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Redefining diabetes ?

Discussion in 'Type 2 Diabetes' started by TerryinDorset, Jun 11, 2019.

  1. Guzzler

    Guzzler Type 2 · Master

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    "Roy Taylor's research demonstrated a strong correlation between the duration of the condition and the response."

    Even "strong" correlation is just correlation.

    "The overwhelming impression gained by doctors from their routine clinical practice is that people with Type 2 diabetes rarely succeed in losing weight, and the critical point that there is a subgroup who are strongly motivated by desire to regain health..."

    This is imo because of the nature of the diet and it does again imo smack of patient blaming.
     
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  2. alienskin

    alienskin · Member

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    "just correlation"
    Literally with 'causation', the fundamental basis of scientific research, especially within medical research. Pretty much any paper looking to improve patient outcomes will start with a hypothesis based on some kind of correlation between an independent and dependent variable. (A well-designed experiment will, of course, attempt to ensure that this correlation also indicates causation by carefully controlling possible confounding variables). Whenever someone on this forum makes any recommendation, there are literally arguing that there is a correlation with their course of action and a positive outcome. There's no 'just correlation' about it.

    "it does again imo smack of patient blaming."
    You've misunderstood the quote it seems. He's talking about the attitude of doctors in general, and that he's saying doctors shouldn't think that way.
     
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  3. Guzzler

    Guzzler Type 2 · Master

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    One could hypothesise that that a preponderous number of coat hangers in your wardrobe strongly correlates with astigmatism but it will never prove (on its own) causation and the operative word you use is 'hypothesis'.

    I misunderstood nowt. We have in the past here on the forum pondered why no mention has been made for the reasons that some people do not do well on ND type approaches. Surely finding out why this happens must be pertinent to the research?
     
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  4. bulkbiker

    bulkbiker Type 2 · Master

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    It should be the outcome not the basis. "Science" is looking to prove causation. Unfortunately in the field of nutrition it seems to only be able to use epidemiological food frequency questionnaire based data which as we all should know by now is pretty much GIGA. As I've said many times before this data will only ever be able to show "association" which is why I believe that negative data is a far stronger way of looking at things. Like black swans.. if you can show as the "PURE" study did that saturated fat intake is not associated with CVD then that's it.. sat fat is off the hook forever. Whether you can say it is mildly protective (which it appeared to be ) is far more dubious and "associational".
    Prof Taylor's research shows the same.. Ultra low cal diets appear to work in the short term but is that because most of the study particiapnts were in "starvation" ketosis , because they were being starved or because even with the carby nature of the shakes they were still lower carb than normal? As yet we don't know.
     
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  5. jjraak

    jjraak Type 2 · Well-Known Member

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    Hi @alienskin

    read your post and agree with a lot of what you said.

    I also read most of @Guzzler posts and usually find i fully agree as i feel we are on the same page, with most things type 2,
    yet here it seems that perhaps the words have been taken differently by us both.
    hoping another view might help clarify what i believe WAS your intention.

    I read that doctors SHOULD recognise the many of us who ARE concerned enough to take action
    ( and for me personally, THAT should be the Norm..for new T2D's. )

    The offer of help and information, ( not just meds,) that others had found good results in dietary form with LC /LCHF, rather then the eatwell plate..would have saved me weeks of worry & angst, until i found this forum.
    Surely succes IS success and should be incorporated into health care as such, even just as an alternative if only for informational purposes.

    I think we all hope it's full on remission, and perhaps even a cure.
    for myself i'm with you, that it's remission..over a long term..( please god,) admittedly..but just well managed remission.
    others will differ, which i fully respect.

    the fact... which i tell myself in the dark of night.
    is that it took me years to get ill in the first place, if i can put this back for 10/20/30 years before i suffer any real complications, my time on earth may well be up anyway.

    So each day i stave it off, IS a victory of some sorts over the devil that is T2D.
     
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  6. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    Mp Tom Watson, diagnosed with type 2 diabetes, lost 7 stone in weight and it was all over the media. He was an inspiration to many other's too. He didn't go to Germany to seek help, but showed that life style changes can be so beneficial. Some can do it on their own, other's like Mr Biggins needed more.
    I did see Christopher Biggins on a celebrity dinner programme a few years ago, and if I remember correctly, he made a trifle for pudding, I think it was an old recipe from his aunt, he did like his food.
    ps whatever way a person changes their lives for the better, is surely a good thing.
     
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  7. Barrowbakers

    Barrowbakers Type 2 · Well-Known Member

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    I have never said I have reversed my type 2 but over 2 to 3 years on lchf I have lost 4 stone and my hba1c is always 6 or below. My other bloods have been good to and blood pressure reduced.
    I have a fantastic diabetic nurse and see her twice a year. Although she is an NHS diet trained person she totally accepts our lchf diet - if it works don’t change it.
    It really does appear simple - I eat good food and even cope with cereals and a little bread. Miss my biscuits and cake but ........
     
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  8. helensaramay

    helensaramay Type 1 · Expert

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    I can't write about nurses at GP surgeries or any understanding of type 2 diabetes.
    However, my hospital based diabetes specialist nurse is amazing. She knows much more about living with diabetes than the endocrinologist.
     
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  9. alienskin

    alienskin · Member

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    "We have in the past here on the forum pondered why no mention has been made for the reasons that some people do not do well on ND type approaches. Surely finding out why this happens must be pertinent to the research?"
    Which is precisely what a well-designed scientific study would seek to find out. By finding and isolating the variables, proper answers to these complex questions can be ascertained. Professor Taylor's research is not just one study: it's the basis of multiple studies by other researchers.

    So for example, Professor Taylor discovering that the non-responders tend to be diagnosed over 8 years ago can then lead other researchers to narrow down reasons for this. It might be connected for example with dedifferentiation and that in turn might lead to personalized treatments that best suit the individual based on their genetic profile or how long they've had the condition. You're doing these researchers a disservice by suggesting that they are not aware of possible confounding variables, and don't understand the limitations of their own research.


    "I read that doctors SHOULD recognise the many of us who ARE concerned enough to take action"
    That's precisely what I meant, and what Professor Taylor is stating.


    "The offer of help and information, ( not just meds,) that others had found good results in dietary form with LC /LCHF, rather then the eatwell plate..would have saved me weeks of worry & angst, until I found this forum."
    Absolutely. And it's clear that there is a disconnect in the medical community between what is advised and what can be achieved with a better lifestyle, and it's also the case that researchers are beginning to take proper note of it. But it's still important to keep asking questions - even about your own success.

    "Surely success IS success and should be incorporated into health care as such, even just as an alternative if only for informational purposes."
    This is the crux. How do we measure success? Suppose for the sake of argument, that we have 2 competing lifestyle changes. One advocates a very low carb diet, and the other one a medium carb diet but with low GI food. How do we know which is better? How do we know they are better than present treatments? We can't just assume these things because our numbers are low today, and thus we have 'success'. Anecdote is not data. For example, we might discover that while one of the diets does indeed lower blood sugar numbers, life expectancy actually goes down because of increased heart disease risk. (This is just an example).

    Personally, I think these dietary and lifestyle approaches are the key. But which one is best? Should I do my cycling before I eat or after I eat? Easy. The science says after. Not so fast. It may be better theoretically but I also have that little thing called reality to contend with, and it can get dark and cold early where I am. So I do before.

    Should I go on a very low carb or low/medium carb? Perhaps some people can't stomach the former, and the latter works better for them. Then what kinds of carbs should they eat? Does taking vinegar before their meal attenuate spikes? How about alcohol? There are so many questions and variations on these lifestyle questions that's its right and proper to question our ideas. We also need to understand that what works for us may not work for others. When someone states that it's "easy to reverse T2D" that is just as dogmatic as certain medical professionals. Meaningless reductionism of 'just correlation' is pointless and serves nobody.

    While a lot of the most recent research hasn't filtered down to the medical treatment community don't imagine that people who have devoted their lives to this condition aren't thinking hard about these questions, and it's disrespectful to them to suggest otherwise.
     
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  10. Guzzler

    Guzzler Type 2 · Master

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    It is disrespectful to assume that n=1 is meaningless. Too many guidelines are and have been set using dodgy hypotheses and equally dodgy correlative epidemiology.

    I have oft said on this forum that the aging process alone is going to change or might change the outcomes of my methods of managing my Diabetes right now.

    You cannot argue that all research is good research (or, rather, that the results of research are always perfect) as their are confounders even when the criteria are set. See; vested interests.
     
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  11. britishpub

    britishpub Type 2 · Well-Known Member

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    If you are going to quote my post, please do not misrepresent it.
     
  12. alienskin

    alienskin · Member

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    "T2D as a condition that can easily be controlled or reversed [...] Whilst we all know this as fact, [...]"
    So what then did you mean by that statement? Given that other posters seemed to interpret the 'this' to mean the first statement, it was a fair interpretation. If you meant something else, that's fine. Perhaps you can clarify.

    "It is disrespectful to assume that n=1 is meaningless. "
    No one is saying that n=1 is meaningless. Researchers use anecdote all the time as a starting point when considering what treatment is promising. But it still needs to be properly researched with proper controls. Certainly, if I believed a certain treatment was effective, I'd want to know that it actually was.

    "You cannot argue that all research is good research "
    Once again nobody is saying all research is good research. But if you'd like to argue what are the weaknesses of Professor Taylor's research beyond the shortcomings he acknowledges in the discussion notes in his papers, and elucidate precisely what you believe the confounders are in his research then please go ahead rather than just dismissing it as 'just correlation'. Some science is bad science is a meaningless argument - it's obvious and known by scientists themselves. We live for finding the weaknesses in studies so we can improve them. You need to address the particular studies.

    And clearly the confounders and lack of control, you find in a non-controlled anecdotal space like a forum are far far more significant. But it does not follow that the ideas being suggested here are wrong. Clearly, they are effective at least in the short term for a good many people, and possibly in the long term. Science thrives on ideas being challenged and improved.
     
  13. Guzzler

    Guzzler Type 2 · Master

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    I am not dismissing Taylor. I am, however, dismissing people like Rory Collins.

    You cannot serve us well by defending all science as well researched, unbiased and without monetary interests.

    Where science is now failing us, all the n=1s, is that some science is becoming Big Business and possibly ego driven (by some) instead of being a discipline that is purely altruistic.
     
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  14. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    I’m not really sure there’s such a thing as nutrition science. It’s all just a game of statistical manipulation and interpretation. This view could be applied to any “side” of course, but the difference with the current pushback against the establishment, is that it’s based largely in disproving correlation. Disproving correlations makes causation impossible, whereas proving correlation is easy when you know what you’re looking for, and only forms the basis of a hypothesis...which then normally skips the requisite controlled trials and goes straight to press. Hey presto...”facts” are etched into the minds of the public. “Scientists” say so, dont ya know.
     
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