According to WHO competent Authorities, there were in 2010 250 milion of diabetics, and they will be 366 milion in 2030, indicating that type 2 DM is today's growing epidemics (1-16).
In my opinion, as far as diabetes is concerned, primary prevention, especially when initiated in the first two stages among the five of th natural history of the disease, is far better than therapy, as usually.
Unforunately, Diabetic "and" Dislipidemic Constitutions, conditio sine qua non of type 2 DM, are nowadays overlooked by the majority of physicians all around the world (12-14). A long well westablished clinical experience allows me to state that with the aid of Quantum Biophysical Semeiotics, physicians can quickly and easili bedside recognize the "microcirculatory remodelling", based on newborn-pathological, subtype a) oncological , and b), aspecific, type I, Endoarteriolar Blocking Devices in tissue, wherein does really exist the inherited real risk of human common and severe diseases, as diabetes (12-16).
Obviously that happens in individuals with defined Biophysical Semeiotics Constitutions, in our case, Diabetic “and” Dislipidaemic, according to Joslin(1-6, 12-16).
To realize on vast scale Diabetes Primary Prevention (PP),enrolling exclusively individuals at Inherited Real Risk, we need new clinical tools, aiming to lower the increasing number of patients, because the present, expensive screening has failed (14). For instance, in the normal Langheran’s islets microcirculatory bed, there are exclusively “normal” type II (= in arterioles, according to Hammersen), but not type I (= in small arterioles) endoarteriolar blocking devices, i.e. EBD, of first and second classes, according to S.B.Curri (See http://www.semeioticabiofisica.it/microangiologia). In health, i.e., not involved by Diabetic Constitution, we cannot observe type I, newborn- pathological, EBD in above-mentioned biological system. On the contrary, in individuals involved by diabetic constitution as well as diabetic "Inherited Real Risk" and overt diabetes, of course, we observe with the aid of Quantum Biophysical Semeiotics also type I, newborn-pathological, subtype b) a-specific , EBD, facilitating the diagnosis and consequently diabetes primary prevention. In addition, the evaluation of Insulin Secretion Acute Pick Renal Test is significantly impaired, corroborating the clinical diagnosis (1-3) (See above cited- website, Practical Applications, and Glossary). Finally, an interesting clinical tool in recognizing diabetic constitution -dependent inherited real risk, as well as in diagnosing diabetes since early stages and diabetic monitoring proved to be bedside Biophysical-Semeiotic Osteocalcin Test and Siniscalchi's Sign (10, 15, 16).
As a matter of fact, Pre-hypertension during Young Adulthood may be involved by Coronary Calcium Later in Life exclusively in presence of Inherited Real Risk of CAD, typical for individuals with lithyasic Constitution, present in about 50% OF ALL CASES OF Pre-Metabolic and Metabolic Syndrome (www.semeioticabiofisica.it; Constitutions and Bibliography). Considering the frequent association between hypertension and diabetes, more important, in my opinion based on 53-year-long clinical experience, is bedside recognizing diabetic predisposition, now-a-days possible since birth, utilising a lot of methods, different in difficulty, but all reliable. For the first time, from the clinical view-point, I have recently illustrated an original manoeuvre, based on a singular activity of osteocalcin, and reliable in bedside detecting diabetes in one minute, with the aid of a stethoscope (10). In fact, osteocalcin, a product of osteoblasts, among other action mechanisms, stimulates both insulin secretion and insulin receptor sensitivity. As a consequence, osteocalcin, secreted by above-mentioned bone cells during mean-intense lasting digital pressure – for instance – applied upon lumbar vertebrae, brings about increasing pancreatic diameters, i.e., technically speaking, type I, associated, Langherans’s islet microcirculatory activation, so that doctors assess pancreas size augmentation, which in health, lasts 10 seconds exactly (1-11). After that, pancreas diameters return to basal value for 3 sec. The second pancreas size increasing lasts 20 sec., and finally the third show the highest value: 30 sec. I terme such as clinical investigation. On the contrary, in case of diabetic constitution (3, 4, 11, 13) the first pancreas increasing persists normally (10 sec.), but both the second and the third are less than physiological ones (i.e., less than 20 sec. and respectively 30 sec.). In presence of intense inherited real risk of diabetes (6), such as impairment is greater. Finally, in case of diabetes the alteration is present already in the first evaluation, wherein duration appears less than 10 sec., inversely related with disorder seriousness. Subsequently, I have ascertained that Ronald’s Manoeuvre result pathological already in individuals involved by both Diabetic Constitution and Inherited Diabetic Real Risk (1-11). Interestingly, not only in examining subject, but also in all others, even if kilometers way from him (her), according to Lory’s experiment, based of no local realm in biological systems (12, 15), pancreas show identical modifications, allowing doctors to made clinical diagnosis until now impossible (1-15).
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. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Travel Factory, Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm
3) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico- Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004. http://www.travelfactory.it/libro_costituzionisemeiotiche.htm
4) Stagnaro S., Stagnaro-Neri M. Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Travel Factory, Roma, 2005. http://www.travelfactory.it/libro_singlepatientbased.htm
5) Stagnaro S. Pivotal role of Biophysical Semeiotic Constitutions in Primary Prevention. Cardiovascular Diabetology, 2:1, 2003 http://www.cardiab.com/content/2/1/13/comments#5753
6) Stagnaro S. Stagnaro Sergio. Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention. www.fce.it, http://www.fceonline.it/index.php?option=com_content&task=view&id=3736&Itemid=47
7) Stagnaro S., West PJ., Hu FB., Manson JE., Willett WC. Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. [Medline]
8) Stagnaro Sergio. New bedside way in Reducing mortality in diabetic men and women. Ann. Int. Med.2007. http://www.annals.org/cgi/eletters/0000605- 200708070-00167v1
9) Stagnaro Sergio. Single Patient Based Medicine: its paramount role in Future Medicine. Public Library of Science. http://medicine.plosjournals.org/perlserv/?request=read-response 2005
10) Stagnaro Sergio. Teoria Patogenetica Unificata, 2006, Ed. Travel Factory, Roma.
11) Stagnaro Sergio. Il test Semeiotico-Biofisico della Osteocalcina nella prevenzione primaria del diabete mellito. www.fce.it, http://www.fcenews.it/index.php?option=com_content&task=view&id=909&Itemid=47
12) Stagnaro Sergio e Paolo Manzelli. L’Esperimento di Lory. Scienza e Conoscenza, N° 23, 13 Marzo 2008. http://www.scienzaeconoscenza.it//articolo.php?id=17775
13) Stagnaro Sergio. Reale Rischio Semeiotico Biofisico. I Dispositivi Endoarteriolari di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico. Ediz. Travel Factory, www.travelfactory.it, Roma, Luglio 2009.
14) . Sergio Stagnaro. New Renaissance in Medicina. Prevenzione Primaria del Diabete Mellito tipo 2. Sito del Convegno, http://qbsemeiotics.weebly.com/atti-del-convegno.html, 16 novembre 2010; English version: http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/report_stagnaro.pdf
15) Sergio Stagnaro. Siniscalchi's Sign. Bedside Recognizing, in one Second, Diabetic Constitution, its Inherited Real Risk, and Type 2 Diabetes Mellitus.
24 December, 2010, www.scivox.com, http://www.sci-vox.com/stories/story/2010-12-25siniscalchi%27signi.bedside++diagnosing+type+2+dm.html; www.sciphu.com; http://wwwshiphusemeioticscom-stagnaro.blogspot.com/ Italian version: http://www.sisbq.org/uploads/5/6/8/7/5687930/segnodisiniscalchi.pdf
16) Caramel Simone. Primary Prevention of T2DM and Inherited Real Risk of Type 2 Diabetes Mellitus http://ilfattorec.altervista.org/T2DM.pdf