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Does the American Diabetes Association work for patients or companies?

theguardian.com

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Re: Does the American Diabetes Association work for patients or companies?

#181

Post by kevinmchugh »

shepherdjerred wrote: post #136
McP wrote: post #112

Earlier quoted context omitted.

Yes it is new. The WHO only changed their guidance about a year ago [1]. Still, as far as I know the evidence is only associational. From the paper the article links to: "Potential for reverse causality cannot be eliminated". [1] https://www.who.int/news/item/15-05-2023-who-advises-not-to-...

So it sounds like artificial sugars can actually cause diabetes? That's unfortunate. Occasionally I drink Coke Zero as an alternative to Coke, but perhaps I should start replacing that with unsweetened seltzer water like La Croix.

An occasional pop, sugar or no, isn't going to cause diabetes.

Re: Does the American Diabetes Association work for patients or companies?

#182

Post by ayakang31415 »

bhelkey wrote: post #75

From the linked study, "These findings of positive associations between artificial sweetener intakes and increased T2D risk strengthen the evidence that these additives may not be safe sugar alternatives." This is news to me. I was under the impression that: 1) artificial sweeteners were a safe substitute for sugar for people with diabetes and 2) diabetes came from excess sugar consumption which wasn't a problem with…

Is the association correlation or causation? Because that is very important. People with higher BMI (thus higher risk of diabetes) tend to be self conscious about their diet, they might consume more artificial sweeteners than healthy individuals. They can be already diabetic to begin with before artificial sweetener was consumed frequently.

Re: Does the American Diabetes Association work for patients or companies?

#183

Post by kevinmchugh »

Animats wrote: post #50

Cures are nice, but the money is in chronic conditions.

Health insurers, who buy quite a lot of diabetes treatment, would much rather buy a cure. And they really don't want to pay for untreated diabetes. I've heard from an insurance CEO who wishes their plan could pay the electric bill for diabetes patients to ensure they don't lose power and refrigeration, which would make their insulin get too warm

Re: Does the American Diabetes Association work for patients or companies?

#184

Post by stephenbez »

guerby wrote: post #9

David Unwin is a real hero, things are starting to move hopefully for diabetics Recommanded readings https://nutrition.bmj.com/content/early/2020/11/02/bmjnph-20... https://nutrition.bmj.com/content/early/2023/01/02/bmjnph-20... https://nutrition.bmj.com/content/early/2023/12/14/bmjnph-20... Those papers are the most read papers of BMJ nutrition whole history, and this is the top journal of the field

I’m curious about this as I have loved ones with T2D.

What makes this work groundbreaking? It seems like one doctor talked about how at his practice he started telling people to go low carb and noticed they were improving.

But his data doesn’t compare the 27% of his patients who opted in to the low carb diet to those who chose another option.

The low carb diet has been around for a while? Has there not been a RCT looking at how it works for treating diabetes?

He makes an argument on why RCTs aren’t so good that is unconvincing to me.

> However, when it comes to actual clinical implementation, RCTs have a problem. So many variables have been removed that the studies no longer represent real people leading ordinary lives outside of a tightly controlled trial. For example, in our National Health Service (NHS) clinic, very few patients with hypertension do not have a weight problem. Many of them are also on drugs for joint pain, reflux or depression. This is why the results seen in RCTs often do not roll out into real-world, clinical practice. For this to occur we need interventions that have a high degree of ‘external validity’—approaches for that better represent the ‘ordinary’ people who populate our clinics. Away from the carefully controlled conditions of clinical trials, results can be very different in the messy, complex world of everyday general practice.

I noticed that he mentioned a RCT on the low carb diet showing good results and read it, but it seems to be p-hacked. They don’t even mention the mean change in weight between the two groups, but only the percent that achieved a 5 or 10% reduction in weight at some point during the study. The also said that 55% of patients lost weight and 45% gained weight.

https://nutrition.bmj.com/content/bmjnph/6/2/326.full.pdf

Re: Does the American Diabetes Association work for patients or companies?

#185

Post by Der_Einzige »

bhelkey wrote: post #75

From the linked study, "These findings of positive associations between artificial sweetener intakes and increased T2D risk strengthen the evidence that these additives may not be safe sugar alternatives." This is news to me. I was under the impression that: 1) artificial sweeteners were a safe substitute for sugar for people with diabetes and 2) diabetes came from excess sugar consumption which wasn't a problem with…

I don’t buy this at all!

Zero calorie sweeteners by definition cannot cause insulin responses.

I can easily verify this by using my families blood glucose monitors before and after I’ve had a diet soda. I’ve done this several times and I have zero increase in blood glucose levels from a Diet Coke. It actually goes down since time passes between me starting the drink and finishing it.

The obsession from even purportedly good doctors with trying to find reasons to vilify anything that might taste good while not spiking glycemic loads is horrifying to witness.

I’m extremely upset, especially as someone with two diabetic parents and a history of diabetes. Both parents are diabetic because they’re fat as hell.

Re: Does the American Diabetes Association work for patients or companies?

#186

Post by monkburger »

AlbertCory wrote: post #133
monkburger wrote: post #129

Earlier quoted context omitted.

> Also note that HbA1c tests aren't perfect for diagnosing type 2 diabetes and can > have false positives or false negatives. When we do workups on pts suspected of diabetes, we use the following criteria. - Iron deficiency anemia workup to confirm accuracy of HbA1C - HbA1C ≥6.5% - FPG ≥126mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least eight hours - Two-hour plasma glucose ≥200mg/dL (11.1 mm…

Excellent. Thanks. Is an A1C level sufficient, all by itself, sufficient to classify them as "pre-diabetic" or are other symptoms required? Or is that even a thing?

Usually, yes.

However, some PCPs / endo will order up A1c as well as glucose challenge, depending on certain factors (eg, family history, BMI, symptoms). If I were you, order up the following:

- A1C - 12 hour Fasting blood glucose levels - Two-hour glucose tolerance test: this test will measure blood glucose levels before and after ingestion of 75 g of glucose solution (if the results show blood levels that fall between 140 mg/dL to 199 mg/dL, it is diagnostic of prediabetes. - A random plasma glucose test

Personally, if you have a family history of diabetes/obesity, you should get checked often. Some providers have been writing rx's of GLP-1's to aid in weight loss, which reduces the risk of developing T2DM.

Re: Does the American Diabetes Association work for patients or companies?

#187

Post by Jensson »

Der_Einzige wrote: post #185
bhelkey wrote: post #75

From the linked study, "These findings of positive associations between artificial sweetener intakes and increased T2D risk strengthen the evidence that these additives may not be safe sugar alternatives." This is news to me. I was under the impression that: 1) artificial sweeteners were a safe substitute for sugar for people with diabetes and 2) diabetes came from excess sugar consumption which wasn't a problem with…

I don’t buy this at all! Zero calorie sweeteners by definition cannot cause insulin responses. I can easily verify this by using my families blood glucose monitors before and after I’ve had a diet soda. I’ve done this several times and I have zero increase in blood glucose levels from a Diet Coke. It actually goes down since time passes between me starting the drink and finishing it. The obsession from even purported…

> It actually goes down

That is what you expect if you raise your insulin, insulin reduce blood glucose, so if the sweetener increased insulin without adding sugar then it reduces blood glucose.

> goes down since time passes between me starting the drink and finishing it.

Blood sugar levels are stable unless you eat sugar, they don't go down over time, unless you do something to add insulin to make it go down or add sugar to make it go up. Here it sounds like you adding insulin when drinking that and thus making it go down.

Re: Does the American Diabetes Association work for patients or companies?

#188

Post by newshackr »

cjensen wrote: post #166
user_7832 wrote: post #69

> In case you’re curious, the ADA and Splenda appear to be still at it. As I write this, the ADA’s Diabetes Food Hub web page still features no fewer than 203 recipes – some marked “sponsored”, some not – that include Splenda, whose parent company’s $1m contribution has brought to light the utter insanity of our diabetes epidemic. If you call yourself the " American Diabetes Association", (why) aren't there regulatio…

Why can they call it the "American Diabetes Association" is a pretty easy question. The First Amendment. Part of the First is that the government cannot ban you from using a word unless there is a very good reason do so. "American" is a word that is not associated exclusively with the government, nor was it ever used that way historically. In fact, the word "American" predates the US Government. Since the word does n…

It doesn't seem much different from trademarks, where you can't use a word if it causes confusion

Re: Does the American Diabetes Association work for patients or companies?

#189

Post by Jensson »

sircastor wrote: post #79
beryilma wrote: post #61

Earlier quoted context omitted.

> Otherwise they wouldn't go to court to force people who don't even want to be in the union... Even worse, they might request your dismissal if you don't join. Here is a direct quote from the Union agreement of a major university, where I teach part-time: "The Union may request that a Part-time Faculty Member who fails to join the Union, maintain Union membership, pay an agency fee, or make a charitable contribution…

Arguably, a union has to hold the position of requiring membership, and against those who don’t want to join. Collective bargaining only works when your position represents the group to the point where it can’t be dismissed. But yeah, It’s challenging for a union to remain exclusively dedicated to serving its membership. I think it’s increasingly complicated with national unions which exist for the sake of unions as…

Unions doesn't work that way in Europe, it is not something unions must do.

Collective bargaining works as long as you are a collective that bargains together, you don't need to have every single person be a art of that collective.

Re: Does the American Diabetes Association work for patients or companies?

#190

Post by Der_Einzige »

Jensson wrote: post #187
Der_Einzige wrote: post #185

Earlier quoted context omitted.

I don’t buy this at all! Zero calorie sweeteners by definition cannot cause insulin responses. I can easily verify this by using my families blood glucose monitors before and after I’ve had a diet soda. I’ve done this several times and I have zero increase in blood glucose levels from a Diet Coke. It actually goes down since time passes between me starting the drink and finishing it. The obsession from even purported…

> It actually goes down That is what you expect if you raise your insulin, insulin reduce blood glucose, so if the sweetener increased insulin without adding sugar then it reduces blood glucose. > goes down since time passes between me starting the drink and finishing it. Blood sugar levels are stable unless you eat sugar, they don't go down over time, unless you do something to add insulin to make it go down or add…

Diet soda using a zero calorie sweetener has an insulin index and glycemic index of zero. You’re just wrong.
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