Sunday, December 2, 2012

How do foreigners with diabetes get health care in the US?

Q. My boyfriend is moving to the US from Spain and is curious about the process for covering the cost of insulin in the US. In Spain, he receives it from the public health care system. What would be the process for him to get an affordable health care plan with which he could buy Humalog Kwikpen and Optimus Lantus?

A. There are no affordable healthcare plans in America.

He will have to pay for it out of pocket..May get help from county health clinics.

Take care

Ben Trolled


What is the biology behind type 2 diabetes?
Q. now i've been wondering for a while what the biology is behind type 2 diabetes, would someone care to help me out, thanks

A. Type 2 diabetes happens when the body either cannot produce enough insulin to process the sugar intake OR the body's cells become unresponsive to insulin. This can happen due to a diet high in refined sugars or it can happen to a seemingly healthy eater.

When sugar is broken down, the sugars are supposed to cross into the cell wall so that they can be used for energy within the cell. With diabetes, the sugar cannot be broken down and let into the cell, so it stays on the outside of the cell. Meanwhile, the cell itself is "starving" while the blood sugar is sky high because it's all floating around outside the cells. Too much sugar where you don't need it...and not enough sugar where you do need it. Symptoms of diabetes reflect the body signaling that it is "starving" when in actuality, there is a dangerous amount of glucose present...it just can't be processed.

The link below gives you a better visual of what I'm trying to explain.

http://www.youtube.com/watch?v=nBJN7DH83HA&feature=related


What happens to a person with type 1 diabetes that does not care for themselves?
Q. What happens to a person with type 1 diabetes that does not care for themselves?? HELP !!

A. They'll ultimately die, but before that they'll have an unhealthy miserable life! Diabetes was a fatal disease until the discovery of insulin. Complications of uncontrolled diabetes includes heart disease, vascular disease, kidney disease, eye disease, sexual dysfunction, increased risk of stroke, coma, unhealing sore, infections and on and on
Chronic ulcers often get infected and lead to gangrene and amputation. Starts with a toe and then they keep hacking away at the unhealthy limb(s).

Short term problems are headaches, vomiting, increased urination, unquenchable thrist, and irritability.

In short, someone with type 1 diabetes MUST contrl their blood sugar as best as they can to feel good.


How does being a vegetarian reduce the risk of diabetes?
Q. I heard that a vegetarian diet reduces the risk of diabetes, but I have yet to find an answer out of some of the sites I have read.

A. Vegetarian diets have a higher ratio of unsaturated to saturated fats. Saturated fats are known to increase the risk of type II diabetes, but this is not one of the major influences- BMI is a much more sensitive predictor of diabetes and at least one study has shown that the types of fat consumed made no difference to diabetes risk for men with high BMI (van Dam et al., (2002). Dietary Fat and Meat Intake in Relation to Risk of Type 2 Diabetes in Men. Diabetes Care vol. 25 no. 3 417-424 http://care.diabetesjournals.org/content/25/3/417.full ). Other influences include fibre intake and the quantity of refined versus whole grain carbohydrates.

What is thought to cause the increase in diabetes risk from consuming meats is the effect of saturated fats on the cell membranes. Every cell in your body is surrounded by a membrane and these are made from the fatty acids which fats are made from, so all the fats we eat are broken down into the constituent fatty acids and these are put to work in our cells. The different polyunsaturated fatty acids (omega 3, 6 and 9) have different conformations and this affects how important molecules are taken in and out of the cell. In terms of diabetes risk, this is thought to influence the way insulin is released and taken up by the cells around the body (Hu et al., (2001). Diet and risk of Type II diabetes: the role of types of fat and carbohydrate. Diabetologia Volume 44, Number 7, 805-817 http://www.springerlink.com/content/mvnfwche17mchgdc/ ).

Another aspect is cholesterol which are also components of the cell membranes. There are two types of cholesterol, low (LDL) and high density lipoprotein (HDL). Meat consumption is associated with increases in the proportion of the bad type (LDL) whereas vego diets can reduce LDL (Appleby et al., (1999). The Oxford Vegetarian Study: an overview.American Journal of Clinical Nutrition, Vol. 70, No. 3, 525S-531S. http://www.ajcn.org/content/70/3/525S.abstract ) and increase the good HDL (Robinson et al., (2002). Changing from a mixed to self-selected vegetarian diet � influence on blood lipids. Journal of Human Nutrition and Dietetics Volume 15, Issue 5, pages 323�329. http://onlinelibrary.wiley.com/doi/10.1046/j.1365-277X.2002.00383.x/full ). This is not thought to directly affect glucose metabolism (an effect of insulin resistance) but cholesterol intake has been linked to increased insulin levels (hyperglycaemia, a major influence of diabetes) in meat eaters versus vegos (Hu et al., (2001). Diet and risk of Type II diabetes: the role of types of fat and carbohydrate. Diabetologia Volume 44, Number 7, 805-817 http://www.springerlink.com/content/mvnfwche17mchgdc/ ).

One final point to consider is the nature of the available evidence. As others have pointed out, vegetarian diets can be high in fats (especially trans fats) and refined carbohydrates and hence very unhealthy. This is a more recent effect of consumption due to increased availability and marketability of vegetarian products which was less common 30 years ago when most of the long term studies looking at diabetes and other illnesses were initiated. I believe that if the consumption of processed foods by vegetarians continues to increase, the risk reduction in various diseases seen in research over the past two decades will disappear, as it is already appearing to do in the case of bowel cancer (Key et al., (2009). Cancer incidence in vegetarians: results from the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford). Am J Clin Nutr. 89(5):1620S-1626S http://www.ncbi.nlm.nih.gov/pubmed/19279082?dopt=Abstract&holding=npg ).





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