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

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

#141

Post by adrian_b »

bsder wrote: post #88
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.

> 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. Research continues its trend against this statement. 1) One problem is the fact that the number of fat cells in the body is conserved after some point. So, if you grew lots of fat cells as a child, sucks to be you, you're now stuck with them as an a…

I agree with a part of what you say, e.g. that exercise is almost useless for weight loss.

I know these theories about the number of fat cells and about their slow replacement, etc. Nevertheless, they do not match my experience.

I have been obese during about 15 years. Then I began to measure precisely the quantities of food that I eat and after almost a year I reduced my weight to only two thirds from that of the previous year. Since then, another 15 years have passed, during which I controlled easily my weight, also by eating most of the time only carefully measured quantities of food.

During my weight loss, I was concerned about possible problems, precisely because I had also heard these theories about the fat cells that you have mentioned.

However, I have not seen any evidence for them. Before losing weight, climbing stairs was difficult, it felt like carrying a huge backpack, and I could not even see my lower body due to my belly.

After losing weight, not only all physical activities became easy, but even if there was a very large reduction in waist circumference, so initially the skin remained rather loose, after not a long time it adjusted, so no signs of the former size remained.

There were no problems whatsoever caused by the weight loss, but I had to retain forever the habit of eating according to a plan, because any day when I eat outside the plan, I immediately gain weight.

If you do not eat enough food to keep alive all your cells, some cells must die (after you have already consumed most of the internal energy supplies stored in fat). It is very unlikely that your internal regulation mechanisms will not ensure that the unused fat cells will die before cells that are in active use, e.g. muscle cells. So that theory about the constancy of the fat cell number can be true only while you are still eating some excess food or while you have not lost most of the fat reserves yet.

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

#142

Post by ianai »

golem14 wrote: post #121
pxeger1 wrote: post #112

Earlier quoted context omitted.

I think it means the genital defect is normally rare, but is much more common in these kids?

Even .24% isn't that rare. From NIH.gov: "In the United States, a rare disease is defined as a condition that affects fewer than 200,000 people in the US."

That works out to 6.0341E-06%

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

#143

Post by watwut »

nradov wrote: post #52
ecf wrote: post #38

Earlier quoted context omitted.

It’s an extremely sad situation and will guarantee every single healthcare system eventually breaks down.

Why was this down voted? You're not wrong. Regardless of whether we have a private or socialized healthcare system, we simply won't be able to afford to continue delivering high quality care to everyone with chronic conditions caused by bad dietary choices and sedentary lifestyle. The resources just aren't there so we will increasingly have to ration care.

All in all, we eat and live in a more healthy way then generations before.

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

#144

Post by carlmr »

rat9988 wrote: post #136
carlmr wrote: post #115

Earlier quoted context omitted.

>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.

From the quote it says they only adjusted for age and smoking.

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

#145

Post by dhmallon »

rscho wrote: post #133
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.

I believe it was published in Annals of Internal Medicine (impact factor of ~4). The link is to a news article in Science discussing the paper.

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

#146

Post by antattack »

dmix wrote: post #100
based69 wrote: post #78

Obese women’s offspring have double the risk of hypospadius, and women having babies after 40 have 4x the risk of hypospadius. Metformin is a drug that men are probably 100x more likely to be on at 45 vs 25. Therefore men on metformin are far more likely to be reproducing with older (and likely obese) women. I’m not saying this explains all the correlation, I’m just saying if the study doesn’t really make a good effo…

The 90 day window for taking the drug and seeing an impact is in the studies favour though. > the researchers saw no effect in offspring of men who took the drug earlier in life or in the year before or after the 90-day window of sperm production. “It really has to do with taking it in that window when the sperm … is being developed,” says senior author Michael Eisenberg, a urologist at Stanford Medicine.

If that is the case (90 days makes a difference in outcome) why even adjust for age and smoking?

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

#147

Post by BoxOfRain »

throwaway22032 wrote: post #139
BoxOfRain wrote: post #120

Earlier quoted context omitted.

>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.

Exactly, the notion that the poor are poor because they're inherently feckless and therefore deserve their poverty is an idea that's long past its sell-by date. These are the systemic issues of our day, and they won't be solved by sneering at the people affected.

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

#148

Post by msrenee »

belorn wrote: post #107
mensetmanusman wrote: post #28

It’s sad seeing the crazy downstream multigenerational damage that massive sugar consumption is causing as obesity rates reach 50%. Good luck future humanity.

From what I recall reading about epigenetics, diabetes is caused by a too fast change in diet towards high calorie. After several generations the metabolism thriftiness goes down if the diet level remain the same, and thus diabetes rates will go down. Same concept happens in reverse when there is periods of famine.

That's quite a claim. Do you have some sources for that?

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

#149

Post by ch0I9daAiO »

robbiep wrote: post #48
freedomben wrote: post #34

Earlier quoted context omitted.

Do you see this as a bad thing? As someone who doesn't have any insurance, I'm extremely grateful for these. I don't want to have to go through the current medical racket where unless you pay a doc $300 you won't be allowed to purchase the medication you want. And then of course there's the follow up appointments, a "med check" where they can bill you $150 every 90 to 180 days just to hear you say, "yep, things are f…

In responding to your example first - to start with, I live and practice in a country where it isn't a choice between healthcare and food on the table. Beyond that, I believe that it is a basic human right to have free healthcare. The next bit is a bit more complex. I don't think it is right or sensible to advertise medications to people directly. The US is almost alone amongst industrialised/western countries in hav…

For finasteride I agree, as it decreases DHT, which is not exactly a useless hormone. It shouldn't be prescribed to anyone, as you have said. I don't necessarily agree for the Viagra/Cialis. Generally cialis is safer than viagra, with less side effects. But their mechanism of action is quite simple and doesn't cascade to a lot of other body functions, inhibition of PDE5. Viagra also inhibits PDE6 more, thats why you get a blue-ish tint to your vision, and PDE1, which is more dangerous and can cause tachycardia. Cialis inhibits PDE11 more, which affects skeletal muscles and the prostate. That's why Cialis is sometimes prescribed for BPH, and why bodybuilders take cialis as a supplement (drive more blood into the skeletal muscles, decrease blood pressure).

Getting to your point of "other psychological issues" that can result in ED. Cialis and Viagra are there for one specific case of ED, which isn't caused psychologically. If you can get an erection in the morning, while you're sleeping, PDE5 inhibitors won't help.

Of course, the less drugs you take, the better, easier on your kidneys and liver. No drugs are without side effects, PDE5 inhibitors have them, but they are mild and can be diagnosed easily. Of course, dose is important, and health issue history needs to be taken into consideration.

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

#150

Post by BoxOfRain »

hypertele-Xii wrote: post #135
BoxOfRain wrote: post #120

Earlier quoted context omitted.

>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.

I propose an experiment, find someone to look after your savings and belongings for a while and move to a new city with nothing more than US$500 or equivalent. You may not have friends or family within seventy miles of this location, nor a pre-arranged place to stay. You can come back for your money and possessions at any point, but if you don't last more than six months then you have to do a write-up on HN of your experiences and admit that poverty is more difficult to get out of than your naïve assumption.
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