Evidence of Nephropathy and Peripheral Neuropathy in US Adults With Undiagnosed Diabetes

Sirs, It's really both true and distressing reading the paper conclusion, at the beginn of third millennium: "A significant proportion of adults with undiagnosed diabetes have signs of nephropathy and peripheral neuropathy. These findings may influence policies about early screening for diabetes". Accordingly, type 2 diabetes is a major problem worldwide, perhaps a serious epidemics. Independent of different countries, in recent decades diabetes prevalence has increased rapidly over time among both developed and underdeveloped populations. Surely, genetic factors alone cannot explain these patterns. However, as allows me to state a 50-year- long clinical experience, (See website www.semeioticabiofisica.it, URL: www.semeioticabiofisica.it/constitutions.htm) an individual, without "diabetic AND dyslipidemic biophysical-semeiotic constitutions", can not be involved by type 2 diabets, at all (1-6). Certainly, rapid changes in lifestyle and risk factors such as obesity, unhealthy diets, physical inactivity, tobacco smoking, a.s.o., acting on people with "diabetic and dyslipidemic constitution" may cause, AT FIRST, Pre-Metabolic Syndrome, I discovered formerly (2, 5, 6), then, over years or decades, metabolic syndrome, IGT, and finally type 2 diabetes. In a few words, the war against diabetes mellitus and its well- known and harmful complications, as well as the war against all other serious and common human diseases, is nowadays possible, all around the world, exclusively by means of a primary prevention, which must be achieved at the bed-side, i.e., "clinically", on a very large scale, using the simple stethoscope. In other words, in both primary prevention and screening programme for whatever disease, including DM and its complications, and cancer, one needs efficacious "clinical" tools to obtain the best results. Really, early diagnosis must certainly be established in "asymptomatic" patients, who, for example, are evolving slowly towards diabetes mellitus, i.e. long time before disease onset, in order to avoid the well known, severe complications. In fact, to prevent these diabetic complications, including diabetic retinopathy, which initiate years or decades before diabetes onset, it is extremelynecessary that doctors use a "clinical" tool reliable in diagnosing early diabetes mellitus stages, from initial stages, i.e., biophysical-semeiotic constitutions, and then the Pre-Metabolic Syndrome (See www.semeioticabiofisica.itmicroangiologia.it,URL: www.semeioticabiofisica.it/microangiologia/Documenti/Eng/Premetabolic syndrome engl.oc) (1-6).

1) Stagnaro S., Stagnaro-Neri M. Valutazione percusso-ascoltatoria del Diabete Mellito. Aspetti teorici e pratici. Epat. 32, 131 1986 2)Stagnaro Sergio, Stagnaro-Neri Marina. Introduzione alla Semeiotica Biofisica. Il Terreno oncologico". Travel Factory SRL., Roma, 2004http://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. Ediz. Travel Factory, Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm 4) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. Una Patologia Mitocondriale Ignorata. Gazz Med. It. - Arch. Sci. Med. 144, 423,1985 (Infotrieve). 5) Stagnaro S. Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. [MEDLINE]. 6) Stagnaro S.-Neri M..Stagnaro S., Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabetemellito. Il Cuore. 6, 617, 1993, [MEDLINE].

Competing interests:   None declared