1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2020 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
  4. Guest, stay home, stay safe, save the NHS. Stay up to date with information about keeping yourself and people around you safe here and GOV.UK: Coronavirus (COVID-19). Think you have symptoms? NHS 111 service is available here.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Covid/Coronavirus and diabetes - the numbers

Discussion in 'Diabetes Discussions' started by Lupf, May 15, 2020.

  1. Lupf

    Lupf Type 2 · Well-Known Member

    Messages:
    81
    Likes Received:
    37
    Trophy Points:
    38
    Apologies @Goonergal , I didn't intend to cause offense.
    I had a professorial moment here. When I see people making loose statements about scientists "But we all know that scientists don’t agree on ... much at all when it comes to Covid)" or "science isn’t a way of establishing unequivocal truth."
    I want to give a robust rebuke. In particular, the latter had me confused and I am glad about your clarification.

    I agree that all opinions are welcome, but as a scientist, I want to be able to point out when an opinion is clearly wrong.
     
    • Friendly Friendly x 1
  2. bulkbiker

    bulkbiker Type 2 · Oracle

    Messages:
    16,640
    Likes Received:
    11,422
    Trophy Points:
    298
    I'm afraid you have a rather naive perception of what happens in "science" these days. And what happens in "legit" journals
    Peer review seems to be more a case of getting your mates to check your homework and then publish whatever.
    or worse paying a journal to publish which is what Elsevier seem to do.
    Recent papers re COVID and Hydroxychloroquine in both the Lancet and the NEJM have shown just how dreadfully flawed the scientific process of publication now is.
     
    #222 bulkbiker, Jun 10, 2020 at 2:30 PM
    Last edited: Jun 10, 2020
  3. JohnEGreen

    JohnEGreen Other · Master

    Messages:
    11,187
    Likes Received:
    22,008
    Trophy Points:
    298
    It's a pity then that you were not about when Ancel Keys was proving with science how bad fat is while destroying John Yudkin's reputation and career you maybe could have stepped in to settle the vehement disagreement between those two eminent scientists.
     
    • Like Like x 6
  4. Lupf

    Lupf Type 2 · Well-Known Member

    Messages:
    81
    Likes Received:
    37
    Trophy Points:
    38
    @bulkbiker Science is not easy.

    This forum should not be about point scoring. "I'm afraid you have a rather naive perception of what happens in "science" these days." I am a scientist and don't need explaining science to me. I don't know what your profession is, but I am not claiming to know it better than you. So can we stop this please.

    Regarding your other comments:
    I strongly object to "getting your mates to check your homework". Peer review is anonymous and lots of scientists, including myself spend a lot of their time - unpaid, BTW - reviewing. This process is not perfect, but it is the best we have. The recent papers, you refer to are actually good illustration of how science works. If, as many expect, their claims were overstated/unsubstantiated/ wrong then other scientists will not be able to reproduce their results and these will be discarded.

    What would be the alternative? In the late 19th century a US state put in law that pi is equal to 3. We can laugh about this, but it is a very serious question. Have you heard of Lysenko? Stalin listened to his claims despite the rest of the world understanding and applying Mendel's genetics and this cause a famine with millions of deaths.

    If scientific decisions were left to politicians and both the US and the UK have some that think they know it better, ... Actually this is exactly what happened and led to 64000 excess deaths in the UK and well over 100k in the US. Other European countries (also in Asia and Oceania) learned from Italy and China and shut down early, in Germany there are 8500 excess deaths while having a larger population than the UK.

    You make a valid point about the way journals are working. Publishing in Elsevier is like baking a cake, taking it to a school event and then paying for the cake you made. This is a serious problem. There is now push to open access which has a good chance to succeed. It is used already by a lot of science.
     
    • Friendly Friendly x 1
    #224 Lupf, Jun 10, 2020 at 3:31 PM
    Last edited: Jun 10, 2020
  5. bulkbiker

    bulkbiker Type 2 · Oracle

    Messages:
    16,640
    Likes Received:
    11,422
    Trophy Points:
    298
    They were lies based on falsified evidence it seems yet passed the peer review stage.

    Other trials were stopped on the back of these "studies" maybe leading directly to excess deaths..

    What should us informed laypeople think of scientists if this is how they publish?
     
  6. liza_h

    liza_h Prediabetes · Active Member

    Messages:
    27
    Likes Received:
    21
    Trophy Points:
    63
    "If you are a fat type 2 diabetic get your eating under control." I'm astounded by this comment.

    That was me. It's taken me the best part of 10 years to get my thyroid hormones under control. Without the thyroid hormones being optimal I can't lose weight even in a calorie deficit. Now my thyroid hormones are optimal I have been able to lose weight and put my diabetes into remission.

    Please be more thoughtful with regards to these sort of comments as many of us struggle for years with an ongoing battle which really isn't just about "getting eating under control".
     
    • Agree Agree x 5
    • Winner Winner x 4
    • Like Like x 1
  7. Lupf

    Lupf Type 2 · Well-Known Member

    Messages:
    81
    Likes Received:
    37
    Trophy Points:
    38
    Wouldn't we all love a simple answer to this disaster which led to 40 years of fat shaming. I am not a historian of science, but with the position of hindsight, I have been trying to understand how this could have gone so horribly wrong. Some of my info is from https://en.wikipedia.org/wiki/Ancel_Keys.

    Unfortunately there is no easy answer. In my opinion a lot of mistakes were made by many of those involved. Here is an attempt of making a list, which is likely incomplete, so no warranty.
    • Ancel Keys arrived at the wrong conclusion. This is not a big surprise, scientists sometimes make mistakes. This does not happen often, but probably more than we would expect. As far as I know Keys did not have an agenda nor was on the payroll of manufacturers of processed food.
    • Ancel Keys dismantling of John Yudkin's findings that sugar is a problem: I don't know, why this happened. Keys was very influential at the time, so my suspicion is that big ego's played a role. Scientists are human beings and not all of us are nice persons.
    • Medical establishment: It looks like they were waiting for the claim - fat is bad - and embraced it without critical judgement and definitely never bothered to check. The "Dietary Guidelines for Americans" in 1977 was in fact based on a wrong finding.
    • Politics - they needed a culprit for Americans getting heart attacks and suddenly had a simply solution, so they ran with it. Blaming fat and fat people is an easy target.
    • Food industry - they saw this as an opportunity and then pushed their sugary stuff relentlessly. According to https://en.wikipedia.org/wiki/Ancel_Keys they tried to prevent John Yudkin from publishing his book "Pure, White and Deadly" in 1972. There were huge profits to be made. As an aside: Just like tobacco never admitted that smoking kills, the food industry is still claiming that sugar is not bad for you despite knowledge to the contrary.
    • Medical Science - as far as I understand no study ever could demonstrate the long term benefit of a low-fat diet. An example is the Look Ahead trial, starting in 2001 when overweight diabetics were put in two groups, one low-fat, one standard diet. The trial was stopped after 10 years with no differences between the groups. Robert Lustig did reproduce Yudkin's result and he also pointed to problems in Keys' analysis, see e.g. https://en.wikipedia.org/wiki/Robert_Lustig. Why did it take the scientists so long to find Keys' mistake? There are probably many reasons for this, one of them is try getting funding for checking something which is well accepted. It still seems rather long from not being able to demonstrate benefits of a low-fat diet to start considering that it is the original hypothesis which is wrong.
    From my view of hindsight, one of the biggest mistake at all levels was insufficient critical judgement. When Yudkin's findings contradicted Keys' claims the Medical scientists and Establishment should have said - Hey wait a second, let's have a closer look, but they did not. This is both bad science and bad policy.

    New claims, like when Keys declared that fat is bad should have required extraordinary scrutiny. Science must always be critical. Never base policies on a single paper. This is still true, in particular with regards to Covid.
     
    • Agree Agree x 1
    • Friendly Friendly x 1
    #227 Lupf, Jun 10, 2020 at 5:21 PM
    Last edited: Jun 10, 2020
  8. Daphne917

    Daphne917 Type 2 (in remission!) · Well-Known Member

    Messages:
    2,927
    Likes Received:
    7,585
    Trophy Points:
    198
    I was similar although it took approx 40 years for my Thyroid to sort itself out and I have been on Thyroxine for 7 years. After my body nearly shut down in my late teens when I went on a very low calorie diet (similar to the Newcastle diet) an endocrinologist told me that I was one of his few patients who could truly blame their metabolism for their weight problems.
     
    • Hug Hug x 2
  9. Lupf

    Lupf Type 2 · Well-Known Member

    Messages:
    81
    Likes Received:
    37
    Trophy Points:
    38
    Apologies but the answer is again - Science is difficult

    There are two issues which you've mentioned

    How can a paper, where the data have been tampered with, pass peer review? I haven't checked this in detail for the case you mention, so my comments are general. This is a feature of peer review which assumes that scientist's data are accurate. When data are falsified with, then peer review might not pick it up, unless it is very obvious. This is far from perfect and I understand that you will say this ludicrous. However this is close to impossible to change. As a reviewer you cannot repeat the work in most cases, your review is based on scrutinising the methods, the results and their interpretation, but it assumes the raw data are accurate. This is why I always stress that the ultimate check on any result is its reproducibility by other scientists. One off results can go badly wrong. We all know what happened when Angel Keys "found" a link between fat in diets and heart attacks. While unfortunately there are cases of scientists fabricating data, this does not happens often as there is usually no incentive for scientists to do this and ultimately it will be found out.

    There is one exception and it is a big issue, namely when companies are involved, who have economic reasons for a certain outcome of studies. Many excellent scientists work for pharmaceutical companies. In these cases it is important to apply methods and procedures which try to prevent biasing results, e.g. when measuring the efficacy of drugs. It used to be that negative results were not reported thus clearly leading to an overestimate of how well a medication will work. Scientists also try to prevent having their own opinions sub-consciously influence their results. For example when scientists analyse data to make very precise measurements, they "blind" their data, i.e. they do the full analysis without looking at the region of interest or multipling the result by a random number. Once all details including uncertainties are understood, the signal will be unblinded and only then the result will become visible to the scientists themselves.

    The second point is an ethical question. To illustrate this, assume that you are conducting a long-term study with a drug suppressing a cancer, e.g. you have patients with leukemia, half are given the medicament the other half not. After only a few months you realise that the drug works extremely well and all patients taking the drug have normal while blood cells again. Thus you decide to stop the study and allow all patients access to this drug. This question always arises when patients well-being depend upon. Covid makes it worse in that decision have to be (or are) taken before results are supported by other studies or maybe even before peer review. These decisions can be painful, and can have bad outcomes, in particular if the result on which it is based does not hold up to scrutiny. However blaming others for such decisions taken as in the case you mentioned is not helpful.
     
    • Friendly Friendly x 1
  10. bulkbiker

    bulkbiker Type 2 · Oracle

    Messages:
    16,640
    Likes Received:
    11,422
    Trophy Points:
    298
    It still is the case.. there is no big record book of studies.. the ones that are published are 90% of the time supportive of what the trial was looking at otherwise they simply don't get published.
    Hard when your salary depends on it though.
     
    • Like Like x 2
  11. Pipp

    Pipp Type 2 · Expert
    Retired Moderator

    Messages:
    7,804
    Likes Received:
    12,800
    Trophy Points:
    198
    Alas, it has been observed that on occasions , when the model / theory / hypothesis are not in agreement with data, some data are discarded. o_O
     
    • Agree Agree x 2
  12. Brunneria

    Brunneria Other · Moderator
    Staff Member

    Messages:
    20,949
    Likes Received:
    34,590
    Trophy Points:
    298
    • Winner Winner x 3
    • Like Like x 2
    • Informative Informative x 1
  13. Lupf

    Lupf Type 2 · Well-Known Member

    Messages:
    81
    Likes Received:
    37
    Trophy Points:
    38
    The WHO has an international Clinical Trials Registration Platform, see https://www.who.int/ictrp/results/jointstatement/en/.
    I notice that Horizon 2020, the EU programme and the Wellcome Trust are signatories, but that the MRC or UKRI are not.
    In 2017 the uptake was 50%, so presumably higher now, but it should be 100%.

    All scientists working for a pharmaceutical company would dispute this. In order to prevent any bias it is very important that there are clear rules, e.g. on disclosure, and a trials registration platform.
     
    #233 Lupf, Jun 10, 2020 at 10:11 PM
    Last edited: Jun 10, 2020
  14. JohnEGreen

    JohnEGreen Other · Master

    Messages:
    11,187
    Likes Received:
    22,008
    Trophy Points:
    298
    You surprise me. (sarcasm)
     
    • Funny Funny x 1
  15. Goonergal

    Goonergal Type 2 · Moderator
    Staff Member

    Messages:
    9,761
    Likes Received:
    17,257
    Trophy Points:
    198
    Hello everyone. The discussion about the validity of scientific findings/publications/research has been helpful and informative, but please could we now revert to discussing the topic raised in the OP. Many thanks.
     
    • Agree Agree x 3
    • Like Like x 1
  16. Jamie H

    Jamie H · Well-Known Member

    Messages:
    126
    Likes Received:
    89
    Trophy Points:
    28
    Don't think this is useful or helpful. Back to the old rhetoric of generalisations around diabetes. There is a very detailed study available via NHS England that looked in significant depth at covid and diabetes, its been talked about at length on this forum. Far greater and more detailed than these two lines on a video.

    It is broken down into far more detail than just controlled and uncontrolled diabetes. It includes parameters such as as age, other conditions, hba1c level, weight and what type of diabetes you have.

    The purpose of the study was to inform people of their own risk factors as much as possible... This is the opposite and is far too generalised.

    Also best to look at a study using our own population and health service rather than one from SA
     
    • Agree Agree x 1
    #236 Jamie H, Jun 12, 2020 at 5:10 PM
    Last edited: Jun 12, 2020
  17. Lupf

    Lupf Type 2 · Well-Known Member

    Messages:
    81
    Likes Received:
    37
    Trophy Points:
    38
    This is a study from South Africa where the population, health and poverty levels are very different from the UK. Thus the actual rates on risk ratio for diabetes will also be significantly different than from the UK. In this thread I discussed studies, which are based on data from hospitals in the UK. These are directly relevant for us and are also very detailed, giving breakdowns, e.g. separate for T2 and T1. This is also stated by @Jamie H
     
    • Like Like x 1
  18. bulkbiker

    bulkbiker Type 2 · Oracle

    Messages:
    16,640
    Likes Received:
    11,422
    Trophy Points:
    298
    Do you have a link to the SA study? I've tried to find it but with no success..
     
  19. Max68

    Max68 · Well-Known Member

    Messages:
    531
    Likes Received:
    591
    Trophy Points:
    113
    Fair enough, taken down,.
     
    • Friendly Friendly x 1
  20. Bill_St

    Bill_St Type 1 · Well-Known Member

    Messages:
    165
    Likes Received:
    62
    Trophy Points:
    68
    New data from the Covid-19 Symptom Study.
    It provides the R value for a very large cohort validated by actual testing
    Somewhat different from media headlines.

    https://covid.joinzoe.com/post/covid-cases-uk?

    New COVID cases continue to fall across the UK, with cases dropping by almost half in a week‍
     
    • Optimistic Optimistic x 2
    • Useful Useful x 1
    #240 Bill_St, Jun 12, 2020 at 8:39 PM
    Last edited: Jun 12, 2020
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook