Diabetes and other things

[Jo_the_boat]

I came across an article by a researcher called Rachel Nicoll, who is widely published.
This piece, in my view, is an interesting perspective on where we are regarding chronic illness, including diabetes. It's a good one for us diabetics in addition to anyone who wants to know a little more about where we are generally health-wise.
I believe our metabolic health, in general, is dreadful and the root cause of many of todays medical conditions.
Ironically, those of us with diabetes and who take great care of our lifestyles may be among the metabolically healthiest. But that's only my hypothesis!
There are some startling fact and figures in the article, not least the amount it costs to treat (manage) all our largely preventable conditions, as against how much is spent on research in reality.

https://dailysceptic.org/chronic-disease-still-no-cures-in-sight/

Edit by mod to insert correct link to article

 

[Dark Horse]

A few alarm bells in the article:-

• the author doesn't mention the usual caveat that an apparent increase in prevalence can be due to better awareness and detection rather than an actual increase in true prevalence, e.g. with autism
• the author doesn't mention that an increase in prevalence of some diseases may be due to the fact that life expectancy has increased with more people living long enough to develop diseases associated with old age, e.g. dementia.
• no references to allow the figures and conclusions to be checked

Edited to add that these comments related to the original article posted which has since been changed.

 

[Jo_the_boat]

A few alarm bells in the article:-

• the author doesn't mention the usual caveat that an apparent increase in prevalence can be due to better awareness and detection rather than an actual increase in true prevalence, e.g. with autism
• the author doesn't mention that an increase in prevalence of some diseases may be due to the fact that life expectancy has increased with more people living long enough to develop diseases associated with old age, e.g. dementia.
• no references to allow the figures and conclusions to be checked

I'm not sure whether you have read the article thoroughly but there are lots of links with supporting evidence.
I believe the overall situation with our collective health is on a downward trend, and is in part a reason why some sections of our population (in addition to the elderly) have been so badly affected by covid.
To briefly address your points:

Point 1. Yes, it’s mentioned, 6 paras before the end.

Point 2. It’s mentioned in the link to The Alzheimer’s Society below

Point 3. There are relevant references to all the points in the links provided in the article.
Here are some of the links:

Obesity
Diabetes
Autoimmune
Cancer
Dementia (ref also point 2)
Cardio Vascular - There are literally thousands of sites linking lifestyle to CVD
Autism - this link has multi-links to citing literature.
Figures on long term conditions and costs. By The King's Fund - who are they?

 

[bulkbiker]

This piece, in my view, is an interesting perspective on where we are regarding chronic illness, including diabetes. It's a good one for us diabetics in addition to anyone who wants to know a little more about where we are generally health-wise.

Great article thanks for posting I'd missed it somehow..

 

[Dark Horse]

Yes, it’s mentioned, 6 paras before the end.

I still can't see the mention. If you could quote a few words from it I would be able to search for it?

It’s mentioned in the link to The Alzheimer’s Society below

I can't see a link to the Alzheimer's society in the article or below it.

There are relevant references to all the points in the links provided in the article.
Here are some of the links:

I cannot see any links within the article or at the end of the article.

Even using your links, I can't find the statistic for hospital admissions for obesity, just for example ( I haven't checked the others) - there is only 1 use of the word 'hospital' in the document and that refers to bariatric surgery only.

Edited to add that these comments related to the original article linked to which has since been changed.

 

[Jo_the_boat]

The article was initially reproduced on my personal (public) site. I had removed the links for simplicity. But one of the mods decided to remove the link from my site and link it to another public site, which did contain the links. So.........
HERE, once again is the article.

Hopefully you can see these links??
If not, with reference to your obesity query this NHS online link (from 2020) may help?

Sorry for the confusion!
It all makes sobering reading I think.

One thing that frustrates me is that articles like this are published on sites like The Daily Sceptic. It in effect means that the mainstream media are loathe (or forbidden?) to publish articles on some topics, thereby shutting down mass debate. It's as if we, the public, can't read everything then make our own minds up.
I know of other experts (one particular doctor for example) who has to publish his research and opinion on Russia Today, because he has been airbrushed out by mainstream media due to his stance against 'establishment' guidelines.

 

[Mbaker]

Personally I prefer the court of common sense, overwhelming correlation and repeatable experiences over references. References that can be traced back to facts I am up for e.g. Virta Health results, Dr David Unwins case studies are good enough for me as a HbA1c being out by a point is ok, but a relative risk of 1.18 using epidemiology and a statistical analysis that is suspect, just no.

This article I find, speaks the truth,and if anything I believe the stats are under estimated.

 

[Resurgam]

All my life I have noticed how weak other people are - I can still lift and move things others struggle with, and I am 70 now.
I used to carry a speaker cabinet in each hand back in my days as a roadie - and I could swing by my hands and cause people to panic for fear I would fall.
Perhaps it is just luck, but I have never had a serious injury or illness and my recovery time after giving birth startled the nurses.
I grew up on a diet high in eggs and meat until grandad lost the house and land....

 

[Dark Horse]

HERE, once again is the article.

The original article linked to did not contain links to references but this one does appear to link to at least some, although not every statistic is referenced.

There are still alarm bells with the article:-

Although it does have a comment, "Even allowing for improved diagnostic techniques possibly increasing incidence rates, it is perfectly clear that there is no decline in incidence of these chronic diseases through provision of improved prevention and treatment", the fact that the author has previously put a whole paragraph about autism statistics would make most readers believe that there is definitely an increase in the real prevalence of autism and this general comment, made in a separate paragraph, would do little, if anything to dispel that notion.

 

[Jo_the_boat]

The original article linked to did not contain links to references but this one does appear to link to at least some, although not every statistic is referenced.

There are still alarm bells with the article:-

Although it does have a comment, "Even allowing for improved diagnostic techniques possibly increasing incidence rates, it is perfectly clear that there is no decline in incidence of these chronic diseases through provision of improved prevention and treatment", the fact that the author has previously put a whole paragraph about autism statistics would make most readers believe that there is definitely an increase in the real prevalence of autism and this general comment, made in a separate paragraph, would do little, if anything to dispel that notion.

I think you're misreading it.
Firstly, yes numbers are growing. A pretty recent article in the Guardian indicates that (March '21).

Secondly, what I believe she means in the italic section you've highlighted is that there is no improvement (or decline) in the prevalence of these diseases because there has been inadequate provision of improved prevention and treatment. In other words we've not done enough. This does not contradict the fact that the numbers appear to be growing.

The overall tenet of the article is that we are not adequately addressing the unchecked growth of some common conditions. Some of them, as we diabetics know, can be improved with basic education on diet and lifestyle. This may well be what the article author is partly referring to when she mentions 'prevention'. In other words if we put more resources into prevention, we may see a slowing, or decline, in some conditions. With T2 diabetes many of us here have seen an improvement through learning from our peers on this site.
Collectively, what we are doing is 'managing' long-term conditions, rather then preventing them, at massive expense both through drugs and doctor / hospital resources. It's putting a crippling strain on the NHS. And that can only increase.
In addition, I think we'll find out that we, in the UK, were woefully underprepared metabolically to combat Covid. Many of the the comorbidities mentioned ultimately led to unnecessary deaths. Tragic in themselves, but more so because they were conditions that could have been prevented or certainly alleviated.

 

[Dark Horse]

I

I think you're misreading it.
Firstly, yes numbers are growing. A pretty recent article in the Guardian indicates that (March '21).

Secondly, what I believe she means in the italic section you've highlighted is that there is no improvement (or decline) in the prevalence of these diseases because there has been inadequate provision of improved prevention and treatment. In other words we've not done enough. This does not contradict the fact that the numbers appear to be growing.

The overall tenet of the article is that we are not adequately addressing the unchecked growth of some common conditions. Some of them, as we diabetics know, can be improved with basic education on diet and lifestyle. This may well be what the article author is partly referring to when she mentions 'prevention'. In other words if we put more resources into prevention, we may see a slowing, or decline, in some conditions. With T2 diabetes many of us here have seen an improvement through learning from our peers on this site.
Collectively, what we are doing is 'managing' long-term conditions, rather then preventing them, at massive expense both through drugs and doctor / hospital resources. It's putting a crippling strain on the NHS. And that can only increase.
In addition, I think we'll find out that we, in the UK, were woefully underprepared metabolically to combat Covid. Many of the the comorbidities mentioned ultimately led to unnecessary deaths. Tragic in themselves, but more so because they were conditions that could have been prevented or certainly alleviated.

I'm not sure that you've understood what I am saying. There is an increase in the number of diagnoses of autism but that does not mean that the numbers of people with autism has increased. The general view is that the numbers of people with autism has likely remained the same but more of those people have actually been identified/recognised as autistic and received a diagnosis. The underlying prevalence is thought to be unchanged although the numbers diagnosed has risen. The way the author wrote the piece makes it sound like the underlying prevalence of autism has increased and she does not explain that this is likely not the case.

The Guardian article that you mentioned does report that the researchers do point this out:-

"The rise, they add, is likely down to improved recognition of ASD." https://www.theguardian.com/society...dren-in-england-than-previously-thought-study​

 

[JohnEGreen]

It would seem that maybe it is not possible to account for the total rise in prevelence by better diagnosis and reporting alone.

"
Scientists can't put their finger on why rates are rising. Some say it's better diagnosis. That is, it's not that more people have autism. It's that we're better at detecting it. Others attribute it to changes in the diagnostic criteria. Specifically, the May 2013 update of the Diagnostic and Statistical Manual of Mental Disorders-5 -- the standard classification of mental disorders -- removed the communication deficit from the autism definition, which made more children fall under that category. Cynical observers believe physicians and therapists are handing out the diagnosis more freely to allow access to services available only to children with autism, but that are also effective for other children.

Alycia Halladay, chief science officer for the Autism Science Foundation in New York, said she wishes there were just one answer, but there's not. While she believes the rising ASD numbers are due in part to factors like better diagnosis and a change in the definition, she does not believe that accounts for the entire rise in prevalence. As for the high numbers in New Jersey, she said the state has always had a higher prevalence of autism compared to other states. It is also one of the few states that does a good job at recording cases of autism in its educational records, meaning that children in New Jersey are more likely to be counted compared to kids in other states.

"Not every state is as good as New Jersey," she said. "That accounts for some of the difference compared to elsewhere, but we don't know if it's all of the difference in prevalence, or most of it, or what."
"

https://leaps.org/why-are-autism-rates-steadily-rising/particle-2

 

[Jo_the_boat]

I

I'm not sure that you've understood what I am saying. There is an increase in the number of diagnoses of autism but that does not mean that the numbers of people with autism has increased. The general view is that the numbers of people with autism has likely remained the same but more of those people have actually been identified/recognised as autistic and received a diagnosis. The underlying prevalence is thought to be unchanged although the numbers diagnosed has risen. The way the author wrote the piece makes it sound like the underlying prevalence of autism has increased and she does not explain that this is likely not the case.

The Guardian article that you mentioned does report that the researchers do point this out:-

"The rise, they add, is likely down to improved recognition of ASD." https://www.theguardian.com/society...dren-in-england-than-previously-thought-study​

I see your point.
There's not really any point you and I bickering.
I think it probably makes more sense if you contact her direct
[email protected]

One thing we have been subjected to, particularly since late 2019, is the increase in various adjectives when describing things that the media a) can't guarantee as fact, and b) need to cover themselves for. One such word is 'likely'. As in they don't know (although in this case I concede they were quoting directly from research carried out by Newcastle University.)
That is lazy journalism, and the use of such words makes it easier to sensationalize stories without the accountability. Much as has been done throughout the pandemic.

I suppose what is disturbing is that even though the underlying prevalence is probably (another of those words) not increasing, we are uncovering an increasing number of suffers. I think I'm right that the recent studies only drew on data from state-funded schools, so there may be more cases.

I think the fact is, as a nation, we are failing to address many common conditions, some of which are treatable through education.

 

[StewM]

I see your point.
There's not really any point you and I bickering.
I think it probably makes more sense if you contact her direct
[email protected]

One thing we have been subjected to, particularly since late 2019, is the increase in various adjectives when describing things that the media a) can't guarantee as fact, and b) need to cover themselves for. One such word is 'likely'. As in they don't know (although in this case I concede they were quoting directly from research carried out by Newcastle University.)
That is lazy journalism, and the use of such words makes it easier to sensationalize stories without the accountability. Much as has been done throughout the pandemic.

I suppose what is disturbing is that even though the underlying prevalence is probably (another of those words) not increasing, we are uncovering an increasing number of suffers. I think I'm right that the recent studies only drew on data from state-funded schools, so there may be more cases.

I think the fact is, as a nation, we are failing to address many common conditions, some of which are treatable through education.

Like this is anecdotal sure, but worth consideration regarding autism.

One of my friends from Uni is an autism support worker. He works with adults who are 'experiencing difficulties'. The reason for the curious phrasing is these people demonstrate a lot of autistic traits* but they are not diagnosed as autistic. He doesn't put them under pressure to pursue diagnosis because, for a lot of them, the stigma associated with a diagnosis is enough to freak them out. Like he tries very hard to reduce the stigma but he feels like he's fighting a one-man battle against societal attitudes a lot of the time, and he has to be realistic about what he can and can't do.

*I'm not sure this is the correct term, but I think you know what I mean.

 

[Jo_the_boat]

Like this is anecdotal sure, but worth consideration regarding autism.

One of my friends from Uni is an autism support worker. He works with adults who are 'experiencing difficulties'. The reason for the curious phrasing is these people demonstrate a lot of autistic traits* but they are not diagnosed as autistic. He doesn't put them under pressure to pursue diagnosis because, for a lot of them, the stigma associated with a diagnosis is enough to freak them out. Like he tries very hard to reduce the stigma but he feels like he's fighting a one-man battle against societal attitudes a lot of the time, and he has to be realistic about what he can and can't do.

*I'm not sure this is the correct term, but I think you know what I mean.

Yes, I understand that. We are getting better at understanding some things, mental health generally for example, so regarding autism it's perhaps an education issue for the majority of us.
One difficulty is that there appears to be a wide range of 'severity' or traits as you put it. It takes skill and knowledge to spot it.
Recognition, diagnosis and acceptance of some conditions is improving. But there are far too many, like obesity, which is getting further and further out of control. What Rachel Nicoll is saying above is, despite supposedly spending a fortune on 'research' into many of these common conditions, we're still losing ground.

 

[StewM]

Yes, I understand that. We are getting better at understanding some things, mental health generally for example, so regarding autism it's perhaps an education issue for the majority of us.
One difficulty is that there appears to be a wide range of 'severity' or traits as you put it. It takes skill and knowledge to spot it.
Recognition, diagnosis and acceptance of some conditions is improving. But there are far too many, like obesity, which is getting further and further out of control. What Rachel Nicoll is saying above is, despite supposedly spending a fortune on 'research' into many of these common conditions, we're still losing ground.

I think the issue I take with her proposition that we're losing ground is that she seems to be claiming that diseases are easy to eradicate. For instance...

"Maybe it is also time to accept that the vast majority of medical research has not provided, and is not going to provide, a cure for chronic diseases."

The implication is clearly that because they've never found a cure they never will, which isn't the most scientific claim in the world. She also, therefore, seems to be arguing no money at all should be spent on clinical research, as she's already said the only 'good outcome', as she herself defines it, is impossible.

 

[Jo_the_boat]

I think the issue I take with her proposition that we're losing ground is that she seems to be claiming that diseases are easy to eradicate. For instance...

"Maybe it is also time to accept that the vast majority of medical research has not provided, and is not going to provide, a cure for chronic diseases."

The implication is clearly that because they've never found a cure they never will, which isn't the most scientific claim in the world. She also, therefore, seems to be arguing no money at all should be spent on clinical research, as she's already said the only 'good outcome', as she herself defines it, is impossible.

Again I take your point, but she points out that a fraction of the amount we spend on managing the diseases is spent on research.
She and others (see last paragraph for example) have suggested how to stop most of these diseases at source, namely combat obesity, poor diet and medical misinformation. The point is we shouldn't need to find a cure for many conditions because they could be halted, or largely alleviated, through a change of lifestyle. They are aiming at cure rather than prevention. You can see the vast amounts spent on healthcare regarding chronic diseases.
To me, medical misinformation is huge. In my opinion decisions on our cumulative health are being instigated by big business, whether that be food manufacture or pharmaceutical. There is just too much profit involved. Many of us, as T2 diabetics, have experienced first hand how a change of lifestyle can lead to a reversal of our symptoms and being able to come off medication. Health professionals, as many of us have also seen first hand, trot out an establishment mantra about diet that simply doesn't stack up, then put us on largely unnecessary medication. Though I think things may be changing, very slowly.
I am laughed at by some friends when I turn down a cake or a pint of beer. 'Go on,' they say, 'they won't do you any harm.'
Most people basically have no idea what is healthy and what is harmful, certainly the latter.
I also think that we're pandering to some people too much. I know some don't agree with this, but regarding T2 diabetes, I have myself to blame. Others too I suspect. I may be disposed to T2 genetically or whatever, but it was me who ate too much of the wrong things.
Regarding obesity, we have people who come on this site who have lost multi-stone through lifestyle change and diet. Which is a terrific effort. In effect because they had to, to get well again. But surely we need to educate people not to get in that situation in the first place.
Likewise with my smoking, I've got myself in a right old mess with that. Everyone knows smoking is a killer. Shouldn't everyone be as clued up on diet and lifestyle, which are also killers.
(Blimey, sorry to go on!)

 

[StewM]

Again I take your point, but she points out that a fraction of the amount we spend on managing the diseases is spent on research.
She and others (see last paragraph for example) have suggested how to stop most of these diseases at source, namely combat obesity, poor diet and medical misinformation. The point is we shouldn't need to find a cure for many conditions because they could be halted, or largely alleviated, through a change of lifestyle. They are aiming at cure rather than prevention. You can see the vast amounts spent on healthcare regarding chronic diseases.
To me, medical misinformation is huge. In my opinion decisions on our cumulative health are being instigated by big business, whether that be food manufacture or pharmaceutical. There is just too much profit involved. Many of us, as T2 diabetics, have experienced first hand how a change of lifestyle can lead to a reversal of our symptoms and being able to come off medication. Health professionals, as many of us have also seen first hand, trot out an establishment mantra about diet that simply doesn't stack up, then put us on largely unnecessary medication. Though I think things may be changing, very slowly.
I am laughed at by some friends when I turn down a cake or a pint of beer. 'Go on,' they say, 'they won't do you any harm.'
Most people basically have no idea what is healthy and what is harmful, certainly the latter.
I also think that we're pandering to some people too much. I know some don't agree with this, but regarding T2 diabetes, I have myself to blame. Others too I suspect. I may be disposed to T2 genetically or whatever, but it was me who ate too much of the wrong things.
Regarding obesity, we have people who come on this site who have lost multi-stone through lifestyle change and diet. Which is a terrific effort. In effect because they had to, to get well again. But surely we need to educate people not to get in that situation in the first place.
Likewise with my smoking, I've got myself in a right old mess with that. Everyone knows smoking is a killer. Shouldn't everyone be as clued up on diet and lifestyle, which are also killers.
(Blimey, sorry to go on!)

No, appreciate your detailed response. I do understand your points and think there's definitely validity to what you say. However, when you say:

"Many of us, as T2 diabetics, have experienced first hand how a change of lifestyle can lead to a reversal of our symptoms and being able to come off medication."

I worry that might predispose you to believe those changes would have the same effect in other scenarios where it might not necessarily be so simple. I'm not saying this to wipe away your whole response as invalid, but it's always important to avoid applying experience outside of its relevant context. It's certainly more comforting to believe that everything is within our immediate control, as that gives us complete and total power over it.

The article is very wide-ranging in what it's talking about, and there's not clear evidence that lifestyle changes could eradicate cancer (which, to oversimplify for a second, is due in part to what Cancer it is bodies aren't made to last forever).

To sum up, I think there's a balance between the points you're making and acknowledging there are some things outwith our individual control which do require investigation by specialists to make any progress, and I worry the article doesn't strike that balance.

 

[NicoleC1971]

I think the issue I take with her proposition that we're losing ground is that she seems to be claiming that diseases are easy to eradicate. For instance...

"Maybe it is also time to accept that the vast majority of medical research has not provided, and is not going to provide, a cure for chronic diseases."

The implication is clearly that because they've never found a cure they never will, which isn't the most scientific claim in the world. She also, therefore, seems to be arguing no money at all should be spent on clinical research, as she's already said the only 'good outcome', as she herself defines it, is impossible.

It is more fundamental than how much money gets spent on research given that for many of these diseases we cannot get to a consensus on what causes the diseases and therefore how to cure them. Furthermore there are plenty of people for whom finding a non pharmaceutical cure would destroy their business model. In the current set up Big Food and Big Pharma want to keep you alive long enough to be a lifetime consumer of drugs and bad food. Governments should have an incentive to reduce the terrible costs of this model but when the research is biased and the lobbying machines rely on muddying the waters to perpetuate the status quo, it is hardly surprising that they lack the will or competence to change our health habits. Instead Public Health has been re branded Health Security which gives us a clue to its focus going forward.
Independent research would certainly help take the debate forward with more discussion on options which truly tackle root causes of disease.
In the meantime your stock market investments should be very safe in Pzhizer, Lilly, Novo Nordisk, Nestle and Coca Cola.
The topic of chronic underlying ill health is one that should be front and centre in any debate about our public health so thanks to the OP for sharing the article!

 

[Jo_the_boat]

It is more fundamental than how much money gets spent on research given that for many of these diseases we cannot get to a consensus on what causes the diseases and therefore how to cure them. Furthermore there are plenty of people for whom finding a non pharmaceutical cure would destroy their business model. In the current set up Big Food and Big Pharma want to keep you alive long enough to be a lifetime consumer of drugs and bad food. Governments should have an incentive to reduce the terrible costs of this model but when the research is biased and the lobbying machines rely on muddying the waters to perpetuate the status quo, it is hardly surprising that they lack the will or competence to change our health habits. Instead Public Health has been re branded Health Security which gives us a clue to its focus going forward.
Independent research would certainly help take the debate forward with more discussion on options which truly tackle root causes of disease.
In the meantime your stock market investments should be very safe in Pzhizer, Lilly, Novo Nordisk, Nestle and Coca Cola.
The topic of chronic underlying ill health is one that should be front and centre in any debate about our public health so thanks to the OP for sharing the article!

I think we're on the same wavelength Nicole.
Just on the cash point (to coin a phrase)....

"Pfizer recently released its second quarter of 2021 results and, not surprisingly, they were nothing short of fantastic for shareholders and corner office dwellers alike.

Sales revenues for the second quarter of 2021 were $19.0 billion, reflecting 86 percent operational growth and 92 percent revenue growth. When the company's COVID-19 vaccine, BNT162b2, is excluded, sales revenues rose by a much more modest 10 percent."