|
|
|
Search
12/19/2016 Robert Kornfeld, DPM
Nutraceuticals and Diabetes (Paul Kesselman, DPM
Here we go again. It is truly maddening to me that the "evidence" the status quo is still looking for are the effects of a drug vs. a placebo. And now, we are substituting nutrients and measuring their effects as if they are drugs. I opine that the entire evidence-based model fails miserably in its understanding of what we should be measuring. I've said this before and I'll say it again, all of these studies conveniently ignore the patient and their unique physiology, genetics, and epigenetics. If you are going to use nutraceuticals in the treatment of diabetic neuropathy, then there must be a deeply layered protocol put into action prior to the prescription of nutraceuticals.
We first need to educate the patient, optimize the epigenetic influence (a healthy patient- specific diet, exercise, stress control, sleep hygiene, hydration, communication skills, etc.) and work to facilitate salutogenesis (a movement toward efficient homeostasis). It starts with a systems analysis. You need to consider the fact that microangiopathy restricts the delivery of nutrients and oxygen to the involved limb. So what are we comparing in a population of diabetics who are all at different stages of pathology when we give them a "pill" and disqualify nutrients as medicinal when we do not see the end point we are looking for.
You will NEVER see a return to health in a patient whose genetics and epigenetics have collided to give rise to Type II diabetes by giving them a "pill". Giving any vitamin vs. a placebo is sheer folly. However, incorporating essential nutrients into a multi-tiered protocol that CANNOT BE DOUBLE-BLINDED (sorry folks) will ultimately net the effect you are looking for - improved symptoms, a decreased need for pharmaceutical glucose control, weight loss, improved sleep, more even temperament with less anxiety, resolution or improvement in other pathology, etc.
Does it really make sense to give an overweight diabetic who largely depends on their medication to control their A1C level a vitamin pill and expect to see any real improvement in the health of the patient. How many patients walk into your office with normal A1C levels but have painful neuropathy and/or numbness? Ladies and gentlemen, we are not treating blood tests. If we continue to pour water on the smoke, we will continue to battle the diabetes/diabesity syndrome that is wreaking havoc on our population.
I haven't had the ability, after 30 years of being a spokesperson for functional medicine in podiatry, to have even a small effect on the paradigm that 99.9% of our nation's podiatrists are employing daily in their practice. For that, I'll say shame on me. But the reality is, if you all continue to believe that "evidence- based medicine" will have any real effect on stemming the tide of pathology in this country, all I can say is shame on you.
Robert Kornfeld, DPM, NY, NY
There are no more messages in this thread.
|
|
|
|