We need to rethink the manner in which we treat obesity related Diabetes Mellitus Type II. The 35-year-old patient in the video had yeast growing over his penis because of uncontrolled hyperglycemia (high blood sugar). His random glucose blood level was 380 mg/dL. He weighed 70 pounds over his expected normal maximum weight of 182 pounds. Exercise and weight reduction are the best therapies available to this patient. A licensed dietitian can guide him but is not readily available in the community. Dietitians are hospital based and are expensive. I should be able to write a theoretical diet prescription for this patient that would read as follows. Patient is to be on a 1,500 Calories per day (24h), which must consist of Protein, 2 grams/kg/d (70 grams of protein equals about 280 Calories), glucose 160 grams/day (640 Calories), and the rest of high value fat that must include 3% linoleic acid and 1% linolenic acid of the daily caloric intake. Linoleic and linolenic fatty acids are the n-3 and n-6 fatty acid series or Omega 3 and Omega 6 essential fatty acids. A high fiber diet must be incorporated into his diet as well as a multivitamin and probably Omega 3 and Omega 6 supplements. The appropriate minerals and rare elements must be included. If patient has gout, his protein intake may be reduced accordingly but not to less than l gram/kg/day. Since the "protein intake of 0.8 g/kg/d meets the requirement in 97% of the adult population," the body would adjust to a lower glucose intake, perhaps 100 grams per day, in order to reduce hyperglycemia (blood sugar). The body can readily convert the extra protein to glucose as it sees fit. This area is highly complex and no person should diet without the proper medical supervision. We could humanely study diabetics in our jails by giving them specific diets. An ethics committee must guide it. The inmate must not be forced to participate but encouraged to do so by giving him or her "bonus points" or by offering special non-meal related activities. The food would be provided to the patient by a nutritionist who would closely monitor his progress. If this patient were to be maintained on this diet, he would lose over 5 pounds per month. His diabetes would be quickly controlled without the use of dangerous and often toxic drugs. Society must become inventive when addressing the problem of obesity and diabetes. Why could this theoretical diet quickly control his diabetes? Carbohydrates are converted to a limited amount of glycogen. The excess carbohydrates are converted to fat. Fat cannot be converted back to glucose. Protein, however, can be converted to glucose and the body naturally does it in the fasting state. Glucose is the brain's preferred energy source (about 120 grams per day) while certain tissues, i.e., the bone marrow cells, eye tissues and peripheral nerves, cannot metabolize fatty acids and require glucose (about 40 g/d). We need to develop new ways of confronting our obesity problems or we can simply let people take dangerous drugs and have the surgeons continue to perform costly, invasive and unsafe bariatric surgeries. In the video, you can see yeast growing on the man's penis (as if his body had become a yeast culture). This reflects his poor health status and relatively immunocompromised state. The drug companies see obesity and its related complications, i.e. diabetes and hypertension, as a financial bonanza. Consider Pfizer's Exubera® (an inhaled insulin) that can cause reduced lung function. Before taking Exubera®, patients must have their lung function checked prior to inititiation and thereafter at specific intervals. Does it make sense to take Exubera® when we have better and safer options? Exubera® can cause reduced lung function (lung damage), shortness of breath, cough, bronchospasm and what else? I will be getting more data from the FDA in regard to Exubera®. In regard to the video, you will notice the large cancer, Basal Cell Carcinoma. I first treated it with liquid nitrogen in order to reduce the bulk of the cancer. Later, I excised about 2/3's of the cancer as shown. In two weeks, I will excise the rest and make sure that the margins are clear. The text in the pictures is important and will greatly accelerate your medical learning. In regard to neonatal jaundice, I will be addressing this topic on my next video. Alcoholism is a big problem. When a drunk "chooses" to drive, he puts at risk his life as well as the lives of many innocent people. In the video you will see a terminally ill patient with cirrhosis, ascites and encephalopathy (brain disease) due to alcoholism. Alcoholics, too often, have an ugly death. Many usually die alone. Luis Lomeli MD/Beta