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Rare genital defects seen in sons of men taking major diabetes drug

science.org

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Re: Rare genital defects seen in sons of men taking major diabetes drug

#21

Post by giantg2 »

brenainn wrote: post #19
giantg2 wrote: post #12

Earlier quoted context omitted.

Wow, if they aren't suggesting dietary and exercise based solutions first, that's a huge red flag. Find a new doctor.

One of my scariest adulthood realizations is that doctors are like everybody else; fallible. And that being certified means you're good at studying, but doesn't always mean you're good at what you've studied. Not trying to discredit medical professionals or the amount of work they put in. I'm sure the majority are intelligent, conscientious and good at their jobs.

True, the field is vast. But I expect that a doctor should know the basics of a common condition. If they aren't counseling diabetics about carbs... wtf is going on? It would be different if it were a rare or complex topic, but even then the Epic system that most places use have standard printouts with information for patients.

Re: Rare genital defects seen in sons of men taking major diabetes drug

#22

Post by dominotw »

giantg2 wrote: post #12
hirundo wrote: post #2

Metformin is the first resort in diabetes treatment. If it proves to truly increase birth defects by 40% that may have to change. It was my doctor's first resort for me, but the side effects were too severe and I stopped it. He vaguely mentioned that it would help if I lost weight, but made no mention of what actually resolved my diabetes, a low carb diet. I hope that becomes the first resort. Apparently around here…

Wow, if they aren't suggesting dietary and exercise based solutions first, that's a huge red flag. Find a new doctor.

>Find a new doctor.

why would someone need to go to a doctor to tell them that

Re: Rare genital defects seen in sons of men taking major diabetes drug

#23

Post by mikeyouse »

giantg2 wrote: post #21
brenainn wrote: post #19

Earlier quoted context omitted.

One of my scariest adulthood realizations is that doctors are like everybody else; fallible. And that being certified means you're good at studying, but doesn't always mean you're good at what you've studied. Not trying to discredit medical professionals or the amount of work they put in. I'm sure the majority are intelligent, conscientious and good at their jobs.

True, the field is vast. But I expect that a doctor should know the basics of a common condition. If they aren't counseling diabetics about carbs... wtf is going on? It would be different if it were a rare or complex topic, but even then the Epic system that most places use have standard printouts with information for patients.

Of course they start with diet/exercise - but ask yourself how many patients you think take that advice… high blood sugar is a really serious problem and the unfortunate reality is that people are very resistant to lifestyle changes — so the least harm is often to medicate.

Re: Rare genital defects seen in sons of men taking major diabetes drug

#24

Post by refurb »

Gatsky wrote: post #11

> In the United States, prescriptions to 18- to 49-year-olds with type 2 diabetes grew from fewer than 2200 in 2000 to 768,000 in 2015. What the hell… that has to be a mistake? What is going on? Can poor lifestyle really cause this massive increase in young people with diabetes??

Treatment guidelines change all the time. Last time I checked metformin is now the the 1st drug therapy for type II diabetes and even "pre-diabetes".

It's basically "oh, your blood sugar might be an issue, let's start with metformin" where in the past it was "lets try a bunch of others things and just watch your levels for a bit"

Re: Rare genital defects seen in sons of men taking major diabetes drug

#25

Post by BurningFrog »

chiefalchemist wrote: post #6

> "...because tens of millions of people worldwide take metformin, chiefly for type 2 diabetes." In nearly all cases, T2 is preventable. That is, unlike T1, there are things an individual can do to not reach T2.

This is true for probably a majority of health problems in wealthy countries.

Re: Rare genital defects seen in sons of men taking major diabetes drug

#26

Post by refurb »

giantg2 wrote: post #12
hirundo wrote: post #2

Metformin is the first resort in diabetes treatment. If it proves to truly increase birth defects by 40% that may have to change. It was my doctor's first resort for me, but the side effects were too severe and I stopped it. He vaguely mentioned that it would help if I lost weight, but made no mention of what actually resolved my diabetes, a low carb diet. I hope that becomes the first resort. Apparently around here…

Wow, if they aren't suggesting dietary and exercise based solutions first, that's a huge red flag. Find a new doctor.

High blood sugar levels are doing damage right now.

Nothing wrong with starting on a therapy while trying to institute a diet and exercise change. The doctor would be negligent if they said "let's try diet and exercise", then after 6 months of damage say "nope, that didn't work, let's try metformin".

Re: Rare genital defects seen in sons of men taking major diabetes drug

#27

Post by robbiep »

hombre_fatal wrote: post #9

I only knew Metformin by name from HNers using it as an anti-aging wonder drug over the years: https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu...

It is also beginning to be prescribed by many of the subscription medication/doctor businesses that are springing up, powered by VC cash and looking to build strong forward flowing subscription businesses. Their model is:

- find areas that aren’t medically serious (speaking relatively, and in relation to life threatening - erectile dysfunction and male pattern baldness)

- run people through online questionnaires

- get an online subscription runner stamped by a doc on their payroll

- send out generic medications that they get cheap, package them nicely, and make bank on markup

- catch them on the next condition they roll along to

The last year I’ve seen a lot of them shifting into metformin (after finasteride and viagra/cialis) for weight loss

Re: Rare genital defects seen in sons of men taking major diabetes drug

#29

Post by ceeplusplus »

giantg2 wrote: post #12
hirundo wrote: post #2

Metformin is the first resort in diabetes treatment. If it proves to truly increase birth defects by 40% that may have to change. It was my doctor's first resort for me, but the side effects were too severe and I stopped it. He vaguely mentioned that it would help if I lost weight, but made no mention of what actually resolved my diabetes, a low carb diet. I hope that becomes the first resort. Apparently around here…

Wow, if they aren't suggesting dietary and exercise based solutions first, that's a huge red flag. Find a new doctor.

Prescriptions of diet and exercise are ineffective because many obese / type 2 diabetic people can't exercise self-control. That's why they're obese in the first place. It's way easier to take a pill than cut to 1500 calories a day for 2 years.

Re: Rare genital defects seen in sons of men taking major diabetes drug

#30

Post by nradov »

robbiep wrote: post #27
hombre_fatal wrote: post #9

I only knew Metformin by name from HNers using it as an anti-aging wonder drug over the years: https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu...

It is also beginning to be prescribed by many of the subscription medication/doctor businesses that are springing up, powered by VC cash and looking to build strong forward flowing subscription businesses. Their model is: - find areas that aren’t medically serious (speaking relatively, and in relation to life threatening - erectile dysfunction and male pattern baldness) - run people through online questionnaires - ge…

I expect those guys will start pushing SGLT2 inhibitors (gliflozins) next.
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