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  1. Join Date
    Apr 2010
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    #111
    Quote Originally Posted by uls View Post
    btw doc jm, you mentioned dumadami ang dialysis patients
    i understand that diabetes and hypertension damage the kidneys
    how exactly does diabetes and hypertension damage the kidneys?
    sa diabetes, high blood glucose clogs up blood vessels depriving the kidneys of blood and the kidneys die?
    scharnhorst explained it very well sir uls.. galing nga e..!

    Quote Originally Posted by uls View Post
    sa hypertension, high bp puts a lot of pressure on the kidneys overworking the kidneys destroying the kidneys' filter allowing protein to pass thru?
    (i understand sa urinalysis pag may protein detected sa urine that means may damage ang kidneys)
    hmmm. let me explain in ways we can understand better.. (ganito ako usually, hehe!)
    since nasa car forums tayo dapat car-related, hehe!

    okay lets say your engine air filter is the kidney, and the air passing through is the blood..
    high blood pressure puts too much task on your kidneys as too much air can rip off your filter.
    in the long run (chronic hypertension) your air filter gives way (kidney damage, renal failure), lessening its efficiency. with this, contaminants can easily damage your engine, limiting its use or destroying it eventually as it is not able to push out wastes (increasing creatinine), needing overhaul (dialysis first, then worst, kidney transplant). protein is needed by the body thats why your kidneys recycles this. and with its decreasing efficiency, it excretes the needed proteins and accumulates the waste creatinine. this is why protein is present in urine, and increasing creatinine in kidney failure patients caused by hypertension..

  2. Join Date
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    #112
    Quote Originally Posted by uls View Post
    since we're on the topic of diabetes, i got some questions
    i understand that type 2 diabetes is caused by insulin resistance
    drugs like metformin and glitazones lower blood sugar by improving insulin sensitivity
    that i get. that makes sense

    what doesnt make sense to me are those drugs that make the pancreas produce more insulin (sulfonylureas, meglitinides)
    i mean the problem isnt that the body isnt producing insulin. the body is producing insulin but is no longer sensitive to it. so why force the body to produce more insulin? why not focus on restoring insulin sensitivity instead? (or reverse insulin resistance)

    if you use drugs to force the pancreas to produce more insulin, arent you making the pancreatic (beta) cells burn out faster? eventually those cells will burn out and can't produce any more insulin and the patient has to inject insulin for life

    you're suppose to preserve those beta cells instead of making them burn out faster right?
    im amazed people with diabetes still eat lots of carbs. they say "may gamot naman eh"
    umm... how about cutting carbs nalang so you don't have to take drugs?

    with those insulin secretagogues -- it's like the medical community is saying -- "hey, we can't stop patients from eating carbs. they love carbs. so to keep patients' blood glucose under control, we have to prescribe drugs that make the pancreas produce more insulin"

    it makes more sense to me to go back to what caused the insulin resistance in the first place -- decades of high carb diet, decades of exposure to high insulin causing the body to become resistant to insulin

    cut the carbs. give the body a break

    do i make sense?
    there is some truth in what you say.. if you follow this line of tinking.
    but its not the problem of the beta cells.. it the receptors.. (masyado na itong biochemical explanation) and its not burning it out faster..

    if you stimulate the receptors to be more sensitive to the glucose present, the secreted insulin will facilitate this glucose metabolism. decreasing your blood sugar by using your own insulin. it is not that your beta cells are not doing their job, but there is just much that they can take.

    there are a lot of issues on medical managements too.. and medicine is ever evolving more rapidly with evidence-based medicine. what can be true now, can be a thing of the past later. (like treatment of schizophrenia before involves "trephining" or opening a hole on the skull at specified locations which we can say bizarre but has been done. only later it is treated w/ oral medications)..

  3. Join Date
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    #113
    Quote Originally Posted by surgeon_jm View Post
    there is some truth in what you say.. if you follow this line of tinking.
    but its not the problem of the beta cells.. it the receptors.. (masyado na itong biochemical explanation) and its not burning it out faster..
    ya i know it's not the beta cells. nagpo-produce pa naman ng insulin eh. so the beta cells are still working. my point is why take drugs to make the pancreas produce more insulin when insulin isnt the problem. the problem is the body is ignoring the insulin. so instead of increasing the amount of insulin, insulin sensitivity has to be restored

    type 2 diabetics usually end up injecting insulin. so that means eventually the pancreatic beta cells cannot produce insulin anymore. kaya i used the term "burn out". what causes the beta cells to stop producing insulin in type 2 diabetes? i think it's the intake of sulfonylureas. those drugs force the pancreas to produce more insulin. years of taking those drugs burn out the beta cells

    if you stimulate the receptors to be more sensitive to the glucose present, the secreted insulin will facilitate this glucose metabolism. decreasing your blood sugar by using your own insulin. it is not that your beta cells are not doing their job, but there is just much that they can take.
    and how do you stimulate the receptors? exercise

  4. Join Date
    Jun 2007
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    #114
    Quote Originally Posted by uls View Post
    ya i know it's not the beta cells. nagpo-produce pa naman ng insulin eh. so the beta cells are still working. my point is why take drugs to make the pancreas produce more insulin when insulin isnt the problem. the problem is the body is ignoring the insulin. so instead of increasing the amount of insulin, insulin sensitivity has to be restored

    type 2 diabetics usually end up injecting insulin. so that means eventually the pancreatic beta cells cannot produce insulin anymore. kaya i used the term "burn out". what causes the beta cells to stop producing insulin in type 2 diabetes? i think it's the intake of sulfonylureas. those drugs force the pancreas to produce more insulin. years of taking those drugs burn out the beta cells

    and how do you stimulate the receptors? exercise
    With the guidelines I have access to... usually metformin ang 1st line drug... which sensitizes the tissues to insulin (especially the liver)

    SUs are for those na mas mahirap i control ang blood sugar since it has a propensity to cause hypoglycemia.

    there is *some* receptor dysfunction but saturating the receptors with insulin will still provoke response from the peripheral tissues, hence the effectiveness of SUs and insulin replacement therapy in those with Type 2 DM

    and yes, exercise does sensitize tissues to insulin

  5. Join Date
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    #115
    free PCOL lectures on the internet :D
    Damn, son! Where'd you find this?

  6. Join Date
    Jul 2010
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    #116
    Hello tsikot doctors and pasyentes....

  7. Join Date
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    #117
    basa-basa bna tayo DF, kelangan na din yan... hehehe
    Fasten your seatbelt! Or else... Driven To Thrill!

  8. Join Date
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    #118
    Quote Originally Posted by Ry_Tower View Post
    basa-basa bna tayo DF, kelangan na din yan... hehehe
    basta continue lang exercise bro....

    wala pa naman akong problema sa alta presyon at cholesterol at sugar.....

    yun lang singaw ko, pabalik-balik...mabuti pa tubuan na lang ako maraming tigyawat sa mukha kesa sa daming singaw...
    ''nyahahaha...parang si boy gayuma sa thread ni broshadow....

  9. Join Date
    Apr 2010
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    #119
    Quote Originally Posted by desert fox View Post
    basta continue lang exercise bro....

    wala pa naman akong problema sa alta presyon at cholesterol at sugar.....

    yun lang singaw ko, pabalik-balik...mabuti pa tubuan na lang ako maraming tigyawat sa mukha kesa sa daming singaw...
    ''nyahahaha...parang si boy gayuma sa thread ni broshadow....
    bumabalik parin ba mga singaw mo sir DF?
    still on steroids pa ba?

  10. Join Date
    Apr 2010
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    1,118
    #120
    Quote Originally Posted by desert fox View Post
    basta continue lang exercise bro....

    wala pa naman akong problema sa alta presyon at cholesterol at sugar.....

    yun lang singaw ko, pabalik-balik...mabuti pa tubuan na lang ako maraming tigyawat sa mukha kesa sa daming singaw...
    ''nyahahaha...parang si boy gayuma sa thread ni broshadow....
    bumabalik parin ba mga singaw mo sir DF?
    still on steroids pa ba?

Salamat Dok!!!!