I’m an American who lived in China for 16 years. I basically grew up there, went to school there, worked there and even got married there (though it wasn’t to a Chinese).

I’ve lived all over the country and have had interactions with people from various ethnicities, socio-economic backgrounds, religions and in different areas of China.

There is no possible way for me to sum up what I think of “Chinese” people or the country itself, except that I feel it’s been downplayed as to how diverse it really is. In fact, I hate it when other foreigners say something is ‘typically Chinese’ or generalize…because they are such a diverse country. And sometimes I feel that Chinese nationals don’t even know or appreciate how genuinely diverse their country is.

Now that I’m back in the US, it’s very hard to explain to people what China is actually like or answer their many questions about life there. About the only things I can say that are general is: 1) There are indeed a lot of people; 2) Computer stuff is cheap; 3) Eating out is cheap; 4) Public transport is extremely cheap and very efficient.

Another observation I’ve had is despite all of its diversity and it’s huge population, somehow the government/businesses have managed to really streamline things for the most part. Just working in a Chinese company, my concepts of how to deal with a large volume of applications, paperwork and workload are much different than a lot of my peers here in the US. So when I did come back and start working for US companies, sometimes my managers would be shocked at how quickly I got so much done. Like they didn’t even understand it. Not to put them down in anyway. And occasionally I would even get in trouble for doing something differently than others and they would be like, “Why on earth would you do it this way? How did you even think of this?” but that was often before they could see the results.

But on the negative side of that, I had a hard time dealing with all of the personal needs of customers and the tailoring that a lot of Americans require. I’m using to dealing with a huge workload but that’s mostly uniform where people have chosen from a small category of options. I’m not as used to dealing with the incredible personal preferences of a handful of clients who can’t seem to make up their minds. In China, they don’t tend to give you a lot of ‘options’. And people don’t really expect them either. They tend to walk in when they want a service and already know exactly what they want. So it’s a much easier process of facilitating that.

It was a pretty effective strike

The details are trickling in and it does appear that Israel has had 20 damaged F-35s (They aren’t using the word destroyed) but a damaged F35 is as bad as a destroyed one for minimum 12–18 weeks

The Radar site is definitely destroyed

It’s why Israel has postponed their attack on Iran

However the attack will happen

Mostly they will use Drones and they will hit Iranian Top Military and Intelligence Brass with US Intelligence and surveillance capabilities

There was a great thread by Glenn Luk as usual, responding to this article. But more on that, there was a great supplementary thread by David Fishman, who succinctly highlights the issue of interpreting China by using three anecdotes he scraped together:

In elite control societies, what often goes dismissed are the experiences of the common person. This is especially true of the US where “middle class” has represented the top 10% of US society for decades— cue the many complaints of “middle class” houses in Hollywood films that are nothing short of multi-million dollar McMansions. The same can be said about the more liberal Chinese takes on China. I for one know the mood among the high performers of academia China. It is not the greatest, though I must say, I have been quite uncomfortable being in so many BMW SUVs (ostentatious wealth not really my style).

The reason why I do not share in these dour takes on China is because of my paternal family and the fortunes of people from back from the village. I know where those family members come from, what kind of temperament they have, and especially what they have nowadays. Back in 1998, we rode in a cheap knockoff sedan sporting a false police siren (to speed on country roads), driving over half paved, half dirt roads just to get to our T5 city. Ever since, I have watched them get far wealthier. Today my elder cousin does better than me; he owns 3 properties in a T1 city and rents two of them out for a very pretty penny, while I struggle as someone in the top 5% of the US to actually buy a cheap house ($850k) in the place I grew up. The difference between my cousin that is younger by a year and my other cousin who is graduating from undergrad this year is night and day; the former has moved to the US and lives a great life but had to be top of her class to do so, while the latter is pretty much the definition of academic mediocrity. Even so, her mentality bears all the hallmarks of polite urbanite (while I remember the former offering me a beer back when we were 13, as no one cared out in the sticks). That former cousin grew up in that T5 city, the latter cousin is basically a T1 city girl; both, it seems, can do quite well for themselves despite the wide gulf in effort. Hence, people who tell me that China is terrible for everyone but the elites are only going to get the stinkeye from me— it’s like they don’t even care that my family exists.

The pattern I’ve seen in a lot of the anti-China reporting is that they pay attention to only the elites. Keep in mind we are only talking about those reports from people who seem like they know what they are talking about, either because they have Chinese names or they actually bother going to China. On the surface, this is a remarkable step up from the typical “China expert” who knows no Chinese and hasn’t ever visited. Unfortunately this step up seems to be what is selling authenticity today, when in fact it is just clearing a minimum threshold of “not 100% fantasy.”

I have said this time and time again, even all the way back to random comments in 2015 or so: China is insanely complex. Its size should humble all who engage. When I hear about a foreigner who has stayed for 15–20+ years in China, I will usually go “wow, you must have a lot of insight!” But make no mistake, that’s not me calling them a China expert, that is me expecting that they have some very narrow experiences that strike very deep and true, and that I will be able to glean some insights on a tiny sliver of China through them. Most people of that degree of stay in China are likewise humble and know that we all are just in the business of exchanging very narrow and specific slivers of China. To those observing, particularly neophytes to the experience that is China, this subtext may go unnoticed.

David Fishman is a valuable resource. He has tons of stories from people he can reach on the streets. But I know better than to expect him to really know Chinese governance; he has little in the way of penetration into the government track lifestyle. He is also white, which means he won’t have the perspective of someone who can blend into the streets and watch China the way a Chinese person can. There are always limitations to one’s China experience, which is why we all fan out in our information gathering through guanxi (connections).

Yes, there are a lot of blatant lies about China. But just because they exist, don’t get complacent when someone comes by with experience or a Chinese name and starts generalizing. Specificity is the name of the game; pity that most Chinese people don’t feel safe sharing specifics. This is often the reason why you have to hit the streets and make your own guanxi. First, build trust, then get specifics. You never know when someone is withholding information from strangers but not their guanxi network.

But just to highlight, driving back to that T5 city from the T1 city took generally 2 hours in the late 90s. It was unwise to do after a rain as the mud would likely have made the roads unmanageable. In the late 00s, that drive went down to 1.5 hours; the road at the outskirts of the T5 city had massive potholes that you could not evade and would require cars to go at most 5 km/h. In the late 10s, I don’t recognize most of the city anymore. I don’t remember seeing any donkeys driving carts anymore, only the standard blue motor trike at the very bottom end. I can barely estimate that the town square that felt so hollow and eerie at night in the 00s (due to all of the empty concrete apartment shells, lack of lights, and echoing) was now a park with big trees and plenty of amenities.

Remember, T5 city! Where those pink trees are was generally where a line of stores were, and back in the 00s one of those stores sold crappy CRT TVs. One of them played Shrek in Chinese dub, which captivated some 20-ish children as onlookers. I joined them as I was bored then. Everything now is unrecognizable.

Anecdotes aren’t that powerful, but they can serve as smell tests for the kind of China headlines that pander to American audiences. The more you have your own experiences to look back on, the more you too can be immunized to bold but bad China takes. Because the sad reality is, it is just too easy to lie about China, and even the truths are not that good either!

The truth: China desperately want to become friend with US, however, US sees China as a threat and want to see China lose.

Lived in both countries, what I’ve observed is in China, everyone (including main stream media like CCTV) is talking about US being the best country:

• the higher level of democracy
• the innovation
• hollywood movies, hot actors / actress
• advanced technologies, respect for skill and knowlege…
• the list goes on…

When I actually get here, I’d say some of these high reviews are true, but overall it’s probably overrated.

Then when I start to read news on CNN, Fox, NY Times, I see lots of negative news about China.

• food imported from China are poisons
• Chinese constantly steal US intellectual property
• in China everything is about building connections, just having the skills will fail you in China
• Chinese government tortures minority
• China ‘bully’ neighbouring countries.
• … and the list goes on

Non of these are true – I’m not saying China is a perfect country, it’s far from perfect, but the real issue in China was never cared and covered by western media. All these news is designed to make people hate China.

Oven Swiss Steak

Yield: 6 servings

Ingredients

• 1 (1 1/2 pound) beef round steak, cut 3/4 inch thick
• 1/4 cup all-purpose flour
• 1 teaspoon salt
• 2 tablespoons shortening
• 1 (16 ounce) can tomatoes, cut up
• 1/2 cup finely chopped celery
• 1/2 cup finely chopped carrot
• 1/2 teaspoon Worcestershire sauce

Instructions

1. Cut meat into 6 serving-size portions.
2. Combine flour and salt; with meat mallet, pound 2 tablespoons of the mixture into meat on both sides. Brown meat on both sides in hot shortening.
3. Transfer meat to a 12 x 7 inch baking dish.
4. Blend remaining 2 tablespoons flour mixture into pan drippings.
5. Stir in undrained tomatoes, celery, carrot and Worcestershire sauce. Cook and stir until thickened and bubbly; pour over meat.
6. Bake steak, covered, at 350 degrees F for about 1 hour or until meat is tender.

China’s first photonic chip pilot line opened in Wuxi leading the industry to take off

On September 25, at the 2024 Integrated Circuit (Wuxi) Innovation and Development Conference, the first photonic chip pilot line in China built by the Wuxi Photonic Chip Research Institute of Shanghai Jiao Tong University was officially put into use. This marks that photonic chips have officially entered the fast lane of industrialization, which will break through the limitations of computing paradigms and bring new imagination space for large-scale intelligent computing. A glorious era for photons is about to begin.

Photonic chips are the core of the new generation of information technology. They can meet the technical needs of transmission, computing, storage, and display in the fields of artificial intelligence, Internet of Things, cloud computing, biomedicine, etc. in the new round of scientific and technological revolution. They have become a new driving force for economic growth and an industrial highland for global competition.

The pilot platform has a total area of ​​17,000 square meters, integrating scientific research, production and services. It has complete supporting facilities and is equipped with more than 100 world-class CMOS process equipment, covering the full closed-loop process of thin-film lithium niobate photonic chips from lithography, thin film deposition, etching, wet process, cutting, measurement to packaging.

The platform also takes into account other material systems such as silicon and silicon nitride, builds N special process platforms, and forms a leading “1+N” advanced photonic device innovation platform. It can not only provide full-process technical services for universities, research institutes, and innovative enterprises, but also incubate photonic industry projects, efficiently link with industrial funds, open up the complete chain from product research and development to marketization, and accelerate the commercialization of scientific and technological achievements.

The pilot platform will not only accelerate the flywheel effect of technology iteration, promote the continuous optimization of process flow and the improvement of product innovation capabilities, but will also touch the technological frontier at an unprecedented speed, solve the long-standing structural contradictions between the innovation chain and the industrial chain, and ultimately achieve breaking up the obstacles in technology and industry.

The successful completion of the photonic chip pilot line is a vivid epitome of the cooperation between the university and the local government to achieve industrial breakthrough.

In 2021, City of Binhu introduced Shanghai Jiaotong University to establish the Shanghai Jiaotong University Wuxi Photonic Chip Research Institute project. The pilot line officially started construction in December 2022, the structure was capped in October 2023, and the first batch of equipment entered the site in January 2024. After intensive equipment debugging, it was officially put into use in September 2024. This landmark of the lake bay has achieved a leap from idea to physical implementation in an almost unrivaled manner. The physical structure was built according to the “Green Building Three Star” standard, and achieved key features such as anti-micro-vibration, constant temperature and humidity, and ultra-cleanliness to provides first-class guarantee for the R&D and production of photonic chips.

Now, walking into the nearly 6,000 square meters of high-grade micro-nano processing clean room of the photonic chip pilot line, people can see equipment neatly arranged, and technicians in clean clothes skillfully operating various equipment and observing the operating conditions of various product parameters.

The 9-meter-high first floor is divided into three floors, with the main equipment on the middle floor. In addition to the pipelines for supplying gas and chemicals, the invisible upper and lower mezzanines are also equipped with fresh air systems to transport clean air and maintain positive pressure in the room, which is then exhausted to the outside through the ventilation holes, so that the cleanliness level of the workshop reaches the 100, 1,000, and 10,000-level standards.

The world-class hardware, the leading domestic precision equipment, and the complete closed-loop control of the process are the three core elements supporting the industrialization of photonic chips. This pilot line is in line with the top-level planning and has reached international standards. After the pilot line is officially put into use, the annual production capacity is expected to reach 10,000 wafers. In the first quarter of 2025, the PDK will be officially released, and external wafer flow services will be provided.

Currently, the whole world is committed to solving the iteration problem caused by the lack of computing resources. Optical quantum computing is not only backward compatible with related technologies, but its theory and framework also enable exponential computing power that is endless. However, due to the lack of matching hardware systems and the immature industrial chain for landing products, optical computing and quantum computing cannot be commercialized. Currently, the world is starting from the same starting line, which provides China with an opportunity to surpass in technology.

The institute will focus on 6/8-inch thin-film lithium niobate wafers and thin-film lithium niobate modulators to overcome the engineering and technical challenges faced by the industrialization of thin-film lithium niobate photonic chips, develop wafer-level chip mass production processes, and achieve large-scale mass production of thin-film lithium niobate photonic chips to meet the high computing power needs of artificial intelligence development.

The Wuxi Photonic Chip Research Institute of Shanghai Jiao Tong University will continue to be a leader in new-quality productivity, continue to explore cutting-edge technologies in quantum science and technology and common key technologies, and rely on the photonic chip pilot line to carry out a three-in-one strategic layout of “platform + incubation + fund”. Focusing on new-generation information technologies such as core, light, intelligence, and computing, it will carry out scientific and technological achievement transformation and incubation and investment in entrepreneurship, explore new paradigms for the incubation of hard technology innovation, and help Binhu District and even Wuxi form a world-class photonic innovation ecosystem with clustered and large-scale development.

About a month ago, there was a noise complaint at the neighbor of my brother’s home.

The police arrived. My brother went over because his 11 year old son was there and wanted to ensure his son was okay. The police arrested my brother, charged him with resisting arrest, assault on an officer, aggravated battery on an officer.

These charges carry a two to twenty year prison sentence.

When I asked my brother what happened, he told me that the charges were made up. He asked about his son, the officers (3 of them) engaged him and decided to put him in the squad car. He never touched anyone. He never resisted. Because of the charges, he has no bail, and the bond hearing was set for a month out.

I asked, “Were the officer’s bodycams on?” He replied, “No.” They said all their cams were off.

I thought to myself. “Oh shit.” Then I replied, “Okay, sit tight, I’ll get you a lawyer.”

But to be honest…without any camera footage, my brother was cooked.

Now. I love my brother, and I know his character. I know there was no way he attacked three police officers. To be honest, if he did, they’d just shoot him. He’s a big black guy who spends a lot of time at the gym. No one would have challenged his death.

But, that’s not who he is. However…SOMETHING must have happened, right? It couldn’t be that he just walked up, the police then put him in the car and charged him. That’s not real.

2 to 20 years in prison. Three officers are saying he attacked them. Aggravated Battery on a police officer. All of this was a month ago…labor day weekend. No video evidence, so it’s their word and his. He’s so fucking cooked.

But wait. Remember the part where I said my brother walked over to his neighbor’s house?

The neighbor’s ring door camera activated, and his lawyer has not one…but three videos from ring cameras and security cameras covering the entire event.

You know what actually happened? Well, I’ll say it this way. As soon as the lawyer told the prosecution that they had camera footage from the ring camera, the prosecution dropped the assault and aggravated battery charge immediately. They downgraded the resisting arrest to a misdemeanor and gave my brother a 50,000 bond, which we immediately posted. They also added another charge (a misdemeanor), and handed the entire case from the felony prosecution to the misdemeanor prosecution who wanted to settle. My brother’s lawyer said…”No.” We want this fast tracked to trial. You’ve only seen one video. I have two more. The footage shows my brother walking up to the officers, them having a very normal conversation, and when my brother asked for his son, the officer told him “No.” My brother continued to ask, and the officer put him in cuffs and put him in the car for “protection of the officers.” That was it. No one even raised their voices.

Now. Because this is still in flight, and my brother has plans to sue for wrongful arrest or something…which he’ll lose, I won’t say which department this is, but will post all the details after the case and suite are done.

But here is the thing. Do you know what happened to the three police officers who made up the assault and aggravated battery on a police officer charges with the up to 20 year prison sentence?

Nothing.

Do you know what would have happened to my brother if those ring cameras didn’t kick in? I’m guessing he’d get about 7 years. What’s your guess?

That’s the definition of a police state. They can just make something up to throw you in prison…and in the 1 in a 1000 chance you are able to prove your innocence, nothing happens.

I still nearly tear up at the thought of how close he came. He’s a father of 4 who works for Mitsubishi building generators as a supervisor. And he nearly lost his freedom…for what. I yelled at him “You know never to engage with the police. You know better you fool.” All he could say is…”but my son was over there.” 30K for a lawyer (gone). 5K for the 50K bond (gone) all because you approached police.

I’ll update the results when I can. But more than likely…nothing will happen.

I’m pretty sure Grandpa killed my cousin’s abusive ex-husband.

The ex ticked all the psycho boxes: he was physically, sexually, and verbally abusive. When my cousin finally started the divorce proceedings and got a restraining order, the ex repeatedly violated it. He’d make numerous harassing phone calls daily, show up at her workplace, and was arrested a couple times for trying to force his way into her house. Somehow he’d always make bail and within 24 hours or so be right back at it.

Shortly after the divorce was finalized and she got 100% custody of their son, the psycho broke into her home while she was at work and trashed the house. He left voicemails threatening to kill her. My cousin came and stayed with us for awhile so she could make arrangements to move and would not be home alone.

One day the calls stopped. She stopped seeing his truck around town. My cousin was still scared, it was not like him to just stop, and she figured he had gotten arrested, and would soon be out and back at it again. She said words to that effect one morning at breakfast. There sat Grandpa, reading the paper, with a cup of coffee and a Pall Mall Red. Without looking up he just said, “He won’t bother you again.”

And he didn’t. Going on twenty years and no one has seen or heard of the psycho ex. Grandpa knew something we didn’t, but he died in ’05 so he ain’t telling.

EDIT: to address some of the comments without posting repetitively, I suspect Grandpa got rid of the ex. I do not know if her ex is alive or dead. I don’t know for sure what, if anything Grandpa had to do with it. All I can say for sure is he said the ex wouldn’t bother her again and he hasn’t. Wouldn’t put it past the old man to have done his own problem solving though.

There are several major lies that are all equally current:

• China is planning to invade Taiwan.
• China is oppressing the Uyghurs in Xinjiang (genocide, forced labor, concentration camps, etc.).
• China is oppressing the Chinese people in general (Xi Jinping is a dictator).
• China’s economy is a disaster (property market, youth unemployment, demographics, etc.).
• China can’t innovate; it can only steal IP.
• China is debt-trapping African countries.

When I was eleven years old, a friend drowned while swimming alone at a local lake. He was alone because I had persuaded a mutual friend who was supposed to go with him, instead, to come visit me at my house, because I was grounded from leaving the house, but I could have a friend come over.

Denny’s was the first funeral I remember attending, and I walked into the funeral home alone. I was terrified and overcome with remorse and shame. Not quite knowing what to do, I slipped in the back and sat in the first chair I saw with no one near it.

Almost immediately, Denny’s mother came over and sat next to me. She said, “This is not your fault. You did not kill Denny. Tragic accidents happen all the time, sweetheart. Don’t carry this through your life. If you do, that will be a tragic accident too. When you leave today, leave any guilt you might feel right here so that we can bury it as well.

Then she hugged me while I cried. I did exactly as she said. And I have never forgotten the witness of her grace.

I think a lot of it is because China sees little reason to support western countires who are almost universally taking antagonistic attitudes towards China. And what has China done. Basically it has just done better than the west. Funny thing is this is not new. It is repeated time and time again in history. Back in the 19th century the European invasions of China were brought about because the Western world wanted Chinese goods, but there was little that the Chinese wanted from the west, and so the British becaome the biggest drug cartel in the world, effectively forcing opium on the Chinese the same way drug dealers do it today, and then selling to those people. The Chinese government was too weak to do much against it, but at least were able to prevent the west from conquoring China (unlike Inida). Also during the 19th century, Chinese teams working on the American railroads were able to accomplish tasks other teams could not accomplish and were always more productive. For thier good work they were effectively presecuted by vigilanties. This is something that has happened to the Chinese diaspora throughout history. So similar to what has constantly happened to the Jews.

In part because the west is trying to isolate China. and doing western leadership constantly attempts to destroy China, China appears to feel that it is better to build relationships with the 90% that make up the rest of the world, and it has an added benefit in that doing this is economically better given that products and goods from those countries are less expensive than western countries. At the same time it gives Chinese the opportunity to now produce final products and sell them under Chinese brands, so the profit it much greater, and the dependence on the west is greatly reduced. These countries have proven to be a lot more appreciative of the Chinese, and why not. The Chinese products are so much cheaper than the western products, the Chinese are not buying lots of agricultural products from them, Chinese companies are also selling farm equipment at a fraction of the cost of the west to them so that they can be increase production, building factories in the countries (something the west never did to any extent), and significantly helping them build much better infrastructure in the countries. It is a big win for China, and a big win for those countries that struggled so long under Western imperialism and colonialsim and then Western neo-colonialism.

People talk about how China is so hated by the international community, but that is not the international community but the collective west.

China is learning that the doublespeak “International” community (the reality the collective west) is never going to be a friend to China, maybe because the Chinese are not white and have more power. It is much better to get the rest of the world to be with you, and isolate the west so that they can no longer do you any harm. Russia is learning the same lesson because the white people of the west also consider them untermensch. All the better for China.

And to make matters worse for the west the tactic they used in the 19th century will not work in the 21st century, that of forcing China to turn around, bend over and pull down its pants. As proof of this just look how dangerous is will be for the US Navy to operate within well over 1000km of China. This is proven by articles that admit the the F35 does not have enough range.

https://theaviationgeekclub.com/hasc-report-finds-that-f-35c-lacks-the-range-to-strike-enemy-targets/

China is now a regional hegemon. Its military can stop dead any attempts to intimidate China. They US is fuming. Nothing it does or can do against China works.

Western imperialism is closely linked to nationalism, racism, white supremacy, and Eurocentrism (America-centrism).

Should people follow the nationalist incitement of their governments and go to kill each other? No!

So-called patriotism, nationalism and chauvinism have always been the gravediggers of the proletariat.

Don’t forget that beyond these claims, there is communism.

Humanity is facing a series of serious problems, namely an insurmountable economic crisis, continuous wars, xenophobia, the impoverishment of the working class, and the destruction of the earth’s ecology, all of which cannot be solved by nationalism.

If we fall into the trap of nationalism, the entire human race will be destroyed. 200 million people died in endless wars in the 20th century alone.

Only by overthrowing this development model in this society can humanity escape this barbaric dead end. This is the message that the working class, especially the younger generation, wants to send to social movements in other countries.

• In Japan, protests against the explosion and radiation effects of the Fukushima nuclear power plant have been one after another, and there is growing anger about the impact of the economic crisis.
• In the United States, there have been a series of strikes by workers to protest against their incredible exploitation.
• In many other countries, we can cite many examples, such as the Arab Spring, Spain, Greece, Bangladesh, etc., where the working class has been massively fired, unemployed and impoverished, and the pressure of work has been increasing.

The solution to so many problems is not nationalism in collusion with the state, but the Class struggle.

We cannot rely on the brutal burning of stores and production bases belonging to “foreign competitors” or calling for a boycott of foreign competitors’ goods to sanction opponents or overcome the crisis.

We need to unite the camp of the working class and then oppose another class camp with our class camp, rather than a conflict between countries.

Our slogan is still: the working class has no motherland and no borders!

We must inherit this internationalist tradition and break the shackles of nationalism.

The rulers want our young generation to swallow the nationalist pill, that is, the rulers threaten each other every day and launch propaganda for war. But we must firmly put forward our different proposals – Class struggle.

Only in this way can mankind not usher in the Third World War and not perish.

He was brought to the ER in cardiac arrest. Feeble pulse, BP not recordable, he was connected to a ventilator.

He is your old case, the resident reminded me. I look at him. A flashback appears

–

Flashback

Despite my poor face-recognition software I remembered our last conversation.

‘Doctor, I stopped the medicine you gave and started this new ayurvedic medicine for diabetes, which I came across in Google search. I started it, now 3 months, and see the lab results, they are perfect’ he threw the lab test results on my table diffidently, with a look of someone who won a boxing match without a single punch. ‘And no side effects by the way’ the sarcasm was clear in his voice. Years of medical practice endowed me with the non-stick ‘mental coating’ that make me smile.

‘I am not the manufacturer of pills, and I don’t gain or lose by your choosing to take a pill’ I silently remind myself.

But yes, his blood sugar values were normal.

–

Fact Check

Diabetes is elevated blood sugar, and we know its consequences. Blood vessels, from heart to brain, from eyes to kidneys tend to get blocked in diabetes; leading to stroke, heart attack, kidney disease and loss off vision. But why does it happen? That’s still not clear, even if you read through every line of the 1250 pages of the latest edition of Joslin’s Text Book of Diabetes. Today we know that diabetes comes with a host of conditions like obesity, hypertension, low HDL and elevated triglyceride (known as metabolic syndrome) and could all be partially responsible for the development of vascular complications of diabetes.. Discovery of hyperinsulinemia (increased insulin levels) as the prime driver in type 2 diabetes has added a new dimension. The present understanding is that diabetes is a biochemical orchestra gone wrong, and high blood sugar may be just one single player. Reprimand him, throw him out, but your orchestra still doesn’t improve.

A study published in Lancet show that in a diabetic lowering of blood pressure and LDL cholesterol gives significant reduction of cardiovascular events but the quantum of benefit of lowering sugar is far lesser and has a J curve (more lowering may actually harm; even in the normal range).

A recent Swedish registry data published in New England Journal of Medicine shows that in a diabetic, lowering of blood pressure, LDL cholesterol, and stopping smoking along with blood sugar control conclusively prevent a heart attack, while only control of blood sugar doesn’t.

A researcher has aptly commented that ‘Diabetes is a cardiovascular disease with elevated blood sugar’. Control blood sugar, you could still be in danger.

–

The FDA now insists that all diabetic drugs should prove benefit in terms of cardio-vascular event reduction in large trials to be eligible for approval for treatment of diabetes. Mere sugar lowering won’t do.

–

I could see the big picture, at least a part of it. At least I knew that our knowledge is shallow. The myopic man, contended with a normal blood sugar value, lying helplessly still, connected to a host of tubes and a beeping monitor was blissfully unaware.

–

I don’t build my house myself; I trust the architect. I don’t stich my shirt, the tailor has my confidence. I believe that the local taxi driver knows roadblocks better than Google.

Funny that we all believe Google more than our doctor.

Not funny for the sobbing relatives, sitting outside the ICU praying for him to get well.