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PAPERS: Nick A Roper, Rudy W Bilous, William F Kelly, Nigel C Unwin, and Vincent M Connolly Excess mortality in a population with diabetes and the impact of material deprivation: longitudinal, population based study BMJ 2001; 322: 1389-1393 [Abstract] [Full text]

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Bed-side primary prevention is the major step in the war against diabetes mellitus.

Sergio Stagnaro   (10 June 2001)

Bed-side primary prevention is the major step in the war against diabetes mellitus. 10 June 2001
Sergio Stagnaro, Specialist in Blood, Metabolic and Gastrointestinal Diseases Riva Trigoso (Genoa) Italy Send response to journal: Re: Bed-side primary prevention is the major step in the war against diabetes mellitus.	Sirs, In my opinion, the war against diabetes mellitus and its well-known and dangerous complications is nowadays possible (See http://digilander.iol.it/semeioticabiofisica;Applications: Diabetes Mellitus) exclusively by means of the "clinical" primary prevention, which must be achieved, of course, at the bed-side, i.e. on very large scale. In fact, it is generally admitted that non-insulin-dependent diabetes mellitus may occur at least 12 years before the clinical diagnosis of DM is made, and retinopathy can develop at least 7 years before the diagnosis. During the time that diabetes is undiagnosed and untreated, complications, that could be avoided, are developing. Therefore, early diagnosis must be established to avoid those complications. In fact, in order to prevent well known diabetic complications, it is extremely necessary that doctors use a “clinical” tool reliable in diagnosing early diabetes mellitus, i.e. from its initial stages (1, 2, 3). Until now, unfortunately, diabetes mellitus is too often diagnosed accidentally, e.g. by occasional urinary or blood tests. Furthermore, epidemiological studies indicate that 50% of individuals with 2-hour postglucose challenge values over 200 mg/dL, a value diagnostic for diabetes, were not previously diagnosed as being diabetic (3, 4, 5). Fortunately, it is now easy to realize "clinically" an efficacious DM primary prevention in a simple manner, with the aid of some biophysical -semeiotic signs, reliable and quick at the bed-side, diabetes mellitus as well as its initial stages. The described method, easy to perform, can be applied on very large scale, "conditio sine qua non" to prevent a serious disease, that notoriously causes morbidity and mortality, through dangerous lesions in the kidneys, retina, heart, brain, etc. Yours, Stagnaro Sergio MD., Member NYAS and AAAS 1.Stagnaro S., Stagnaro-Neri M. Valutazione percusso-ascoltatoria del Diabete Mellito. Aspetti teorici e pratici. Epat. 32, 131 1986 2.Stagnaro-Neri M., Stagnaro S., Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. 6, 617 1993 3.Harris MI: Undiagnosed NIDDM: Clinical and public health issues. Diabetes Care 16:642-652,1993 4. Stagnaro-Neri M., Stagnaro S., Semeiotica Biofisica: la manovra di Ferrero-Marigo nella diagnosi clinica della iperinsulinemia- insulinoresistenza. Acta Med. Medit. 13, 125,1997 5. Stagnaro-Neri M., Stagnaro S., Semeiotica Biofisica: valutazione clinica del picco precoce della secrezione insulinica di base e dopo stimolazione tiroidea, surrenalica, con glucagone endogeno e dopo attivazione del sistema renina-angiotesina circolante e tessutale – Acta Med. Medit. 13, 99 1997