average 130 mg/dl
    and this whereas known beginning from Av. 105 mg/dl or higher just get it, possibly also with Ulcers !!





    2. HbA1c or A1C Values & Target Value !
    Here is a Link for the Conversion of A1C New % DCCT- and New IFCC- Norms

    with the Average mg/dl or mmol/l Values from A Certified German Laboratory.

    By inserting the A1C New % or New mmol/mol Numbers it shows 4 Results
    with the right relations to each others ! 
    By shifting here the A1C Numbers you can find out about the relations of some

    specific Average Glucose mg/dl or mmol/l Values show up.

     ( Sorry, anything like this could not been found in English )
     
https://www.labor-limbach.de/laborrechner/labor-rechner/hba1c-standardisierungeneinheiten/
    It became pretty confusing with the A1C Numbers, because what
    used to be A1C 5.4 % for Average Glucose 97 mg/dl became 5 %
    and A1C 4.5 % was for Average Glucose 68 mg/dl it became 4 %.
    Resulting for A1C we should apply Its Calculated Average Glucose Value Only
    and that not higher than Average 97 mg/dl To Be Safe as
within the Normal
    Human Healthy Range of 70 mg/dl to max. 97 mg/dl or max. 5.4 mmol/l !!
    More Examples:  

    By the Old System A1C 6 % was Average Glucose 117 mg/dl or
    A1C 7 % was Average Glucose 149 mg/dl !
    But by the New System A1C 6 % is Average Glucose 125 mg/dl
    and A1C 7 % is now Average Glucose 154 mg/dl !
    Diabetics get cheated ?
    Therefore Use Only The Average Glucose Values mg/dl, because
   
mg/dl is mg/dl it cannot be changed by the same for mmol/l
    We have now the problem of several A1C to Average mg/dl Calculators

    in the Internet and also at Laboratory Reports, but rarely have specified
    by which Norm they really functioning and so The Patients need to make
    sure and possible need to do phone-calls to ask for the Average Glucose
    Values mg/dl of its A1Cs to avoid any mistakes !!

    General Target HbA1c or A1C for Any Diabetes Type, Age, Gender:
    4.7 - 5.2 % or Average Glucose Range of 88 - 103 mg/dl
    ( By NIH.Gov, Av. Higher 103 mg/dl provides Increased Heart Complications. )
    See NIH.Gov Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911067/

    As known there is a problem with the Laboratories A1C Evaluations, where
    depending on the kind of Equipments, Calibrations and Handlings the A1C
    Results can vary by a disturbing Tolerance of plus-minus 12 % ( 24 % ) !!
    Until today there are still not better Standards developed to avoid this
    Important About HbA1c or A1C Tests !
    As a Doctor or Patient you need to make sure that you selecting the
    Right Laboratory with the Right Equipment as necessary !
    Regrettably there is presently worldwide only One FDA approved A1C
    Equipment available which offers the Precision Tolerance of Less 2 %
    and that is the Cobas Tina-Quant HbA1c Gen.3 as by the Link seen:
   
http://www.cobas.com/content/dam/cobas_com/pdf/product/Tina-quant-HbA1c-Gen-3/Tina-Quant%20HbA1c%20Fact%20Sheet.pdf




    3. Diagnostic Standards
    They regrettably not Physically based, but more by Convenience for Patients
    or Doctors and Commercially for the Health Insurances, by the Therapies
    Standards also under the same methodology, as for example compare A1C of
    8 % the A1C of 7 % shows 12 % less Permanent Diseases, how the Rest % ?   
    According NIH.Gov Average Glucose higher 97 mg/dl ( higher Former A1C 5.4 % or
    today’s 5.0 % ) shows already an Increased Heart Failures Rate at Normal People.
    See here the NIH.Gov Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911067/
    Now maybe some will say Diabetics are not normal people anymore, but
    for us they’re also just as normal people with the same bio-anatomies !
    By this it’s good to understand, Why at Diabetics under Therapy we recommend an A1C
    of Average Glucose 88 - 103 mg/dl. This In The Best Interests of Diabetics People Only !!
    Our Recommendation of Average Glucose 88 - 103 mg/dl also for as well known To Avoid
    Swollen Feet’s or Neuropathies, Etc. caused by Micro- Vascular Blood Circulation Disorders.
    As known the beginning of Swollen Feet’s starting from continuously 105 mg/dl. 


    Before 2008 by the Old Norm A1C 5.5 % was corresponding with
    Av. Glucose of 100 mg/dl as the Max. for Normal Healthy Humans.
    By the Old Norm A1C 5.5 % Av. Glucose 100 mg/dl and A1C 4.5 %
    for Av. Glucose of 70 mg/dl as the Min. for Normal Healthy People.
    The range for Normal Healthy People was Av. Glucose 70 - 100 mg/dl.
    Then the Norm got changed from A1C 5.4 % to 5 % as Av. Glucose
    of 97 mg/dl and A1C 4.5 % changed to 4 % as Av. Glucose 68mg/dl.
    NIH.Gov by Big Study the A1C 5 % Av. Glucose 97 mg/dl got proven
    confirmed as the ideal, because higher A1C causing Heart Failures
    by A1C 5 % compare to 5.5 - 6 % the Risks Doubles !
    See the Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911067/   
    But 2017 by ADA & Co. for Normal Healthy Humans is confirmed
    the A1C of Max. 5.7 % Av. Glukose 117 mg/dl !!
    How much more Fooling do we deserve ? ? ?
     ( It shows how the Diabetic Epidemic is handled or not handled by just creating
     more So-Called Healthy Humans with higher Average Glucose than ever before ! )


    We basically have about 20 Years old Standards by A1C 6.5 % Average
    Glucose 140 mg/dl ( before 133 mg/dl ) or higher defined as Diabetes.
    Under these recommendations as of ADA the present Diabetes Epidemic
    developed worldwide. For This Will We Ever Get A Sorry ?
    Newly since 2017 we got the Pre-Diabetes defined by A1C 5.7 % Average
    Glucose 117 mg/dl or higher up-to A1C of 6.4 % and/or Morning Fasting
    Glucose 100 - 125 mg/dl defined as Pre-Diabetes.

    To handle the present Diabetes Epidemic within the next years we can
    expect, but maybe already as from 2018, that Diabetes will be defined
    from A1C 6 % Average Glucose 125 mg/dl or higher and A1C of 5.3 %
    Average Glucose 105 mg/dl or higher to be defined as Pre-Diabetes
    and Age independent Stage 1 Diabetic Therapies get developed for it.
    Presently Only Forward Strategies Can Help Where The Diabetics First !

    Today in Hospitals or Chirurgic Clinics we can see the Surgeons at

    about 60 % occupied with Diabetics by vascular bypasses operations
    and various amputations. This under the present Standards where
    of such as the ADA it has never been seen any Press Releases.




   
4. Diabetes Awareness & Precautions
    Since Sooner or Later In Life Anybody Could Get Diabetes. Therefore at every
    household, beside the Thermometer, Blood Pressure Meter there should also be
    a Calibrated Glucose Measuring Device to measure every 2-3 months.
    The Glucose Measuring Device calibrated by taking blood for in the Laboratory to

    measure the Glucose and at the same time to do 3 Glucose Measurements to write
    down the numbers and date, for by the Lab Report later to know how much it may
    shows too less or too much, because the cheap devices are usually not accurate set
    by the producers. Measure every 2-3 Months the Morning Fasting Glucose Level and
    if
you have it within 100 -125 mg/dl, repeat the measure and measure it monthly and
    contact your Diabetes Doctor, because you will have Pre-Diabetes maybe also age
    related to aware and take care of by Therapy & Lifestyle as early as possible as
    better it is to avoid any permanent affections. 
    Do Glucose measurements only at good cleaned Just Water rinsed and after well dried 

    Fingers without using any Disinfectants, Soaps, Crèmes or Lotions and for that purpose
    reserve A Clean Towel to dry the Fingers, that’s very important for reliable values !!



    5. The Simple Therapy Rules For At Any Diabetes Types To Apply:
    1. Fasting Glucose Value before or after any Meals 80 - 100 mg/dl !
    2. During any Meals Glucose Above 100 mg/dl for Max. 2 ½ Hours !
    ( By This Your A1C Will Improve. )

    General Target HbA1c or A1C for Any Diabetes Type, Age, Gender:

    4.7 - 5.2 % or Average Glucose Range of 88 - 103 mg/dl
    ( By NIH.Gov, Av. Higher 103 mg/dl provides Increased Heart Complications. )
    See NIH.Gov Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911067/




    6. Swollen Feet's & Higher Blood Pressure & Neuropathies Checking
    By Diabetics The Blood Pressure as very important should been seen in combination
    with the A1C !
    This means that All Diabetics should also have an "Omron" Blood Pressure Meter at
    home for at some Relaxed Moments to measure once weekly.
 
    Measuring the Blood Pressure is as important as daily measuring the Glucose
    and daily watching the Feet’s !!
 
    The normal healthy Blood Pressure is Systole-High 110 - 120 mmHg ( Systole max. 140 mmHg )
    and
Diastole-Low 70 - 77 mmHg to keep in mind.
    Diastole-Low is representing the Average Blood Pressure between the Heart-Beats
    and resulting the most important pressure to watch.
 
    Diastole-Low of 80 - 89 mmHg is Risky Pre-Hypertension and at Diabetics confirm
    Initial Blockage Micro- Macro- Vascular Blood Circulation Disorder in The Body’s
    Capillary Veins Netting and resulting Swollen Feet’s and A1C above the
    Recommended Average Glucose of 88 - 103 mg/dl !!
 
    Diastole-Low of 90 - 99 mmHg confirms Stage 1 Hypertension - Higher Risks.
 
    Diastole-Low of 100 mmHg or higher confirms Stage 2 Hypertension - Highest Risks.

    Risks for Cardiovascular Complications and for Neuropathies, Etc. ! ! !
 
    Watching The Feet’s At Daily Base
    During the day and especially when doing some sitting work it is normal that
    until the evening the Feet’s will have a tendency for some little swollen, but
    the Veins should remain visible and not begin to disappearing by swollen.
    In the morning when getting out the bed, the Feet’s should never been swollen
    and if swollen it confirms something wrong with the Therapy Parameter Setting
    and Resulting the A1C Too High and you also at Neuropathies Risks !!
 
    If something is wrong with the Therapy Parameter Setting, you either experienced
    by yourself to adjusting it or you contact your Doctor in Diabetology to be sure.

    Monthly Check Your Feet’s For Neuropathies
    At Sole of the Foot and Toes by a Ballpoint-Pen by gently touching to draw Lines
    everywhere You should been able to create some Tickling-Feeling if OK and otherwise
    if you feel nothing you will have Initial Neuropathies and when you partially not even
    feel the Pen touching or its pressure on the Skin you will have Acute Neuropathies
    to take care of by immediately reducing your A1C to the well recommended Average
    Glucose of Max. 97 mg/dl and apply some medications to improve the Blood-Flow
    and reduce Inflammations as here initially introduced at the Micro- Macro- Vascular
    Blood Circulation Disorders.
 
    For this have a look at initial “Diabetes-Related Microvascular and Macrovascular
    Diseases in the Physical Therapy Setting” from NIH.Gov with related Comments !

    As here seen; Swollen Feet’s, Higher Blood Pressure and Neuropathies are interconnected !! 





    7. When You Get A New Insulin-Pen To Use !!
    You should first apply the two steps setting Procedure as following:
    1. Take the Pen without inserting any Needle and set 4U and gently press until
    you cannot complete it to reach Zero
because you feel a resistance. At that
    moment do not forcing to reach the Zero for not breaking the mechanics.

    2. Then insert the Needle and press to Zero by some Insulin drops coming out.
    You need to see some drops coming out.


    If you do not apply this Setting Procedure, the internal mechanism at the
    Piston is not at Zero and resulting your first Dose will be incomplete ! ! ! 




    8. Calibrations at CGM-Continuous Glucose Monitoring Systems

    If you are a user of any such system as it preferably to be, then read
    carefully about the important daily calibration, for things not going wrong.
    You should never not doing any calibrations or not applying comparisons
    also at systems even the producers may say “no need of calibrations”.
    At any CGM-System when you change the Sensor apply at the first day
    at least 2 Calibrations, by the first one 1-2 Hours after replacing it and
    8 Hours later a second one to make sure !
    As you know the measurement is made in The Tissue and not directly in
    The Blood Flow as principally necessary for any Real Time Measuring.
    Measuring in the Tissue as known has a time delay of about 10 Minutes
    where it can go Up or Down in the blood stream and therefore to
   
have a good calibration, the calibration should always been made at some
    period where at the monitor is seen that the Glucose-Level is going Flat
    Horizontal for some time usually between the meals or 4 hours
after
    any meals or drinks, beside of water drinking only !! !!

    By this kind of calibration method you could then also see that sensors
    been used for longer, become even more precisely with less to correct.

    ( If not yet have a CGM-System but like to decide to get one, then decide
    only for a type able to connect with some Insulin-Pump System to use in
    the Close Loop configuration, because only that will give real advantages
    as for example At Night To Stop any Insulin Supply when going to Hypo
    and if may like to decide to get a Insulin-Pump System, then decide for
    one able to use by Close Loop Application combined with CGM-System.
    For example Metronic has a Insulin-Pump System where the CGM-System

    is integrated means there is only One Patch on the Abdomen to wear. )
    
https://www.medgadget.com/2014/06/medtronic-minimed-duo-integrates-glucose-sensor-insulin-infusion-into-one-device.html




    9. Important Information’s For Basal-Insulin Users And Patients
    There is a strategy applied by the Insulin Producers to respect its Doctors Clients
    discretion only to create consultations to pay for, where even Diabetes- Associations
    or Communities or Forums, Etc. participate with and
therefore Important Practical Info
    For The Diabetes People Applications, regrettably
are not published, but here will all
    this been compensated by all important details herein shown as following.
    Generally, All Patients by The Laws are permitted to know everything’s about its

    Diseases and Medications, where the Health Industry is obliged to provide All

    Related Information's, but this is not completely fulfilled as regrettably seen !  
    ( This by Doctors and Companies supported who welcome the contrary. )
  




    10. Injection Technique / Basal-Insulin
    Selecting The Right Injection Location
    With the Needle-Point first carefully Test The Skin-Locations if you could
    feel it or not, for if you feel it, just select another location where you
    feel nothing or not much and then do there the Injection to have it
    painless and also to be more save for not getting any blood vessels,
    because usually near blood vessels there are also more nerves to feel !
    Insert the Needle slowly and if you start to feel some pain do not insist
    just retreat and pullout the Needle and select another location to have
    it painless and resulting also without any bleedings after the Injection,
    this also by counting slowly to 15 before pulling out the Needle.
    If possible bleedings after the injection should been avoided, especially
    at 24h Basal-Insulin, because with the Blood also Insulin comes out and
    then the Doses is not right anymore and it could not been corrected.
    After injection have a look for about 20 seconds to see if some
    bleeding at the injection location occurs or not.
    In case of Any Bleeding, after 10 - 15 seconds just quickly use the Finger-Tip to
    block it by some gentle pressure to keep for One Minute To Stop The Bleeding.
    In case you have Bleedings from the moment when you pullout the Needle
    then do not use any pressure or Fingertip just some clean toilet paper to
    absorb the Blood and let it bleeding until it stops by itself. This can happen
    when you incidentally as rarely puncture some little vein at Insulin injection
    and that’s why you should let it bleeding for as much as possible Insulin
    coming out together with the Blood. If you do not let it bleeding and press
    with your Fingertip to stop it, then the effect will be as if you Intravenously
    injected the Insulin and resulting quickly within 10 minutes get a strong Hypo
    you would need to fight against it with sugar. Therefore if this happens just
    5 - 10 Minutes later measure your Glucose and if below 70 mg/dl quickly
    take some sugar drink for not waiting for the stronger Hypo !! !!
    Therefore it’s better to take the time it need for the Injections.

    Do not share your Insulin- Injections or Pens with Other People, even if the needle
    has been changed. You may give other people a serious Infection, or get a serious
    Infection from them ! ! !

    Basal-Insulin
    The Basal-Insulin should been injected at body locations where there is not a strong
    blood circulation to provide the good 24 hours effect it really should have to be basal
    only. It therefore is good to be applied Abdominal or at Upper-Legs if there is enough
    fat underneath the skin as usually at Legs more by women’s exists.
    The Basal-Insulin should subcutaneous been injected into the low blood circulation

    Dermis of about 5 mm thickness underneath the Skin of about only 2 mm thickness.
    To achieve this it is proposed to use Ultra-Fine 0.25 x 8 mm Needles by injecting it

    Diagonal at about 30°- 45°degrees angle to get it underneath the Skin into the Dermis
    and when by the Insulin-Pen the complete Dose is injected, for counting slowly to 15
    before pulling out the Needle to ensure the complete Dose as set is really injected,
    to
see by afterwards not having any Insulin-Drops coming out of the Skin.
    Using Needles not shorter 8 mm is also to ensure that after injection not any Insulin is
    coming out of the Skin in combination with counting slowly to 15 to make sure. Inject
    into the Dermis it also means usually not even feeling any pain at injections, because
    the Dermis has not much of blood vessels or nerves either.


    10.A) At Rapid-Insulin Applications
    At any Rapid-Insulin to be applied at meals or snacks or any corrections, we have the

    contrary situation of Basa-Insulinl to use Ultra-Fine 0.25 x 8 mm Needles by Injecting at
    45°- 60° Degrees to get a little deeper into the little more blood circulated Fatty Subcutis
    for a better and faster Insulin Reaction. At Rapid-Insulin the effect start should
be within
    10 - 20 Min., but some have the effect start at up-to 1 Hour or more and they
should
    resulting do Intra-Muscular Injection by 12 mm Needles at Upper-Arm Muscle to
get
    the same 10-20 Minutes !

    Here also, when by the Insulin-Pen the complete Dose is injected, for counting slowly
    to 15 before pulling out the Needle to ensure the complete Dose as set is injected.
    For Safety apply Rapid-Insulin at Eating- Start or Soon After and set the Units for that
    conditions to be safe and possibly measure the Glucose 3 Hours after Eating-Start to
    apply some corrections if the Glucose is still above 100 mg/dl and this by the Units

    Calculation Base as from 80 - 90 mg/dl always to be applied !!
    ( If you know well your Time of Rapid-Insulin Effect-Start, you should by that Time
    Inject before the Eating-Start, for additionally reducing the Glucose-Increasing ! )

    It’s Important that you Evaluate your Rapid-Insulin Unit-Factors to find out how much
    Glucose mg/dl Reduction you personally get Per-Unit and for quantities of Carbon
    Hydrates to Apply Calculations and this You have to do in combination with your
    Basal-Insulin applied, because the Basal-Insulin Dose is also influencing the
    effectiveness of The Rapid-Insulin Unit-Factors !

    In such cases where the effect of Rapid-Insulin is drastically delayed and therefore
    IM-Intra Muscular Injections are the possible solution to get the Reaction-Time to be
    as normal by 10-20 Minutes, anybody should prior discuss this with the Doctor and
    possibly apply the First Such Injections under the Doctor's Observations and Glucose
    measuring as very important for not causing any Insulin-Shocks may resulting !! !! !!


    10.B) Hypoglycemia - Hypos - Low Sugar - Cramps, Can Also Occur By Rapid-Insulin
    Is defined by Blood-Sugar less 70 mg/dl or practiced by less 60 mg/dl since
    even healthy People by some Sports, Sex, Etc. body activities can reach 60 mg/dl.
    For corrections it should been taken care for not going from one extreme to
    another and therefore is the following procedure proposed.
    Take 2 Sugar-Cubes of about 8 grams or one Heaped Teaspoon Sugar which
    is also about 8 grams mixed in warm Water to drink and it will increase the
    Glucose by about 25 mg/dl within 30 minutes, measure the Glucose 30 - 40
    Minutes later and if still a little too low repeat the same until you have
    the Glucose stabilized at higher 85 mg/dl !
    The impact of Body Training or Exercise or Sex related to Hypos need to be
    considered by taking up-front some carbon-hydrates
and about every 40 - 50
    Minutes possibly some Sugar-Cube or
Crackers, Etc. and afterwards checking
    Glucose Level
s by its after effect to possibly eat something to avoid Hypos !

    Aware of Hypos Symptoms !!
    Concentration Reduced, May Trembling Hands, Sunlight or Strong Lights Blinding,
    Dizziness In The Head, Increased Hunger Feeling, The Balance At Walking A Little
    Disturbed and Some Can See A Yellowish-Greenish Illumination At Closed Eyes or
    In The Dark At Very Low Sugar, Wakeup At Sleep and The Sleeping Disturbed.

    Hypos by Too Low Glucose Could Also Cause Cramps. If this happen take
    some Magnesium-Liquid combined with Sugar-Water to relax the muscles
    and to increase the Glucose and the Cramps will very quickly disappear !
    Cramps get also By Blood-Circulation-Disorders In The Muscles Created
    and therefore Diabetics should take every second day Aspirin with daily
    600 - 800mg Vitamin-E !!


    To have no hangover from stronger Hypos you should supplement
    Potassium of about 1000 - 1200 mg or eating 2 1/2 Bananas !!
    Strong Hypos do consume Potassium and it gets quickly too low.

    The best to avoid Hypos is by using a Therapy with only Non-Hypogenic
    medications where even a much better Glucose control can been achieved
    with
resulting much better and healthy A1C Values, but there is not much
    existing of Non-Hypogenic.

    As Non-Hypogenic there is only Metformin as Glucophage SR or XR the best,
    possibly combined with Glucobay and possibly also combined with a 24 hours
    Basal-Insulin such as the well known Toujeo.


    Hypoglycemia https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024700/

    About Hypos Handling Have Also A Look At Below Point 18. In Combination With Alcohol.


    10.C) Hyperglycemia - Hypers  
    This is usually defined by Glucose above 100mg/dl, but mainly by the meaning
    of Glucose 150 - 400mg/dl as example and not so much related to the Glucose
    increase at any Meals which by the right Injection-Factor should been corrected.

    It also means when the Glucose even without eating anything goes to 200mg/dl
    or higher as it also possible by any Infections or by the Liver as uncontrolled.
    For if the Glucose surprisingly is really high, it is Good To Apply The Rule
    of 1. Measuring Again at cleaned Fingers and 2. Not More Than Maximum 5 Units
    Rapid-Insulin To Inject At The Time and control the Glucose after 1 ½ Hour and
    if necessary apply again Max. 5 Units Rapid-Insulin
to check again after 1 ½ Hour,
    Etc.  

    This is the System for by Steps gradually reducing the Glucose for not getting from
    One Extreme Into Another and gradually not so fast coming down is also better for
    the Body and also for not maybe too easy getting into any Hypos by surprise !
    High Hypers create also dizziness, but additionally some tiredness where at
    Hypos  The Contrary of awakens is because of the Body On Alert .   

    Applying The Rule of Max. 5 Units Rapid-Insulin For Reducing High Glucose is also
    For The Safety for when maybe Stupid or Unwanted Things happen where always
    More Than Just One Factor Comes In Play At Such Situations !!  
    Stupid Things like measuring the Glucose at not cleaned Fingers or the Towel
    where the Hands got dried after cleaning did have some Sugar Containing
    Substances or Rest of Lotions or Syrup and For This Is The Second Rule To

    Be Applied - As At Any Unexpected or Extremely High Glucose Measuring To
    Always By Again Cleaned Fingers, Repeating The Glucose Measurement !! !! !!

    For example when someone feels a little dizzy and like that is quickly doing
    some measurement ( at unaware dirty fingers ) and the reading shows high
    Glucose of for example 300 mg/dl, where in reality its low Glucose by the
    dizziness and would apply the Rapid-Insulin correction by the Usual Injection-
    Factor, Instead By The 5U Rule, then there is not much of a chance to survive
    when as Too Late the Rapid-Insulin-Effect kicks in and simultaneously also a
    Potassium-Hypo get created by The Too Quick Glucose Falling where finally

    the Heart-Beat Can Stop by Lack of Potassium !!

    Hyperglycemia https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024701/
       https://www.ncbi.nlm.nih.gov/books/NBK430900/


    10.D) Glucose Measuring - Lost Insulin Effect
    Normally there should been several Glucose measuring during the day if you
    have no CGM-System as preferable.
    -- Generally the very first Fasting Glucose Measuring in the morning is one of
    the most important, because only that one can show you clearly how your
    Basal-Setting works or if something has changed by your Diabetes and
    resulting need to adjust. It also means if you do not daily so many Glucose
    Measuring, then at least the very first one for Fasting Glucose in the morning
    you should every day do to be aware about your Basal- Insulin or Medication
    Setting. For how to set the Basal-Therapy have a look at Point 3.
    -- At Meals you should 3 Hours afterwards do some Glucose Measuring and if
    necessary by your Insulin Unit-Glucose-Reduction-Factor-mg/dl you need to
    evaluate for at over 100 mg/dl doing the necessary corrections.
 
    The Simple Therapy Rules For At Any Diabetes Types To Apply:
    1. Fasting Glucose Value before or after any Meals 80 - 100 mg/dl !
    2. During any Meals Glucose Above 100 mg/dl for Max. 2 ½ Hours !
    ( By This Your A1C Will Improve. )

 
    Lost Insulin Effect
    This is now something we all hope will never happen, but it could happen within
    2 - 3 Days or Weeks or Months or Years, by the body’s immune system producing
    Too Much of Antibodies Against It and by that quickly or gradually it can lose
    the Effect.
    When it happens quickly it can easy been realized, but when it happens gradually
    it becomes a little complicate, because of the uncertainty if the Diabetes Has
    Changed ? or just the Insulin-Effect ? or Both ?
    -- For example if Basal-Insulin and Bolus-Rapid-Insulin at Meals are applied and if
    at certain Meals the Rapid-Insulin Doses drastically increases, but the Basal-Insulin
    Dose as good remains stable by the morning Fasting Glucose Measuring confirmed,
    then we can see that the Rapid-Insulin Effect is reduced and therefore need to be
    changed to some Other Type, because increased Insulin-Resistance could not be
    the case since the Basal-Insulin remained stable.
    Here if the Meals Rapid-Insulin Doses remain stable, but not the Basal-Insulin
    Doses as confirmed by the morning Fasting Glucose Measuring and resulting
    drastically need to increase, then we have to change the Basal-Insulin Type.
    -- Now if both changed Basal-Insulin- and Meals Bolus-Rapid-Insulin- Doses,
    then we usually assume, that increased Insulin-Resistance is the case and
    resulting Adjust the Doses, because having the Effect lost at two different
    kind of Insulin all at the same time is really very rare, but not impossible.





    11. Metformin or Metformin Containing Medications - Type 2 + Type 1
    This is mainly for Type 2 Diabetes and some possible support at Type 1 to
    achieve Better A1C !

    Metformin Medications are registered as also in combination with Insulin, Etc.
    Metformin as the best for controlling or reducing Liver-Glucose-Production
    and additionally has also some small Insulin-Sensitivity increasing effect.   
    The Metformin has a Half-Value Time of 3 Hours after its maximum in the
    Blood called Tmax. That means when swallowing it takes about 2 ½ Hours
    to reach the Tmax Plus the 3 Hours resulting to 5 ½ Hours after swallow
    and only the Half Amount or mg is remaining for the resulting Half Effect.
    Under this consideration Metformin by the Daily Dose should been divided
    to take it at least by 3x Daily every 8 Hours or better by 4x Daily every
    6 Hours for the necessary 24 Hours effectiveness !!
    For convenience can the Daily Dose also been taken by Slow Release or
    Extended Release as for example the Glucophage SR or XR but here is
    to mention that the Tmax. is only 7 Hours and that means it lasts only
    for 14 Hours as the double of Tmax. and therefore the Daily Dose should
    be taken 2x Daily every 12 Hours for necessary 24 Hours effectiveness !!
    ( Glucophage SR or XR is only called once daily, but has no 24h Effect. )

    Its Basal-Effect at Morning Fasting Glucose to Set At 80 - 90 mg/dl !


    For Type 1 Diabetes 3x Daily 125mg ( as 1/4 of round 500 mg with
    Tablets Divider ) has the advantage to control the Liver-Glucose for
    better A1C or HabA1c Values and handling the Glucose Control and
    is preferable compare the Glucophage SR 500 mg for the same purpose.
    By this can have an A1C of 5 % ( Old 5.4 % ) or Average Glucose of
    88 - 103 mg/dl without any Hypos just as any Normal Healthy People !

    ( This naturally with the Right Insulin Settings as herein described. )
    It shows also advantages by reducing the known Heart Risks at Type 1
    as here seen in the Link: http://thediabeticnews.com/type-2-diabetes-drug-may-slow-heart-disease-for-type-1-diabetics/ 
    Regrettably until today is No 24 Hours Release Metformin available
    and Metformin is not causing any Hypos as sometimes described !

    General Type 2 Metformin Dosing

    1. For Pre-Diabetes 3x Daily 250 mg or 500 mg ( 250 mg of divided 500 mg Tablets )
    or by the Extended Metformin SR or XR by 2x Daily 500 mg or 750 mg or 850 mg.
    2. For Diabetes 3x Daily 500 mg or 750 mg or max. 850 mg or by
    the Extended Metformin SR or XR by 2x Daily 750 mg or 1000 mg.
    3. The Dosing should been Set to Morning Fasting Glucose of 80 - 90 mg/dl and
    if this with solely Metformin cannot been achieved, then it means that it should
    also been combined with some other Glucose Reducing Medications.

    4. Based on the main Effectiveness of 6 Hours it need the 3x Daily or at the
    Extended Metformin SR or XR Effectiveness of 14 Hours it need the 2x Daily !
    ( If this Metformin dosing is not enough to achieve the Lowest Fasting

    Glucose of 80 90 mg/dl as it normally should be, then the additional
    use of any 24 hours Basal-Insulin as Toujeo should been considered !
    This provides a simple but very effective Combination Therapy without

    any Hypos possible when the 24 hours Basal-Insulin is right adjusted.
      
This as the best way, because not using any Hypogenic medications. )

    Metformin Characteristics At Type
1 Diabetes where the Metformin is been
    combined with the Insulin-Therapy for better A1C by better Liver controlling,
    but here is to mention that Daily 3x 125 mg ( as 1/4 of 500 mg Tablets )
    will not allow to gain or losing weight and at any Daily Doses above 375 mg
    as higher above as more weight losses need to be expected !
    At Daily only 2x every 12 hours Metformin 125
mg as 1/4 of the 500 mg,
    small weight-gain at Daily 250
mg is gradually possible as experienced,
    but the Glycemic-Effect is not as good as by the usual 3x Daily.
    For Example, if have a Therapy A1C of 6 % and combine with Metformin can
    have an A1C of 5 % or Av.- Glucose of 97mg/dl by an improvement of 1 % !
    ( Funny, the ADA does not inform about such matters. In favor of the Pharma Industry

    do they like to keep the People sick ? ) 


    The Simple Therapy Rules For At Any Diabetes Types To Apply:
    1. Fasting Glucose Value before or after any Meals 80 - 100 mg/dl !
    2. During any Meals Glucose Above 100 mg/dl for Max. 2 ½ Hours !
    ( By This Your A1C Will Improve. )


    The Metformin Intake for at any PET-Tomography needs 2 Days before
    been stopped. By about 94 % within 16 Hours by Urinating and in the
    Plasma or Tissue the 6 % take one more Day to be out of the Body
    where Metformin remains stabile and does not form any Metabolites.
    Before Operations the Metformin 1 Day before need to be stopped.

    The best to avoid Hypos is by using a Therapy with only Non-Hypogenic

    medications where even a much better Glucose control can been achieved
    with
resulting much better and healthy A1C Values, but there is not much
    existing of Non-Hypogenic.

    As Non-Hypogenic there is only Metformin as Glucophage SR or XR the best,
    possibly combined with Glucobay and possibly also combined with a 24 hours
    Basal-Insulin such as the well known Toujeo.

    Metformin and/or Statin combined with Cancer Therapies :
   
https://www.forbes.com/sites/arleneweintraub/2018/06/07/how-an-old-diabetes-drug-made-a-big-splash-at-cancers-biggest-confab/#1c7af09a4ac1




    12. How to set the Basal-Insulin Dose as very important for the Necessary Base Effect.
    For this it is necessary to take the time it needs to do this correctly and over many Days or
    Weeks by a step by step procedure according the lowest Fasting Glucose Level at Night
and/or
    in the Morning after sleeping, or Whenever during the Day the Lowest Glucose Level will be to

    find out very carefully for then At The Lowest Point by small steps of only 1 Unit adjusting it
    to 80 - 90 mg/dl or 4.4 - 5.0 mmol/l only

    Apply just every 4 - 5 Days one adjustment and observe by measuring, because The Metabolism

    needs 3 - 4 Days to find its final answer or balance.
    By this procedure and since the Glucose Is Set at the lowest point within of 24 hours,
    it makes it impossible for the Basal-Insulin to create any Hypos, but it provides you
    the preconditions for the Best A1C you need and that means, if any Hypo occurs
    it can be from Rapid-Insulin Dose at Meals only to know well about !

    This is very important for the right preconditions for at Daytime in combinations with the
    Rapid-Insulin as usually at Type 1 Diabetes or at Type 2 Diabetes where Metformin 30 Min.
    before of any meals in combination with the Basal- Insulin is applied.
    Only by setting the Basal-Insulin as above, the necessary very good HbA1c or A1C of only
    Average Glucose 88 - 103 mg/dl or 4.9 - 5.7 mmol/l for No Neuropathies or No Retinopathies,

    Etc. Affections possible by without any Hypoglycemia’s !!
    The A1C of Average Glucose 88 - 103 mg/dl as of Healthy People, by what’s good for Healthy
    People is also good for Diabetes People since they also just People or Humans and we all

    know it’s not that easy to achieve, but by the Basal-Insulin Therapy Base not set or adjusted
    properly, it could never been achieved ! ! !
    This is related to Any Type of Diabetes where it has been decided to apply
    Insulin or a Mix. of Medications by Insulin also in combination with other
    Medications. 

    About this you should speak with your Doctor or for any reconfirmations contact
    also the Insulin Producer and they will confirm the procedure as above described,
    as only perfectly correct to be handled like that.

    General Target HbA1c or A1C for Any Diabetes Type, Age, Gender:

    Max. 5 % Tol.+0.2 -0.3 or Average Glucose Range of 88 - 103 mg/dl
    ( By NIH.Gov, Av. Higher 103 mg/dl provides Increased Heart Complications. )
    See NIH.Gov Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911067/




    13. About Glucose mg/dl ! 
    The normal range at healthy People is objectively 70 - 97 mg/dl  ( 100 mg/dl by
    objectively is already too much and just a nice old number only. )  What is OK for
    Healthy People is also OK for Diabetes People, since they also just People or Humans ! 
    The healthy People have a HbA1c or A1C of Average Glucose 88 - 103
mg/dl or by New
    DCCT-Norm 5 % ( It used to be 5.4 % by the Old-Norm ), but for convenience only the
    Doctors will to Diabetes People reiterate the failed ADA Guidelines / Recommendations
    to have HbA1c or A1C of 6
% or less 7 % and if Older even 8 - 9 % as to be OK 
    Only For Impression Purposes and when asking them, would a healthy HbA1c or A1C
    of Average Glucose 88 - 103 mg/dl not been better as for any Healthy People to be
    On The Save Side for not getting any additional affections ?
, then all Doctors will
    inform, if could achieve that naturally would been Superior ! ! !
    At Healthy Peoples it can also happen, that temporarily the Glucose falls to about

    60 mg/dl only by for example doing sport, sex, but this is no problem still aware of
    everything’s and soon get again above 70 mg/dl, but when reading some Diabetes
    Associations Info to scare Diabetes Peoples, below 70 mg/dl would be Hypoglycemia as
    a Clinical Condition to desperately call 911, instead to Drink Just Some Soft drink or
    taking a Sugar-Cube !  At less 50 mg/dl it usually gets a little dizzy just to take some
    Sugar-Cubes.
    An average Glucose of 97
mg/dl represents HbA1c or A1C of 5 % by New DCCT-Norm
    ( or 5.4 % by the Old-Norm ) and since 2017 the Fasting Glucose of 100 - 125 mg/dl
    is already Pre-Diabetes to possibly apply Some Therapy.
    The International Diabetes Scientists Committee by its new 2017 Standards decided

    that the earliest possible to treat Diabetes by Therapy, the better it is to keep
    Diabetes at lower intensity level, at Type 2 possibly to reverse and to avoid
    any permanent affections.





    14. About Diabetes Therapies In General  
    If years ago it was clear that Type 1 gets Insulin and Type 2 gets Medications such as

    Metformin, Etc. as since over 50 Years, it today is differently applied. As seen, Doctors
    more and more prescribe the Individual Patients also Individual Therapies where just
    anything useful for the Glucose Management gets applied.
    Today are certain T2D Mediations for better T1D A1Cs get combined with Insulin-Therapies.
    There are no Narrow Minded Stigmas or Taboos anymore and anything
for individually better
    and/or more easily Glucose-Controls is legitimated.

    This also under consideration, that much more Types of Diabetes exist and Not Only
    Two Kinds, but for example even combinations of Type 1 with also Type 2, Etc., about
    10 different Kind of Diabetes by each one with some different characteristics. As result
    we today can see some Type 2 Patients with Insulin Therapies as before only at Type 1
    has been applied and we can see for better Type 1 Management to achieve better

    HbA1c or A1C %, by for example the Prolonged Metformin as Glucophage SR or XR
    of daily only 500 mg get also to Type 1 Patients prescribed by some Doctors for the
    better Liver-Glucose Control and also to reduce the Type 1 possible Heart Problems
    for like that to solve two aspects for better Patients Health. Today also more and
    more Diabetes Patients apply some Therapies Supplementations as for example
    Vitamin-D, Vitamin-B12, Etc. much more as Therapy Support. The main breakthrough in
    Diabetes Therapies will also come with the Artificial Pancreas by Insulin + Glucagon now
    in developments with
very good results as already seen and we possibly will see that
    this will be applied for
Any Types of Diabetes ! This maybe even combined with the
    Peptide-C as a Triple- Pump System, which the body is producing
in the same amount
    as the Insulin and it has also a function in the body.

    Because Subcutaneous in the Tissue, these Systems have an Effect-Delay of 25 30
    Minutes for the Measuring about 10 Min. plus about 15 Min.
for the injected Insulin
    starting to have an effect to reach the peak within additional 30 60 Minutes.

    ( They try by Smart- Programming to compensate the Delay, but could Never Really
    as good as any Direct- Drive Real-Time Intravenous System can do by without
such
    Programs just simply using a Hysteresis to set. )

    The big breakthrough will be by some Intravenous Pump System which In Real Time
    could function just in the same way as The Natural Pancreas. A Swiss Company is
    presently working on this for at first for Clinical-Applications, for afterwards to be
    produced for
the worlds public market, by injecting and measuring all intravenously. 
 

    The Simple Therapy Rules For At Any Diabetes Types To Apply:
    1. Fasting Glucose Value before or after any Meals 80 - 100 mg/dl !
    2. During any Meals Glucose Above 100 mg/dl for Max. 2 ½ Hours !
    ( By This Your A1C Will Improve. )

    Here the Scientists about Typ 1 Diabetics Heart Disease:

        http://thediabeticnews.com/type-2-diabetes-drug-may-slow-heart-disease-for-type-1-diabetics/




    15. Beta-Cells Transplants or Beta-Cells-Therapies or Immune Therapies To Cure Type 1 ?
    Presently they last only 1 - 2 Years by the Body’s Autoimmune Reactions Ongoing.
    The main obstacle is The Ongoing Autoimmune Reaction where also Medications
    to suppress the Immune System with huge side-effects cannot really eliminate this.
    It would need an Immune-Therapy able by formatting to re-orientate the Immune
    System, but until today all Mono-Immune-Therapies did fail and so it maybe need
    some Multi-Immune-Therapies to eliminate and stop the
Ongoing Autoimmune
    Reactions before any Cells-Transplants could become
permanently successful,
    or Gene-Technologically Modified Beta-Cells which
could resist The
    Autoimmune Reactions would be a second opportunity !
   
If the Autoimmune Reaction could been stopped, in many cases the
    Pancreas itself could recuperate and get back to normal function.
    Without This Pre-Conditions Fulfilled There Are No Chances For This !!

    Here a New Way of Immune Therapy by Instead of Suppressing, Boosting The Immune
    System By Certain T-Cells To Re-Orientate It, Which Looks
More Successfully At Human
    Trials, but it's not yet ready to increase the Beta-Cells Amount or the Peptide-C  !!

       https://www.ucsf.edu/news/2015/11/328176/immunotherapy-type-1-diabetes-deemed-safe-first-us-trial

    Here a New Stem-Cell Immunotherapy
    By Mice Trial – But maybe at Humans also successful !
       http://stm.sciencemag.org/content/9/416/eaam7543
       https://health.economictimes.indiatimes.com/news/diagnostics/stem-cell-therapy-used-to-reverse-diabetes/61674465 




    16. Doctors Symptoms List - For The 3 Months Consultations
    This every Diabetes Patients should do to take with them when they meet the Doctor
    at the Standard 3 Months Consultations for A1C or HbA1c, Etc. for Doctors to know
    clearly
at which Topics they may also have to concentrate on and find solutions for !!
    This since Diabetes is generally not so stabile but some very individual ongoing
    kind of condition.

    This means for the Patients to observe themselves and Write On That List any kind of
    Changes or Symptoms may occur, as also the Fasting Glucose Changed
or The Feet’s feeling
    Colder when compare the Temperatures By Hands or its
Color tend to Turn Reddish or are
    Swollen as not before or more often some Head Pain, Etc.
, just anything may changed or
    did not experience before. ( Here Also Some Blood Circulation Disorder Symptoms
. )
    This for in addition to the Daily Glucose Measuring List, for the Doctors being able Just
    In Time to possibly adjust or alter The Individual Therapies to avoid
any additional
    affections may possible !! !!





    17. Healthy Nutrition Opportunity & Supplements
    If you like to reduce weight or to achieve or preserve the ideal Bodyweight
    or just like to Eat Healthy To Look Good, without any negative Side-Effects.
    As a Protein Rich Diet ideal for Type 2 Diabetics or People to remain healthy.

    Starting by what is the Ideal-Normal-Bodyweight really and explaining this by some
    simple system. Take the Inches above 40 (1m) and calculate with the remaining
    inches above by for example calculate per each additional Inch (2.54cm) = 4.65 lbs (2.11kg)
    this for Women with smaller skeleton and for Women with wider skeleton to add 6 % and for
    Men with smaller skeleton to add 11 % and for Men with wider skeleton to add 18 % of lbs.


    In Nutrition and especially at any Diets, it’s always important to have also
    the necessary right amount of good protein, where too much is also not
    good in general, where too much is creating increased urine in the blood
    and this increases the risks of arthritis, etc., and not enough could create
    complications as by women’s getting interruptions into monthly menstrual
    cycles by possibly instead monthly just every 2nd or 3rd month or even
    none of any, what is not good for any normal conditions in general.  
    Therefore the Right Amount and Good Quality of Protein should been
    taken by One Egg-White per 22lbs (10kg) of Ideal-Bodyweight and by
    Egg-White
we have the Cheapest and Best Natural Protein to think of.  
    This is easy to apply once daily by taking the right amounts of Egg-Whites
    to put into the Blender add 16 onzes Water and a Teaspoon Margarine with
    Two Teaspoon Egg-Yolk and some Avocado or Strawberry, etc. any Fruits for
    taste and mix it to
get a very tasty healthy Shake Drink. This allows you the
    Whole Day just
to eat any kinds of Vegetables, Potatoes, Beans, Oatmeal, Salads
    ( Bread, Noodles, Rice only reduced. ), Etc., this as without any Meats, because the
    right amount of
Protein you need you have already by your Egg-Whites Drink as
    in Best Quality
and Superior Healthy, also for nice Skin and against Cellulites !

    This is also important for any such who Digest Superior, or when
    Older and therefore have problems to keep the Ideal-Bodyweight.
 
    About Nutrition Supplementations
    Some People or Doctors say, just a healthy nutrition is all it need, or applying
    standard Vitamins & Minerals Blood Tests and if there is a Reference Amount
    Deficiency shown of some Substances, then discuss this with your Doctor to
    possibly using some supplementations for any corrections or completions.
    That sounds perfectly, if there would not been the problem with these Blood
    Tests since they’re made for Normal Healthy Humans, but Diabetics as known
    have not Normal Conditions By It’s Metabolic Problems and beside some of
    the Medications can also create certain deficiencies and at some Vitamins
    or Minerals Diabetics by its Metabolism- or Biological- Disorders resulting
    have higher demands which not so easy and sure could be compensated
    by any nutrition ! ! !
    Today’s Nutrition Quality is not anymore the same as 50 Years Ago,
    because in the Industrialized So-Called Civilized World, the SOIL is not
    anymore the same by the Acid-Sauer-Rain about 50% of the important
    Minerals as Zinc, Potassium, Etc. got ALL Washed-Out or Neutralized !!
    The international Nutrition Scientists since over 20 Years warning and
    complaining about, but the Medical Society just ignoring The Reality
    and telling everybody that a normal good nutrition is all it need, but
    Today How Is It Possible To Have Again The Normal Nutrition ? ? ?
 
    Therefore as following for Diabetics to consider :

    Generally do not take Multi- Vitamins & Minerals Products containing any Iron or
    Iodine and better just take certain Vitamins & Minerals by individual products but
    in good qualities.

    As Diabetic do avoid any Supplements with Iron or Iodine Concentrates,
    because they Increase Glucose, the Diabetic Metabolism cannot handle
    this Extracts anymore, therefore if you need Iron eat Beans or Celery
    and if you need Iodine take Sea-Salt instead or use at any cooking. 
    The Multi- Vitamins & Minerals Products usually have also too many

    different Substances combined with too many chemical interactions
    resulting between them which partially are neutralizing each others.


    Potassium ( Kalium )
    It’s upfront because it’s one of The Most Important Supplement
    Mineral Especially For Diabetics !
    Without Potassium or Too Low, there is No Heart Beat ! ! !
    -- It is very important to maintain and preserve the Normal Potassium Level
    of 3.6 – 5.2 mmol/L, but at Diabetics for safety 4.2 – 5.2 mmol/L as in the
    upper halve for some reserves and to ensure that the Potassium Storage is
    full as necessary. The Potassium Blood Test does not show Total-Potassium
    stored in the body as necessary and the Blood Test should never show a
    Potassium Level higher 7 mmol/L for also not getting No Heart Beat ! !
    If there is No Kidney Problem it would not be possible to have it
    too high, because The Body by urinating is well regulating it !

    See Mayo Clinic Link https://www.mayoclinic.org/symptoms/low-potassium/basics/definition/sym-20050632
    -- Diabetics should monthly test the Potassium Level ! If the body temperature
    has not the normally 36.5°C but only 35.5°C it could be caused by the Potassium
    Level too low to aware and/or the Thyroid function low also to check.   
    -- Diabetics to maintain the right Potassium Level and to make sure, should daily
    eat
2 Bananas ( Middle Size Banana 400 mg Potassium ) or take Daily One Novartis
    Slow-K® 600 mg Potassium Tablet and every Second Day Two Tablets, together
    with normal Meals containing Vegetables.

    ( If experience some Hypo by the Rapid-Insulin of 60 mg/dl take immediately 1 Slow-K Tablet
    extra and if even any Hypo of 50
mg/dl take immediately 2 Slow-K Tablets extra combined
    with the usual Sugar amounts to increase the Glucose ! )
 
    About the Potassium function. Potassium can be quickly released combined with
    Adrenalin at Alarming condition, but the storage is a slow process. This can been
    seen at any Extreme Hypo caused by wrong measurement where Rapid-Insulin got
    injected for Glucose 300 mg/dl instead some Sugar taken at effectively 55 mg/dl.
    When the Insulin-Effect kicks in it’s already too late and the body get flushed
    by Adrenalin and Potassium with as result only 10 minutes later additionally
    a Potassium-Hypo gets created, by the Blood Pressure and Heart Pulse goes
    drastically down and the body temperature also, difficult to remain conscious.
    In such a situation before falling in a KOMA, only 911 Ambulance can help
    because Sugar not really functioning just reducing the KOMA-Risk and they
    will quickly give some intravenous Potassium to transport into the Intensive
    Care Hospital for there to receive 24 Hours Potassium Infusion to restore
    the Bodies Potassium Storage !
    As seen in the publications, the international Nutrition-Scientists agree that an
    Adult Human from its daily Food Intake should have Daily 4000 mg Potassium,
    but strongly mention that this usually is not achieved and therefore a complex
    worldwide Study will be made.
    See Here at NIH.Gov:
       https://ods.od.nih.gov/pubs/2015_DGAC_Scientific_Report_ODS_Compiled_DS_Statements.pdf#search=%22potassium%22
    Generally About Potassium  https://medlineplus.gov/potassium.html
    Hypokalemia https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357351/
    Low Potassium Level https://medlineplus.gov/ency/article/000479.htm
    Potassium In Diet https://medlineplus.gov/ency/article/002413.htm
    Potassium Test https://medlineplus.gov/ency/article/003484.htm

    By today’s Foods or Diets or Medications there is a worldwide
    deficiency of Potassium, Zinc, B12, etc., as Risks of Diabetes.
    See the Studies in the Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197792/ 

    Potassium can also reduce the Effects of Diabetes and Improving A1C Values !!

    Important Potassium Information
    WDHCO became to know that Potassium is reducing the Insulin Resistance
    and Disease Progression. At some Patients with a Rapid-Insulin Glucose
    Reduction Factor of only 10 - 20mg/dl per Unit, under Potassium of daily
    800 - 900mg it became a Reduction of about 40 mg/dl per Unit.
    The normal individual Reduction Factor per Insulin Unit is in the range of
    30 - 50mg/dl, at Type 2 with its Insulin Resistance in the range of 1 - 20mg/dl.
    Under this Reality it’s really surprising that Potassium is not part of any
    Standard Medications at any Diabetes Types Therapies, also to Reduce
    Heart Failure Risks !!

    Have also a look at Topic No. 30 !!


    Vitamin-B12
    Preferable in the form as 1st and best Hydroxyl-Cobalamin or 2nd Chloride-Cobalamin.
    Never use the cheapest common Cyano-Cobalamin, because Cyano is toxic
    and therefore neutralizing the positive effects of Cobalamin-B12 !

    The usually recommended Dose of B12 is daily 2.5 mcg, nearly useless, because
    to be effective For Diabetics but also any Normal People it needs daily 30 mcg
    and there we are at beginning of recommended medical dosing it really need.
    The daily B12 30 mcg also protects the lungs and also important for smokers.
    B12 in the nutrition-chain is a very seldom substance and therefore it’s nearly
    impossible by normal meals to get enough from and Vitamins should never
    been heated to higher 45°C or 113°F !!
    B12 is one of most important Vitamin related to many essential biological
    functions as can be seen at following NIH.Gov Link and B12 get reduced by
    any Metformin Medications as typically applied at Diabetic Type 2 Patients
    and B12 is also strengthening the immune system and improves healings of
    wounds, something important where Diabetics often have healing problems.
    Regrettably it’s a little difficult to get B12 by the right quality at commercial
    products.
    The best is you know a good pharmacy you also have a good relation with
    and order to do some 1dl Distilled Water Solution by 5 mcg B12 per Drop,
    where you take 6 Drops for Daily 30 mcg and this by using for the Solution
    liquid Injection-Ampoules of Hydroxyl-Cobalamin as the best quality or as
    second best Chloride-Cobalamin, to keep in the refrigerator above freezing
    temperatures. It will not be so expensive, but maybe because made by the
    medical quality you may need a Doctor’s prescription, that joke but . . . .  
    Here the NIH.Gov Link to know about : https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/


    Vitamin-D3
    In the form of Cholecalciferol.
    This is also a Vitamin not easy to get by any meals, because it’s principally
    synthesized within the body under the skin by the sunlight, but by Diabetics
    or Older People the synthesizing process is not functioning as it used to be
    where the demand is even increasing. At Diabetics generally D3 is at lowest
    of normal or below, where it needs more for immune system and hormones
    production and many more biological functions in the body as seen at Link !
    Also here the Daily Dose should be 15 mcg or 600 IU and this is already in
    the beginning of medical dosing. To be effective buy any Liquid Product !!
    Here the NIH.Gov Link to know about : https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/


    Zinc
    In the bioactive Zinc-Gluconate Form take daily 5 mg and never buy
    any cheap but useless Zinc-Oxide Form.
    It’s good in general for the Metabolism and Immune System Strengthening !
    There is a worldwide Zinc deficiency in the populations.
    Here the Pauling Institute to know about : http://lpi.oregonstate.edu/mic/minerals/zinc
 

    Manganese
    In the bioactive Manganese-Gluconate Form take daily 2.5 mg and never buy
    any cheap but useless Manganese-Oxide Form.
    I’ts Metabolism Harmonizing and reducing Glucose Level Tolerances !
    Here the Pauling Institute to know about : http://lpi.oregonstate.edu/mic/minerals/manganese


    Boron
    In Liquid Distilled-Water Made From Boric-Acid At Concentration of 1.6 w%,
    Adults to take Daily 2x 5 Drops morning evening resulting to about 12 mg !
    This any Pharmacy cheap can produce for you, for storage at refrigerator
    Above Freezing Points temperature.
    Boron is also the general natural hormones building motivator for the
    body to produce enough from and this especially also when older to
    bring back the hormone levels to where they used to be and it means
    such as Menopause Symptoms by Women’s or Men’s can be eliminated
    and is also against Arthritis or Osteoporoses, Etc. 
    Boron has such Multiple Advantages and Metabolic Importance’s, that
    Everything to mention would been too much here and therefore you
    should to take the time to go through the NIH.Gov Link here : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4712861/


    Chromium
    In the form of Chrome-Yeast is the best followed by Chrome-Glukonate as
    bioactive to be biologically useful to take Daily 40 mcg. Chrome is also useful
    to reduce Glucose and together with Niacin-Vitamin B3 are essential to form
    the GTF - Glucose Tolerance Factor and for Metabolic Harmonization’s, Etc. 
    Here the NIH.Gov Link to know about : https://ods.od.nih.gov/factsheets/Chromium-HealthProfessional/


    Niacin-Amid & Niacin 
    Vitamin-B3-Amid in the body get reduced to the bioactive B3 Niacin-Acid Form,
    for Niacin-Amid Daily to take 100 mg.
    Where the Niacin-Acid could create reddish-skin, flushes, itching and Increases
    Glucose at higher Doses, Niacin-Amid does not doing this and is safe to take.
    Together with Chromium, B3 is essential for the GTF - Glucose Tolerance Factor
    and to reduce the Blood Fatty-Lipoids Triglycerides by reducing the Bad LDL-
    Cholesterol and to increase the Good HDL- Cholesterol, many more Functions. 
    Here the NIH.Gov Links to know about : https://medlineplus.gov/druginfo/natural/924.html
        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2757682/
   
    To improve Blood-Circulation by opening the Veins or at Neuropathies take Slow
    Prolonged Niacin-Acid 3x daily 125 mg
!
    ( This by its 125 mg dosing will not create reddish-skin, flushes, itching and will
    not increase
the Glucose. )
       Upsher Smith Laboratories has one called “SLO NIACIN” 250 mg dividable for 3x 125 mg.


    Vitamin-B Complex
    In addition to above Vitamin-B3-Amid to take a good Vitamin-B Complex, but
    Daily only 1/2 of any recommended Dosing, it is important for any metabolic
    Fuctions where Diabetics have problems with.
    Here the NIH.Gov Link to know about : https://medlineplus.gov/bvitamins.html 


    Selenium
    The best source of Selenium is Selenium-Yeast because it mimics the natural Selenium
    Source of such as Tuna-Fish where 100 g contain 100 mcg of Selenium.
    The problem with Selenium is to get Pure Selenium-Yeast not mixed with any Magnesium
    Stearate as for example clumsy in the US at most products in powder form is applied
    and this where The Neutral Micro-Crystalline Cellulose could do the same
just to
    keep powders flowing at Capsules producing machines.

    Magnesium has a chemical interaction with Selenium where it get nearly neutralized
    and losing it’s bio-effectiveness, therefore never any Magnesium combined with !!
    You need to find a Pure Selenium-Yeast product with additives by Micro-Crystalline
    Cellulose and/or Shellack for Tablets hardening, to be bio-effective ! ! !
    Take Every Second Day 350 mcg Selenium for the metabolism not getting a custom
    to it to remain effective and take it 2 Hours apart from any other Substances
    because Selenium as very sensitive get affected by about anything and just
    at any
temporary Acute-Inflammation conditions for not more than 8 Days
    you could
take it daily at 350 mcg as the well experienced max. Dose !!
    The Selenium Effect last for about 26 Hours Without Any Negative Side-Effects !
    By the Effect of Selenium not only Bacteria’s get eliminated,

    but Viruses also, something Antibiotics cannot, because only

    eliminates some specific Bacteria’s by specific Antibiotic !! !!      

    Selenium as essential is definitive strengthening boosting the Immune System
    and this is very important for Diabetics which often experience Infections or
    Inflammations by the weakened Immune System.
    The Selenium is very well known for its huge Inflammation- or Infects- Reducing properties
    and resulting is also reducing and eliminating Diabetic Pain !!

    It together with Vitamin-E and Aspirin as here explained could play a key role
    as prevention or to fight any kind of Diabetic Neuro-, Retina-, Etc.- Phaties !
    People should also more carefully study the life of People in Okinawa Island where
    they eat Tuna at a regular daily base and at its Monthly Marathon of 10 Miles
    they have even some already 100 Years old and still regularly participating at
    or such of 110 everyday working at it’s small gardens happily.
    Here the NIH.Gov Link to know about : https://ods.od.nih.gov/factsheets/Selenium-HealthProfessional/

    At Acute Neuropathies reduce the A1C to Average Glucose of Max. 97 mg/dl

    and take Every Second Day the 350 mcg Selenium as above, but in-between take
    also only 250 mcg
Selenium to strengthen- and preserving- its Effect.
    Selenium to preserve its Effect need to be taken 2 hours apart from any other
    Medications or Substances or Supplements.  
    By this in combination with the Aspirin every second day and daily Vitamin-E 600 - 800 mg
    plus Vitamin-B12 daily 30 mcg, B6 10 mg and 3x daily Slow Niacin 125 mg ( B3 ) it’s possible
    to recover within 1 - 2 Years by the Feelings also returning again.

       ( For example Alpha Lipoic Acid provides too little recovery if any and is not solving the problems. )  



    Vitamin-E
    There it would be important to have the Natural Vitamin-E Complex of at
    least the 4 Tocopherols https://en.wikipedia.org/wiki/Tocopherol and the
    best would be with also the 4 Tocotrienols https://en.wikipedia.org/wiki/Tocotrienol
    to have the Complete Complex As In Nature.
    It is known that principally Vitamin-E is providing its advantages only by
    the Complex, but to get the Complete Complex by the 8 Different once
    is not easy to get in the market.
    Therefore as easy to get Complex by the Natural 4 Tocopherols is mentioned
    the product as from VitaminShoppe, Item No. VS-1551 200 IU Softgel-Capsules,
    or any other supplier with the same product quality.

    Take Daily 600 - 800 IU as Prevention or Reduction of the known Blood Circulation
    Disorders Diabetics experiencing by the higher Glucose Values where the Blood
    Bodies stick together and resulting causing it combined with Inflammations or
    Swollen and/or Reddish Feet !
    Vitamin-E as known by the Red-Blood-Bodies is keeping them separated and
    like this the Blood get better higher flow characteristics or improved flowability,
    but before of any Operations the intake must 48 Hours before been stopped
    for not having increased bleedings ! ! !

    Here the NIH.Gov Link to know about : https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/


    Aspirin
    As known by the White-Blood-Bodies is keeping them separated and like
    this the Blood get better and higher flow characteristics, but before of
    any Operations the intake must 10 Days before been stopped for
    not having increased bleedings ! ! !
    The White-Blood-Bodies when getting once in contact with the Aspirin
    Substance, losing its interconnecting ability important at any wounds
    healing to stop the bleedings and it takes 7-8 Days for all the White-
    Bodies to renew again and therefore Aspirin should never been taken
    at a regular daily base to Increase The Blood Flow Characteristics !!

    In combination with Vitamin-E and Selenium; therefore take it just every
    2 Days, means taking it and Pause for One Day then take it again, etc.,
    this as compromise and without any Risks of internal bleedings by just
    using it’s advantages. This by
preserving enough of the White-Blood-Bodies
    ability at any
Wounds-Healing and providing enough Improved Blood Flow-Ability !
    Here the NIH.Gov Link to know about : https://pubchem.ncbi.nlm.nih.gov/compound/aspirin#section=Absorption-Distribution-and-Excretion

    If like to take Aspirin regularly as a Vascular- and Blood Circulation-
    Supporting Precaution, it should never been taken at a daily base to avoid
    Substance- and Effects- Accumulations resulting to possible uncontrolled
    internal bleedings anywhere in the body. Therefore and to have only the
    advantages of Aspirin it is proposed to take it by ½ Standard Tablet
    Every Second- Day by One Day Pause to preserve only the Advantages
    of Aspirin. Regularly, Never Take It Daily !!

    The Aspirin related to Blood- Dilution cannot really been Doses controlled
    and this means even the Baby- or Cardio- Aspirin daily taken can cause
    internal uncontrolled bleedings, because the White- Blood bodies need to
    get only
in contact with the Substance to lose its Interconnecting- Ability !
    Maybe you get this Science Based Information here the first time, but when
    discussed with any Doctors, everyone will confirm this as the smart- way to
    handle Aspirin.




    18. Drinking Alcohol and Diabetes
    Generally Medications and Alcohol is not a good combination and for
    example by Metformin the alcohol effect is increased and so possible
    Diabetic complications. A Glass of Wine or Beer is OK but not more !!

    At Diabetics using Insulin-Therapies we need to apply preconditions
    if it’s not just a glass of Wine or Beer and turns-out more like to
    be a drinking session with friends as the worst case.
    The Liver occupied with the Alcohol cannot anymore supply the body
    with Glucose as it usually does so well and resulting much less and
    not enough Glucose is available and the Glucose-Level is going down
    into Hypos when not parallel to the drinking also any food is eaten
    to compensate the lack of Liver-Glucose and the usual Hypo Signs
    under Alcohol cannot been realized anymore and therefore it need
    someone nearby to check your Glucose to provide you any Carbon
    Hydrates when necessary !! !!
    You have to imagine and keep in mind, that by eating the carbon
    hydrates at digestion will go directly into the blood independent of
    the Liver-Conditions and you have to keep in mind, that emergency
    Glucagon injection’s to promote the Liver to release Glucose under
    Alcoholic Conditions will possibly not work ! It gets Dangerous !!
    The Alcoholic Effect last longer where the most critical conditions
    will be 3 – 6 Hours after drinking where the Potential For Hypos
    is the greatest because the Liver will need more time to get back
    to its normal functions, possibly your Basal-Insulin is also working
    to make it worse and that means at middle in the night after the
    drinking it gets the most dangerous and someone should be nearby
    to watch and measure the Glucose to intervene with Sugar-Water
    drinking in up-right position as long as any drinking is possible.

    When the Sugar-Water drinking gets difficult and the speaking get
    difficult Call 911 Emergency and until its arrival by a Teaspoon in
    up-right position put Sugar-Water in the Mouth and that will go
    down to digest and like that the Glucose-Level can also be lifted
    or at least not lowering any more to stay-out of any coma-risks.
    If a Person is alone in such conditions and has nobody to help,
    it could Die to be aware of !!
    The emergency team needs to be qualified for such Extreme Hypo
    conditions. That means by the standard procedure if the Glucose
    is still too low, that Intravenous Glucose gets slowly injected and
    the lost Potassium important for the Heartbeat by Intravenous
    Potassium slowly injected get quickly supplemented and the patient
    connected to a Glucose & Potassium Infusion to be transported
    to the hospital Emergency Room.

    For such Situations prepare 8 oz or 2 dl of Sugar-Water made by 4 Heaped
    Teaspoon of Sugar put into Warm-Water and stirred until it becomes clear
    again to keep beside the bed for any emergency to drink. This will increase
    the Glucose by about 110 mg/dl within 30 Minutes and when may necessary
    to prepare more !

    ( If the person is also using Glucobay Medication, then instead any
    normal sugar, it needs Dextrose ( Fruit-Sugar ) to be effective !! )

    At Alcohol drinking sessions there are some Rules, Do Not Inject
    any Basal-Insulin, because that by its long-term-effect will make it
    after more difficult and at any eating do not apply any Insulin for
    that moment and this independent of how high the Glucose may
    will go, because its better and more safe under that conditions
    to keep the Glucose higher for after to have less lowering and if
    possible to stay away from any Hypo may 40-50 mg/dl and try to
    keeping it above 100 mg/dl and this also by keeping eating !! !! !!

    Here one more Link about this topic: https://health.usnews.com/health-care/patient-advice/articles/2017-09-28/is-it-ok-to-drink-when-you-have-diabetes





    19. Diabetics Erection Disorders
    This Must Not Be. If the A1C is in the Range of 5 % or Average Glucose 88 - 103 mg/dl
    as by the Healthy People, then there is no physical reason why that should be, because
    there would not be any Blood-Circulation-Disorders and other reasons as also possible
    by Healthy People are the real cause, such as Mentally or possible Not Enough
    Testosterone-Hormone especially by Men’s above 30 Years of Age !!
    As a Men and within the healthy Average Glucose Range as above described and
    when in the early morning hours at sleeping or just wakeup, has not at least a
    Half- or Full- Erection as very natural by Men’s, then it means that there is
Not
    Enough Testosterone and for this should contact the Doctor
for by Blood-Test
    testing it and ask the Doctor for some Testosterone
Tablets to prescribe, maybe
    temporarily also combined with Viagra and applying Products To Improve Blood-
    Circulations such as every 3 Days some Aspirin with Daily 600 - 800 mg
natural
    Vitamin-E ! 
A Boron Supplement of daily 3x 5 mg can also help to increase the
    Men's Testosterone Level to normalize.

    Usually Erection Disorders are not just caused by one factor alone, but have
    Multi-Factors in play, such as what is Attracting, what kind of Desires may not
    Fulfilled and it’s necessary to concentrate on what is providing the Right Kick
    May Need or have Interests For and find the right solutions for this in reality
    to have also a happy sexual life too and not just a nice monthly income !!

 



    20. Misdiagnosed Diabetes Type 3c
    This is not to blame Doctors where under the present Situations are much more
    Diabetes Patients and not enough Qualified Professionals are available and where
    it is very individually or complex.
    The Type 3c Diabetes diagnosed as Type 2, this happens often and where today
    statistically this Type occurs even more often as Type 1 Diabetes.
    Type 3c Diabetes mainly caused by Pancreatitis Inflammations where the Pancreas
    resulting is not producing enough Insulin and resulting Hyperglycemia occurs and
    where instead immediate Insulin-Therapy just getting the typical Type 2 Medication
    such as Metformin can be fatal for the Pancreas and the Patients health.
    This has also to do with the applied Standard Tests and where not all possible
    Tests are Standardized.
    For Example :
    - OGTT Tests will not show the difference between Type 1, Type 2 or Type 3c,
    if after two hours the Glucose is not below 200 mg/dl just Diabetes is defined,
    but not which Types !
    - If a HbA1c or A1C Test is made and 6.5 % or higher it confirms Diabetes and
    when 5.7 % or higher it confirms Pre-Diabetes, but not which Types !
    - If the Morning Fasting Glucose Tests show less 99 mg/dl it’s interpreted as healthy,
    But Possibly Not and if it shows 100 - 125mg/dl its defined as Pre-Diabetes and
    at 126 mg/dl or higher is Diabetes defined, but it does not definitely confirming
    which of the Types or really Healthy !
    - If Peptide-C Tests made they would show if the Pancreas is producing enough
    Insulin or not enough or too much Insulin and by this provide some direction to
    decide which Types may possible, but since there are no Standards of How To
    Do this Test under which None Existing Standard Pre-Conditions, it has a poor
    evidence, because when for example made by Blood Glucose of 70 mg/dl all
    Patients will not produce enough Insulin, because at Glucose of 70 mg/dl there
    is no need for Insulin but possibly for Glucagon to avoid any Hypoglycemias !
    - Autoimmune Antibody Tests to prove Type 1 or LADA Type, but this test will
    not prove Type 3c or Type 1 with Type 2 as by the AAN Type.   
 
    ( Here to make it simple we have to keep in mind, that for example Type 1 is
    not producing enough Insulin and resulting has Hyperglycemias and Type 2 is
    generally producing Too Much Insulin but because of Insulin-Resistance where
    the Insulin cannot show the Effect has resulting Hyperglycemias. Hyperglycemias
    by the Two Different Characteristics caused and by Type 3 the Pancreas maybe
    producing still enough Insulin to keep healthy Fasting Glucose Levels only, but
    not producing enough for at Meals and therefore causing Hyperglycemias !
    A Mix of Type 1 with Type 2 is also possible and even LADA without any
    Autoimmune Antibodies as by the AAN Type is also possible. )
 
    To Really Differentiate Some Diabetes Types Exist Test Procedures,
    but these are regrettably None Standardized Once, as following:
    -- The Insulin Resistance Test. Keep the Patients at Glucose 180 - 200 mg/dl
    for example with Reis
and apply 3 Units Rapid-Insulin and measure Glucose
    after 2 Hours.

    If per Unit Rapid-Insulin there is a Glucose Reduction of 30 - 60 mg/dl per
    Unit there is No Insulin Resistance just individual efficiency differences.
    If per Unit Rapid-Insulin there is a Glucose Reduction of Less 20 mg/dl
    then there is typical Type 2 Insulin Resistance proven.
    Repeating this Test 3x and if at least 2 Results confirm the same the
    Test can be used as Reference !
    To avoid any Hypoglycemic Risks during the Test, liquid Sugar to drink
    should been prepared.
    By this Test can clearly been differentiated between typical Types 1 or
    Types 2, but it remains an opportunity of Type 1 with Type 2 Mix !
    -- Peptid-C Test Under Glucose Load of 140 - 160 mg/dl to show the
    maximum
possible Insulin Production of the Pancreas !!
    The Pancreas at over 100 mg/dl getting forced to produce as much
    Insulin as it can and by that shows its maximum capacity.
    By this any Type 1 Characteristic could never reach the Normal Maximum
    and it would
also show to at which % the Pancreas may still functioning.
    By this any Type 2 would show even more than the Normal Maximum
    and this could been taken as a clear Proof of Type 2.
    -- By combining the Results from above Insulin Resistance Test and the
    Peptid-C Test Under Glucose Load, the Type 1 or Type 2 or Type 3c or
    Type
1 with Type 2 or Type AAN- Autoimmune-Antibody-Negative with the 
    Reactive-T-Cells, by Proof could all been
differentiated and evaluated !
 
    ( ADA As World Reference For Diabetes, where are The Diabetic Standardized
    Test Procedures Necessary to cooperate with The World Diabetes Epidemic ? )

    Here More From NIH.Gov About Type 3c Diabetes:
       https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5003514/
        
https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis
           https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045545/

    As a Scientist of a well known Big Pharma Company once mentioned:
    Medicine is a Kind of Art regrettably not more Physically Based, where
    even The Doctors Individuality and Attitudes are considered to respect,
    but now we need The More Physically to handle the Ongoing Epidemic !





    21. Gene Mutation Causes New MODY Diabetes 
    European and Japanese Scientists did find a new type of Diabetes caused
    by mutation in the Gene RFX6 which offers a possibility of 80 % for within
    25 - 50 Years to develop the Disease.  
    It means Gene Sequencing Screening makes sense to know before !

    See here the Link: https://www.nature.com/articles/s41467-017-00895-9




    22. UKs Top 10 Priorities For Type 2
    Its principally something which already long ago should have been done,
    but it’s sure better now than never.
    See here from Oxford University: https://www.phc.ox.ac.uk/news/top-ten-research-priorities-for-type-2-diabetes 





    23. Smart Synthetic Beta-Cells Insulin T1D & T2D Patches Treatments ?  
    At Mice’s it looks successful, but has to prove the same at Humans. 
    See Here For T1D: http://news.unchealthcare.org/news/2017/october/smart-artificial-beta-cells-could-lead-to-new-diabetes-treatment
       http://news.unchealthcare.org/news/2015/june/smart-insulin-patch-could-replace-painful-injections-for-diabetes
    Supplementary Information: https://images.nature.com/original/nature-assets/nchembio/journal/vaop/ncurrent/extref/nchembio.2511-S1.pdf  


    See Here For T2D: https://www.nibib.nih.gov/news-events/newsroom/pain-free-skin-patch-responds-sugar-levels-management-type-2-diabetes
    https://www.nature.com/articles/s41467-017-01764-1




    24. The Brain Also Produces Insulin
    This is not surprising considering that the Brain produces many different kinds of
    essential Hormones and where as known any Nutrients, Vitamins, Minerals and
    Hormones can pass the Brain’s Blood Barrier !
    In contrast to some interpretations, Insulin has also an important role in the Brain
    to function as seen in the following NIH.Gov Links.
  
    In the following NIH.Gov Link read the Titles :
    - Central origin of insulin
    - Detection of C-peptide in the brain
    - Detection of insulin mRNA in certain brain regions

    - Experimental approaches with brain cell cultures
       https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191295/
 
    Brain insulin: regulation, mechanisms of action and functions.
       https://www.ncbi.nlm.nih.gov/pubmed/12701881/
 
    Brain insulin, energy and glucose homeostasis; genes, environment and metabolic pathologies.
      
https://www.ncbi.nlm.nih.gov/pubmed/18407262/




    25. Over Weight Problems & Type 2
    If all Your attempts and intellectual Goodwill fails to reduce the Bodyweight to Normal
    as also described here at Point 17. Healthy Nutrition Opportunity, then you possibly a
    Superior Digesting Person by Your Genes and this by some Surgery should been
    corrected to the Normal and let Your Belly- Fat at the same
time remove to have
    also one problem less for the future. For example the Native
Hawaiian People
    have the same problem by its Genes and therefore usually Type 2.

    There are many Surgeons today with good experiences which could help You really
    and You better do this sooner than too late for your general health conditions !!


    New Study Finds Diabetes Under Control Without Insulin, 7 Years After Bariatric Surgery
   
https://www.prnewswire.com/news-releases/new-study-finds-diabetes-under-control-without-insulin-7-years-after-bariatric-surgery-300548433.html


    If the Nose is not strait in the Face, usually get corrected and
    if Genes not able to fit the Living it gets today also corrected.

    See Also Here:

    There is increasing evidence that by helping speed weight loss, bariatric surgery
    may be one of the most powerful tools in the fight against Type 2 diabetes for
    people who are candidates. In fact, many patients who have the surgery no
    longer need medication at all to control their diabetes.  
    “For people who are obese and dealing with Type 2 diabetes, the benefits of the
    surgery usually far outweigh these risks,” said Dr. Tohamy. “The surgery can help in
    the battle against obesity, which in turn helps to improve or eliminate your diabetes.”  
    “Bariatric surgery can be life-changing for the right person who is struggling with
    excess weight and diabetes,” said Dr. Tohamy. “If you’ve tried and failed to manage
    your weight and disease through more traditional methods, talk to your doctor to
    see if surgery could be a good fit for you.”
   
http://www.crozerkeystone.org/news/press-releases/2017/november/can-bariatric-surgery-reverse-type-2-diabetes/




    26. Nov. 2017 Study Report - ADA Diabetics Fooling Masterpiece ?
    By its Nov. 2017 Supplementary Report about Brain-Volumes Affections as seen
    in the Below Links and PDF Tables, as attempt to reconfirm its Poor- Guidances.
    As seen in the Report they just decided that A1C 5.7 % or Less is adequate
    None Diabetes, but as seen in the PDF Table 3. They Have No References of
    Real None Diabetics with A1C of 5 % to compare as necessary for Proof as
    at any Reference
Study made by International Studies Standards ! 
( Hallo ADA ? )  
    Further they hypothesized, where frequently the wording “hypothesized” or
    “hypothesis” is applied and therefore it need to be explain that a Hypothesis
    is anything unproven just Like Fantasies, where in contrary Any Theory Is Proven
    and therefore to be declared as Theory because by Scientific Evidences proven
    and herewith is the difference between Hypothesis and Theory proven as any
    Scientists would only confirm.
    By hypothesizing in The Report they also mentioned that they could not find
    any evidence that Vascular ( Brain’s Micro- Vascular Capillaries Netting ) causes
    the Diabetics Brain Volume to become smaller and therefore speculative concluded
    that
it must be something else causing it.
    ( Any of the world leading Profs. Neurologists knows reduced blood circulation
    causes low inflammations as caused by higher Blood-Glucose and that causes
    Partial Brain Cells Dead resulting to Reduced Brain Volume.

    The Study is made by MRI-Tomography and the Brain-Volumes are calculated
    by 3D-Software. MRI as known by anybody has a Resolution of max. 1 mm, but
    the Micro- Vascular Capillaries Netting Veins have a Diameter of only 0.01 mm
    ( Diameter 1/100 mm, see the Link https://en.wikipedia.org/wiki/Capillary  )
    as 100x smaller than the MRI could find or see and with a Microscope as necessary
    by Biopsies going
into the Brain for Proof, that they did not do for not harming or
    stressing the Participants.
    ( Brain- Tissue Samples Usually Taken From Dead People Or At Brain Surgeries.
)
    This ADA Study Is Not Made By The International Study Standards And
    Not Considering The Existing State Of The Art Knowledge !!

    The Report mentioned that more detailed Studies are necessary, as objectively
    just one of
the very few valuable info provided.
 
    Here the ADA Study Report and PDF Tables Links:
    Report http://care.diabetesjournals.org/content/40/11/1514
    PDF Tables http://care.diabetesjournals.org/content/diacare/suppl/2017/09/12/dc17-1185.DC1/DC171185SupplementaryData.pdf
 
    Luckily We Have The NIH.Gov by A1C higher 5 % ( Old 5.4 % ) or Average
    Glucose higher 97 mg/dl, confirming Vascular Affections, see the Link:
       https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911067/ 

    NIH.Gov and Diabetes Brain Issues, Vascular Caused Brain Volume Reductions:

       https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3836136/
       https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273865/
      
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064119/ 

    Here is the international Proof by the Link the ADA by it’s

    attempts to increase the A1C’s, sure don’t likes !!
    HbA1c – A1C Diabetes and Cognitive Decline
       https://www.ncbi.nlm.nih.gov/pubmed/29368156


    NIH.Gov As The World Reference In Medicine !




27. Nov. 30th - How Naïve To Reach Out To NIDDK !

Here below is the result to see if someone is trying to Cooperate or
Discuss with such as NIDDK, ADA, Etc., to help at Diabetic Epidemic !
https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/prediabetes-game-plan
 
Discussion on NIDDK 0 comments
Talking to your Patients about Prediabetes - Do You Have a Game Plan?
Comment Nov. 30, 2017 - Detected as spam. Thanks, we'll work on getting this corrected.
healthinfo@niddk.nih.gov
.
 
Dear NIDDK,
 
Since there nobody replied to you, we now reply.
We can be agree with everything of Dr. Ann Albright here.
At NIH.Gov are enough Studies to be considered and there is no need
for new Studies, except for new kind of therapies.
Its important for diabetics to get objective and reliable information and
for that purpose we established the WDHCO as here seen by the link:

http://worlddiabeteshealthcareorg.business.site/
 
1. It is troubling if the NIDDK is coming with ADA info as for Normal Healthy
People A1C of less 5.7% or Av. Glucose less 117 mg/dl where since over
40 Years its Av. Glucose less 100 mg/dl.
( New Norm A1C 5% or former 5.4% = Av. Glucose 97 mg/dl )
Here NIH.Gov Link compare to A1C of 5%, the 5.5% has already double Risks:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911067/
 
2. The NIDDK should enforce better A1C Laboratory Evaluation Standards.
Presently there is the Tolerance of plus-minus 12% or total 24% and this
where the Doctors and Diabetics should been able to relay on.
The Calibration Process of these Equipments need improvements !!

 
3. The NIDDK should achieve that the FDA has only one class “Diabetic
Controlling Medications” and not anymore the Type 1 and Type 2 System
where finally the Health Insurances deciding the therapies and possibly
not the Doctors.
Same as the Type 2 get some advantages from typical Type 1 Medication,
Type 1 can possibly also have some advantages from Type 2 Medications.
For any devices by FDA just the class “Diabetic Controlling Devises”.
This by simplicity to preserve the necessary therapies flexibilities.

 
 
Kind Regards,
 
Ch.R.– Founder of WDHCO
 

--------------------------------------------------------------




    28. The ACCORD Study 2009 Should Never Been Made By Its Incomplete Conclusions,
         but now By Joslin it gets warmed-up again to mislead !
   
http://www.joslin.org/news/Trial-Suggests-Way-to-Personalize-Heart-Health-in-Diabetes.html
    Accord Study 2009 Fulltext  http://www.ajconline.org/article/S0002-9149(07)00438-9/fulltext
 
    The Study Facts As Following:
    -- Only Type 2 Patients with CVD-Risks considered where as known Type 1 has the double CVD-Risks !
    -- It’s the Study which tells compare A1C of 8 %, A1C of 7 % has 12 % less Amputations and how many % remain ?
    This to confirm the convenient A1C less 7 % Rule !

    -- For the CVD-Risks to evaluate applied 2 Groups, A1C less 8 % and less 6 % !
    -- Where never more than 2 Factors or max. 3 should been taken for reference purposes, this Study
    has nearly unlimited Factors in play and resulting about 10 more Studies should been made to clarify !
    -- Here by every used Medication or kind of Nutrition the Factors shown:  Treatment algorithms using Metformin,
    Sulfonylureas, Meglitinides, Thiazolidinediones,
α-Glucosidase Inhibitors, Insulin, and Insulin Analogues, coupled
    with Lifestyle Intervention, have been developed for the 2 groups. Exenatide was added to the available formulary in
    April 2007 ( See the Side-Effects of Each Medication by some even supporting CVDs ! ).
    Normal Nutrition and for at A1C less 6 % also Low-Carb Nutrition to achieve ! 

    By Low-Carb Nutrition is known that in the Digestive gets less GLP-1 Hormone produced and therefore it’s no surprise
    that the Also Heart-Supporting Hormone is getting too low and that has been proven at this Study as the only Merit
    and useful Fact ! ! !

    -- Totally 13 Factors applied, where even any Super Computer could not handle more than 5 Factors with all it’s variables !!
    -- The A1C less 6 % T2D Group, should have been treated with Metformin plus Basal- and Bolus- Insulin only and under
    Normal Nutrition and the Result would have been the opposite by the normal GLP-1 and would have confirmed the NIH.Gov
    Study Result of 2010 as seen by the Link here, where the IDEAL with lowest CVDs by A1C of 4.7 to 5.2 % or Average Glucose
    88 - 103 mg/dl is proven by Non-Diabetics with Normal Nutrition ! 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911067/
    -- This above proves the Medicine as Kind of Art, where any Physicists regret that it is not more physically based also by
    more systematical methodologies !

 
    Harvard Please Do Better Than That !




    29. Diabetes and 30-40% Chronic Kidney Disease: an increasingly common multi-morbid disease
        in need of a paradigm shift in care !

    The Result of Micro-, Macro- Vascular Blood Circulation Disorders
Caused By Too High A1Cs !
    See Here: https://www.ncbi.nlm.nih.gov/pubmed/29247554
 
    Right, It Need A Paradigm Shift In Care ! ! !
 
    But Very Regrettably This Is Not Possible With ADA & Co. where they defend
    only the convenient ways and to preserve the Diabetic Status also for in favor
    of the Pharma- Industry !
    ADA by Guidance’s like Glucose Range 80 - 180 mg/dl, or 80 - 120 mg/dl now
    even increased to 80 - 130 mg/dl, with A1C at best less 7 % but prefer 8 %
    instead of 5 % as for Healthy People
for the Diabetics daily to apply and this
    where between the Meals it should been Glucose 70 - 100 mg/dl and at Meals
    above 100 mg/dl for not more than
2 ½ Hours.
    Such simple things are not even possible at ADA and that’s why also the
    Cardio-Vascular Professors complain about the ADA.
    If the ADA continuously likes to have the world leading role, then they need
    to do much better than that and as during the last 20 Years of watching
    only how the Diabetes Epidemic got created !!

    There is one more Scandal. The Surgeons at a daily base by about 60 %
    occupied with Diabetics by various Bypass- or Amputation- Surgeries where
    the ADA Guidelines do not help, contrary ! The ADA not commenting on this.
    ( Just ask the Surgery Dept. of your Hospital nearby. )

    It’s now the "Personalized Care" which gets the New Slogan, but just by some
    new fake fooling attempts, where by convenience the Glucose Guidance and
    A1C gets increased, also to save costs. This where anybody with a little of
    Diabetes Know-How
knows, that the Diabetes at every Patient is individual and
    different by it’s
Characteristics and the Resulting Necessary Medications and
    Doses, where
the Diabetes Experts need to show much better considerations
    and efforts
at every Patient, instead complaining about the Patients !
    It’s really disturbing of what presently is ongoing also by So-Called Studies
    just to save costs !! 




    30. Diabetes & Potassium – Very Important For Heart & Health !

    Without Potassium or Too Low, there is No Heart Beat ! ! !
    -- Thiazides as commonly first-line agents for the treatment of hypertension,
    have a common side effect of Lowering Potassium !!
    See NIH.Gov Link https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197792/
    -- Insulin Therapy when reaching Glucose of less 70 mg/dl or Hypo as usually
    at Bolus-Meals Rapid-Insulin possible, as known is Lowering Potassium !!
    ( At lower normal A1C 5 5.5% naturally easier possible and some Studies  
    quickly formed wrong conclusions as if paradox higher A1C’s are better. )
    -- It is very important to maintain and preserve the Normal Potassium Level
    of 3.6 – 5.2 mmol/L, but at Diabetics for safety 4.2 – 5.2 mmol/L as in the
    upper halve for some reserves and to ensure that the Potassium Storage is
    full as necessary. The Potassium Blood Test does not show Total-Potassium
    stored in the body as necessary.   
    See Mayo Clinic Link https://www.mayoclinic.org/symptoms/low-potassium/basics/definition/sym-20050632
    -- Diabetics should monthly test the Potassium Level ! If the body temperature
    has not the normally 36.5°C but only 35.5°C it could be caused by the Potassium
    Level too low to aware and/or the Thyroid function also to check.   
    -- Diabetics to maintain the Potassium Level and to make sure, should daily eat
    2 Bananas ( Middle Size Banana 400 mg Potassium ) or take daily one Novartis
    Slow-K® 600 mg Potassium Tablet together with normal Meals containing Vegetables.
    ( If experience some Hypo by the Rapid-Insulin of 60 mg/dl take immediately 1 Slow-K Tablet
    extra and if even of 50 mg/dl take immediately 2 Slow-K Tablets extra combined
with the
    usual Sugar amounts to increase the Glucose ! )

    -- Metformin User should daily also take 30 mcg Vitamin-B12, because as known
    Metformin is reducing B12 and that is also essential for the Body and Heart.
    -- Maybe daily also GLP-1 Hormone injection for the Heart would possibly be

    a good matter to discuss with the Doctor in Diabetology – Endocrinology.
    ( This since Diabetics often apply some diets with reduced Potassium, GLP-1 and
    Vitamin-B12 resulting. )

 
    About the Potassium function. Potassium can be quickly released combined with
    Adrenalin at Alarming condition, but the storage is a slow process. This can been
    seen at any Extreme Hypo caused by wrong measurement where Rapid-Insulin got
    injected for Glucose 300 mg/dl instead some Sugar taken at effectively 55 mg/dl.
    When the Insulin-Effect kicks in it’s already too late and the body get flushed
    by Adrenalin and Potassium with as result only 10 minutes later additionally
    a Potassium-Hypo gets created, by the Blood Pressure and Heart Pulse goes
    drastically down and the body temperature also, difficult to remain conscious.
    In such a situation before falling in a KOMA, only 911 Ambulance can help
    because Sugar not really functioning just reducing the KOMA-Risk and they
    will quickly give some intravenous Potassium to transport into the Intensive
    Care Hospital for there to receive 24 Hours Potassium Infusion to restore
    the Bodies Potassium Storage !
    It’s possible as by above example, where until The Incident over 6 years
    long the Doctors and Prof’s in Diabetology – Endocrinology mentioned
    about anything as Glucose mg/dl, A1C %, Metformin and Insulins, Hypos or
    Hypers, Meals, CGM, but never mentioned anything about the for the Body
    most important Potassium. Potassium has also metabolism harmonizing and
    regulating abilities to reduce the Average Glucose without creating Hypos !!
    The Potassium is very effective, but tricky or sneaky and can over years be
    on the lower Level if not checked frequently or Supplemented and by that
    affecting the Left-Side of the Heart-Muscle which is responsible to pump back
    the Blood out of the Veins into the Right-Side of the Heart-Muscle which is
    pumping the Blood into the Arteries to start the circulation-cycle all over.
    Under this conditions the Left-Side Heart-Muscle chronically becomes weaker
    by lack of Potassium the Diastole-Blood-Pressure increasing, where the Right-Side
    Heart-Muscle is trying to compensate this for some time, but under that double
    work where the Right-Side has to pump against a higher resistance the Systole-
    Blood-Pressure as result is increasing and the Right-Side-Heart-Muscle becomes
    also chronically weaker until collapses and this beside of Too High Glucose of
    above Average 105mg/dl causing Micro-Macro-Vascular Problems by the Blood
    not able to flow freely and so also causing resistance able to see by Feet
    start
to get swollen, finally also by Too Low Potassium Level Is Too Much !
    ( Two Factors For Swollen Feet. )
    When the Left-Side-Heart-Muscle is under the conditions to become weak, it can
    be seen by the Feet starting to get swollen, because the Left-Side-Heart-Muscle
    not pumping enough to reduce pressure and that is the last moment to counter
    act by supplementing
Potassium and applying monthly Potassium-Checks !!
    Just the minimum of the Normal Potassium Level is also not enough to know.

    Have also a look at initial Topic No. 1 and 17 with important Potassium info !!


    Here is well explained how to avoid Diabetic Heart Problems.

       ( The ADA about all of this so important also not mentioning anything !! )

     ( As seen in the publications, the international Nutrition-Scientists agree that an Adult
     Human from its daily Food Intake should have Daily 4000 mg Potassium, but strongly
     assume that this usually not achieved and therefore a complex Study will be made. )





    31. ADA & Co. Keeps You Sick By Its Hugh Conflicts of Interests !!
    They get annually $ 150 - 200 Millions Donations & Sponsors Money from
    the Health Insurances, Pharma-Industries, Etc., they don’t like to mess-up !
    That’s the Reason why they have so Poor Guidance’s & Standards
    for Type 1, Type 2, Etc. Diabetes and No Guidance’s for Prevention
    or the well proven Reversal of Type 2 Diabetes.
    For example worldwide are about 10,000 People which already proved
    to Reverse Type 2 Diabetes, but the ADA & Co. is just
ignoring this
    Reality Facts and informing about Chronic Progressive Disease.


    The ADA & Co. like this not able to handle the worldwide increasing
    Diabetes Epidemic which resulting during the last 20 Years created !

    The ADA claims that since 1952 they supported over 4700 Studies
    or Clinical Trials, but at basic ADA Guidance’s or Standards noting
    has changed
or improved within the last 20 Years !
    ADA never paid for any FDA 3 Phases Clinical Trial Costs of about
    $ 50 - 100 Millions.

    In 2016, the ADA’s total Revenue was $ 171 Million !
    See here: https://en.wikipedia.org/wiki/American_Diabetes_Association
    The ADA since 1952 by 19% of Revenues or $ 807.4 Million supported diabetes
    related
projects & research from its Total Revenues of $ 4.25 Billion at hands !!
 
    Here some examples of Type 2 Reversals:
    Reversal of Type 2 Diabetes to normal metabolic control by either Bariatric
    Surgery and/or Hypocaloric-Diet or Low-Carb-Diet combined with Exercises.
    See at following Topic 32.





    32. Type 2 Diabetes Can Be Reversed !
    Reversal of Type 2 Diabetes to normal metabolic control by either Bariatric
    Surgery and/or Hypocaloric Diet or Low-Carb-Diet allows for the time
    sequence of underlying
pathophysiologic mechanisms to be observed.
    It is a fact that Type 2 can be reversed as long as not any resulting
    permanent disorders exist and the pancreas function is not reduced.
    In Europe about 10,000 Type 2 Diabetics have been reversed !
    This naturally not by OB body weight of for example 300 lbs.
    Prof. Dr. Taylor in the UK giving classes and symposiums to Doctors
    in Diabetology to be able to do the same.
    See the links:
   
http://ncl.ac.uk/magres/research/diabetes/reversal/#publicinformation
       https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609491/
       https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168743/
       https://paleodiabetic.com/2014/01/25/dr-roy-taylor-on-the-cause-of-type-2-diabetes-and-what-to-do-about-it/
       http://care.diabetesjournals.org/content/36/4/1047.full?sid=abfe05d0-e52c-4d6d-b356-4c794f9d5f69





    33. HbA1c - A1C Diabetes And Cognitive Decline !
    See Here https://www.ncbi.nlm.nih.gov/pubmed/29368156  
    The English 10 years study the ADA would not like. Because contrary to it’s
    strategy to even generally increasing the A1C’s as convenience for patients-,
    doctors- and health insurances for with reduced live span to save healthcare
    costs and by increased A1C’s the pre-diabetic and diabetic numbers in the
    epidemiology looks also much better.
    As reminder, any normal healthy A1C is at about 5 % since 40 years.



( More Important Completions Will Soon Follow. )










   To Keep Well In Mind, The Additionally About 20 Disorders or Diseases
   All Diabetics Have The Risks For, Are Principally As Initiated Caused By
   Blood Circulation Disorders / Problems Established By Increased Glucose
   Above The Levels Of Any Normal Healthy People ! ! !


   Therefore Any Therapy Can Only Be A Good Therapy If By Its Medications
   Diabetics Can Live Within The HbA1c Or A1C Of Normal Healthy People !




   At Any Matters Herein Described; Before Applying Should Been Discussed With And Approved By Doctor's In Diabetology - Endocrinology !!





   This Above By All Intellectual Properties Under Copyrights© Reserved For World Diabetes Health Care Org.  



 


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