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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

#131

Post by orwin »

darawk wrote: post #117
lippel82 wrote: post #95

Earlier quoted context omitted.

From the artcile: "The numbers were small — 13 metformin-exposed boys were born with genital defects. But after the researchers adjusted for factors including parental ages and maternal smoking status, they found a 3.39-fold rise in the odds of a genital defect. “The rate per se was surprisingly high,” Wensink says."

Adjusting for confounders on an n of 13 is statistically ridiculous.

i'll call n the total number of patients. if n * 9 / 1000 = 13, you'll find out that n is around 1400, which is a pretty high number in discovery studies. Maybe not for diabetes though, i remember hosting anonymized data from a lot more patients two years ago, i felt this was THE subject all the medical founding was put into (that and air quality and its effect studies).

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

#132

Post by bschwindHN »

sp332 wrote: post #64
adewinter wrote: post #60

Earlier quoted context omitted.

You're saying that it's a guarantee that every single healthcare system (in the world?) will break down because of _sugar consumption_? Seriously?

Diabetes is really rough on the organs. Especially once the kidneys go, you need dialysis 3 times per week and the treatment takes hours. If a substantial fraction of the population needs that treatment, it's going to be rough. Plus the eye surgeries for glaucoma, and other kinds of organ failure.

> Especially once the kidneys go, you need dialysis 3 times per week and the treatment takes hours.

My grandpa went through this in 2020. He was a tough navy guy, and even he said "This is a half-assed way to live", stopped the dialysis, and passed away a few weeks later. Once you're on dialysis, there's not much of a chance of going back to a life without it.

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

#133

Post by rscho »

ImaCake wrote: post #119

Whatever your opinion on metformin this study is not really providing strong enough evidence to take seriously. No one should give it any attention, except the researchers who will try and do a better one next time and hopefully can prove/disprove this important hypothesis. The authors have done a lot of tests here. If you do enough tests, even on null data, you eventually get false positive results. Nevermind the ef…

The bonferoni correction is known to be overly restrictive, though. But yes, probably many more models were fit and results are questionable. The author will at least be able to claim a Science paper...

Also, adjustment of the p-value doesn't do anything to solve the flaws of hypothesis testing. But that's another debate entirely.

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

#134

Post by fleddr »

idorosen wrote: post #40
ceeplusplus wrote: post #29

Earlier quoted context omitted.

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.

It is a harmful stereotype to label obese people as lacking willpower as you have done. Many obese people don’t have the resources (time, money) or tools (nutrition understanding) to improve their situation. Many have metabolic or familial history of obesity which has both physical and psychological (normalization) impact on their ability to control their weight. The former can be helped with diet and/or medication,…

It's much more harmful to obsess over the optics of something potentially offensive at the expense of reality. None of the excuses you listed hold any ground.

Time: it costs about 20 minutes to cook a simple, basic fresh meal. With a single weekly groceries delivery (or visit to the store), you're covered for some 5-6 main meals as well as breakfast and lunch. Are you telling me Americans don't have 20 minutes to prepare a meal yet do have that time, or more, to eat out? I've been home cooking 6 days a week for 2 decades. It costs LESS time, not more.

The average American watches over 3 hours of TV, or TV-like experiences in their leisure time, but they don't have 20 mins to cook a meal? I guess they all get home from work and fall asleep?

Costs: Rice, potatos, bread, vegetables and lean meats...please do the math for me how this is unaffordable? They are incredibly cheap commodities.

"Most people in the US live in poverty".

Now they do not. The US is in the top 5 of median incomes worldwide, one of the richest countries in the world. If you dismiss Luxembourg and UAE, the USA is in the top 3. It's not a monetary issue.

Further, 12 hour work days are an anomaly, not a standard. And even 12 hours is not an excuse. Exercise isn't the core of the issue, junk food is.

Time needed to educate on nutrition: your parents or school should have done that, but here goes: don't eat garbage. Cut down on fats, sugars. Education completed. But it's not an educational issue as the person sitting in McDonalds knows exactly what's up.

It most definitely is a willpower issue as every other excuse does not hold ground. People in other countries have less time and less money, and still don't have this issue at this scale.

Please know that this is a not a burn at obese people, I fully sympathize with the difficulty of lifestyle changes, even more so in a culture like the US where the environment seems stacked up against healthy eating.

But we need to attempt to come to real and realistic root causes, and time and money are not the core issues. It creates this illusion that if only economic conditions would improve, we'd all be eating healthier, which is false.

The issue is cultural.

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

#135

Post by hypertele-Xii »

BoxOfRain wrote: post #120
hypertele-Xii wrote: post #111

Earlier quoted context omitted.

> I've lived in food deserts and I can tell you getting healthy food can be quite an arduous task, especially if you rely on public transportation. That's what food desert means. As in, no food. Therefore food must be imported. Therefore it's expensive. Sugar just happens to be a well-preserving food. The solution is quite simple: Don't live in a food desert.

>The solution is quite simple: Don't live in a food desert. For the people on HN who tend to skew towards wealthy white-collar work this is fine advice, but it's absolutely not possible for a lot of people from lower incomes. Not only can they not afford to move, they can't afford to leave their entire social support structures and build them anew.

Excuses. History is rife with entire peoples migrating to greener pastures. If they wanted to move and eat better, they would.

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

#136

Post by rat9988 »

carlmr wrote: post #115
lippel82 wrote: post #95

Earlier quoted context omitted.

From the artcile: "The numbers were small — 13 metformin-exposed boys were born with genital defects. But after the researchers adjusted for factors including parental ages and maternal smoking status, they found a 3.39-fold rise in the odds of a genital defect. “The rate per se was surprisingly high,” Wensink says."

>But after the researchers adjusted for factors including parental ages and maternal smoking status, they found a 3.39-fold rise in the odds of a genital defect If they didn't adjust for obesity, then it's really pointless to attribute this to the drug. Age and smoking status is not enough.

Why would you assume they didn't? They most likely did.

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

#137

Post by adrian_b »

arvinsim wrote: post #116
AmericanChopper wrote: post #80

Earlier quoted context omitted.

I would say it’s much more harmful to rationalize obesity as something that afflicts people according to their circumstances, rather than what it actually is, a direct outcome of a person’s intentional choices. It’s also quite harmful to dramatize the solutions out to be something unattainable to many people. They are attainable to all people. The healthiest diet I’ve ever eaten was also the cheapest diet I’ve ever e…

Nutrition and fitness are hardly a one-size-fits-all problem. To take an example, my self, I am doing intermittent fasting and do moderate intensity exercise everyday for at least 30 minutes(gym, cycling, bouldering, etc). No matter what I do, I still have a muffin belly.

I also believed that for many years, that no matter what I do, I cannot control my weight.

Until one day I began to both weigh myself each day at the same hour with a precise digital scale and also weigh or measure by volume all the food that I eat.

After that moment, I reduced my weight by 2/3 and I have maintained easily any target weight. Even now, after some culinary orgy I easily gain a couple of pounds in a day, but then, by eating only measured quantities of food, I lose them after a week.

The reason why I have failed to control my weight during many years and most people also fail, is that if you eat until you are satiated, then it is guaranteed that you will not be able to control your weight, no matter how much exercise you do.

If you measure what you eat and you only eat pre-planned quantities, it is trivial to reduce how much you eat until you see that the next day you weigh slightly less (e.g. 100 grams less). Then you must keep eating such quantities until you reach the target.

If you do not respect your plan and you eat random extra snacks or drink sweet beverages, then of course you have no chance to control your weight.

It is much easier to follow a plan when you eat less meals per day, because they can be larger. When eating small meals many times per day it is far more difficult to stop after eating just a little. It is much easier to not start eating.

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

#138

Post by AmericanChopper »

imtringued wrote: post #129
AmericanChopper wrote: post #80

Earlier quoted context omitted.

I would say it’s much more harmful to rationalize obesity as something that afflicts people according to their circumstances, rather than what it actually is, a direct outcome of a person’s intentional choices. It’s also quite harmful to dramatize the solutions out to be something unattainable to many people. They are attainable to all people. The healthiest diet I’ve ever eaten was also the cheapest diet I’ve ever e…

>a direct outcome of a person’s intentional choices. You mean like a politician promoting obesity inducing foods? If it is really about individuals then obesity shouldn't be going up in African nations that quickly.

No food is specifically obesity inducing, and you personally are responsible for everything you choose to eat, not a politician.

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

#139

Post by throwaway22032 »

BoxOfRain wrote: post #120
hypertele-Xii wrote: post #111

Earlier quoted context omitted.

> I've lived in food deserts and I can tell you getting healthy food can be quite an arduous task, especially if you rely on public transportation. That's what food desert means. As in, no food. Therefore food must be imported. Therefore it's expensive. Sugar just happens to be a well-preserving food. The solution is quite simple: Don't live in a food desert.

>The solution is quite simple: Don't live in a food desert. For the people on HN who tend to skew towards wealthy white-collar work this is fine advice, but it's absolutely not possible for a lot of people from lower incomes. Not only can they not afford to move, they can't afford to leave their entire social support structures and build them anew.

They also can't afford to eat shit and have a shit life as a result.

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

#140

Post by AmericanChopper »

arvinsim wrote: post #116
AmericanChopper wrote: post #80

Earlier quoted context omitted.

I would say it’s much more harmful to rationalize obesity as something that afflicts people according to their circumstances, rather than what it actually is, a direct outcome of a person’s intentional choices. It’s also quite harmful to dramatize the solutions out to be something unattainable to many people. They are attainable to all people. The healthiest diet I’ve ever eaten was also the cheapest diet I’ve ever e…

Nutrition and fitness are hardly a one-size-fits-all problem. To take an example, my self, I am doing intermittent fasting and do moderate intensity exercise everyday for at least 30 minutes(gym, cycling, bouldering, etc). No matter what I do, I still have a muffin belly.

If you want to lose body fat you need a caloric deficit, squeezing a caloric surplus into a smaller window of the day isn’t going to do anything productive. Intermittent fasting itself has absolutely no benefit, it can only be useful if the fasting routine helps you maintain a caloric deficit.
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