[HN Gopher] Does the American Diabetes Association work for pati...
___________________________________________________________________
Does the American Diabetes Association work for patients or
companies?
Author : rokkitmensch
Score : 133 points
Date : 2024-05-04 17:52 UTC (5 hours ago)
(HTM) web link (www.theguardian.com)
(TXT) w3m dump (www.theguardian.com)
| GiorgioG wrote:
| The ADA has for a very long time told diabetics to keep eating
| carbs. Their tune is finally changing, but no, they don't give a
| shit about anyone other than themselves.
| code_biologist wrote:
| One drug advertisement I've seen on Pinterest lately says "diet
| and exercise can't treat diabetes" which may be true of type 1
| diabetes, but last time I checked 90% of the diabetes in the US
| is type 2 and diet improvements should absolutely be the first
| line intervention.
| connicpu wrote:
| It would probably be more accurate to say that diet and
| exercise _alone_ are not enough for most people with Type 2
| diabetes in the US. They are still an important part of
| intervention. But as a practical matter, telling people who
| 've developed Type 2 to just suddenly gain the willpower to
| do both of those things really isn't going to be enough to
| stop progress of the disease.
| nradov wrote:
| Diet and exercise are extremely effective in treating type 1
| diabetes. But some exogenous insulin (and other medications)
| are usually still required.
|
| For type 2 diabetes, research had shown that many patients
| can put the condition into remission through lifestyle
| changes alone. Nutritional ketosis is very effective in
| reversing insulin resistance.
|
| https://www.virtahealth.com/research
| UncleSlacky wrote:
| Agreed, I've just successfully reversed mine using the
| "Newcastle Protocol" (calorie restriction for ~12 weeks):
|
| https://www.ncl.ac.uk/magres/research/diabetes/reversal/#pu
| b... https://www.diabetes.co.uk/news/2017/dec/newcastle-
| diet-achi...
| ksaun wrote:
| > Diet and exercise are extremely effective in treating
| type 1 diabetes. But some exogenous insulin (and other
| medications) are usually still required.
|
| I think you are misinformed about Type 1 diabetes. Maybe
| you are thinking of some other condition?
|
| In Type 1 diabetes, the pancreas stops producing any
| insulin. Insulin must be administered regularly (always,
| not usually) or the person will die. "Other medications"
| aren't required.
|
| One's diet and exercise are relevant to Type 1 diabetes
| treatment, but are not a treatment method.
|
| Source: my daughter has Type 1 diabetes
| addicted wrote:
| There is nothing about carbs themselves that is bad for
| diabetics.
|
| Carbs are necessary macronutrient for everybody.
|
| If you mean certain foods that also have a high percentage of
| carbs then sure but carbs are not the problem.
|
| Take this line from the article itself, for example.
|
| > It can be challenging for many people with diabetes to forgo
| the breads, sweets, pastas and starches that form the basis of
| many diets.
|
| What's common about these foods isn't that they're high in
| carbs. It's that they're nutritionally deficient foods that
| have been stripped of all their fibers and basically reduced to
| sugars.
|
| Further, the diets promoted as low carb popularly are not good
| diets either for diabetics or for non diabetics.
| Sargos wrote:
| >Carbs are necessary macronutrient for everybody.
|
| This is a wild claim to make and doesn't seem to hold true
| scientifically. Humans require fat, protein, and various
| vitamins usually received from vegetables. There is no
| requirement that comes from carbohydrates as they effectively
| are just empty calories.
| meroes wrote:
| Nothing gives me quick, accessible energy like carbs
| though. Energy to think and love my body. Yes I've seen
| documentaries on low carb high fat ultra athletes, but they
| still have their fats with a bowl of pasta. God only knows
| their saturated fat intake too. A carbless diet does not
| seem well rounded, and is thus unhealthy. So carbs are
| essential.
| cempaka wrote:
| It does not follow from you personally deriving
| psychological benefits or quick energy from eating carbs
| that a diet which excludes them is not well rounded or is
| unhealthy.
| toast0 wrote:
| Keto isn't no carbs, but it's a pretty small number
| compared to typical diets.
|
| It's not for everyone, but it can help some people manage
| blood sugar.
| kjksf wrote:
| So you go from "does not seem well rounded" to "therefore
| is essential"?
|
| Here's some facts.
|
| There are nine essential amino acids that our body needs
| to function properly and cannot produce by itself from
| something else.
|
| Meat provides those amino acids and carbs do not.
|
| Carbs are a source of energy but so is fat, proteins,
| ketones and alcohol.
|
| In addition to reversing diabetes, people on low carb /
| high fat diets, including carnivore, often report
| increase in overall energy levels and lifting of a mental
| fog that they experienced on standard carb and sugar
| heavy diet.
|
| That energy spike that carbs and sugar give you is a
| glucose spike in blood and the downside of it is that
| often it goes in the other direction (i.e. lethargy) when
| you come off of it.
|
| That's the "nap after heavy meal" effect.
|
| This is not an anti-carb just anti what you do, elevating
| carbs into some unquestionably good, unique energy source
| necessary for you to think or love your body.
|
| Consuming carbs in moderation is fine.
|
| The problem is that our modern diet and what is available
| in grocery stores or restaurants make it almost
| impossible to consume carbs in moderation.
|
| And apparently plenty people like you don't even
| understand that carbs are, in fact, bad for most people.
|
| U.S. stats on this are shocking: 73.6% americans over 20
| are overweight and 42.4% obese (all obese people are
| overweight but not all overweight people are obese)
| adaptbrian wrote:
| This is exactly how I felt when I went keto/low
| inflammation foods. Would have never expected it.
| keybored wrote:
| > A carbless diet does not seem well rounded, and is thus
| unhealthy.
|
| Why "thus". Just saying that lacking something is not
| well rounded _thus unhealthy_ just looks some sort of
| middle of the road fallacy.
|
| Diets that are not about calorie restrictions are all
| about excluding certain things. And they all claim to be
| better than the potentially more versatile middle of the
| road diet.
| adrian_b wrote:
| Carbohydrates are not necessary for survival, but there are
| circumstances when they are necessary, for instance when a
| very intense effort is required to be sustained for a long
| time it is impossible to achieve a maximum performance
| without eating carbohydrates, because they can be absorbed
| and used for energy production faster than the
| alternatives.
|
| Moreover, there is not enough data to decide whether a diet
| lacking almost completely carbohydrates results in optimal
| health in the long term, even if it may have favorable
| effects when replacing a worse previous diet.
|
| Carbohydrates are also the cheapest kind of food. While
| eating them in excess is bad, obtaining less than 50% of
| the energy intake from carbohydrates still results in a
| much lower cost of the food than replacing all of them with
| expensive fats and proteins.
|
| For diabetes prevention, it is likely that it is more
| important to avoid sugar than it is to avoid starch,
| because in many traditional societies where starch was a
| big fraction of their food, diabetes was nevertheless
| uncommon.
| keybored wrote:
| > Carbohydrates are not necessary for survival, but there
| are circumstances when they are necessary, for instance
| when a very intense effort is required to be sustained
| for a long time it is impossible to achieve a maximum
| performance without eating carbohydrates, because they
| can be absorbed and used for energy production faster
| than the alternatives.
|
| And some people require an intake of 8000+ kcal a day.
| Not relevant to anything.
| watwut wrote:
| What is know for fact that this "carbs are evil"
| messaging absolutely sux for anyone having to deal with
| eating disorder - both sic people and their close ones.
| And if I had to choose between diabetes and eating
| disorder, I would go for diabetes.
|
| Eff the demonizing of whole food groups of food.
| kamens wrote:
| "nothing about carbs themselves that is bad for diabetics"
|
| is like saying
|
| "nothing about waves themselves that are bad for boats"
|
| kinda sorta true...but turns out sailing in calm waters is a
| hell of a lot safer than heading into rough seas
|
| (type 1 for 28 years)
| kjksf wrote:
| This is shocking misinformation.
|
| > Meat is considered a complete protein source, meaning it
| contains all nine essential amino acids that your body cannot
| produce on its own
|
| Do carbs?
|
| > Carbohydrates primarily provide energy for your body and
| are not a significant source of amino acids. Essential amino
| acids, which your body cannot produce on its own, are
| primarily found in protein-rich foods such as meat, dairy,
| eggs, and some plant-based sources like quinoa and soy
|
| So you're 100% wrong: carbs do not provide essential amino
| acids and meat does.
|
| The mechanism behind type 2 diabetes is well known and it's
| all about eating too much carbs.
|
| Sugars and carbs are converted to glucose in your blood.
|
| You can't have too much (or too little) glucose in blood.
|
| Some of it is burned as fuel but the rest has to be removed
| somehow so body starts producing insulin to push glucose into
| cells where it's get converted into fat.
|
| If you can't produce insulin, you have type 1 diabetes and
| need insulin injections.
|
| If you overeat carbs you store more and more fat. You become
| over-weight and insulin gets worse at moving glucose from
| your bloodstream.
|
| The diagnostic test for diabetes is literally: do you have
| too much glucose in your blood (compared to what is healthy
| range) or related test a1c which tests for elevated levels of
| insulin in your blood.
|
| If you know the above, then how in the world can you claim
| that carbs are not the problem? It is literally the thing
| that causes diabetes.
|
| The simple solution to reversing type 2 diabetes is therefore
| to stop eating carbs. That's low carb diets like keto or
| carnivore.
|
| You make very wrong assertions (carbs are not the problem;
| carbs have all macronutrients; low carb diets are bad)
| without a single supporting argument or reference.
| UncleSlacky wrote:
| > The mechanism behind type 2 diabetes is well known and
| it's all about eating too much carbs.
|
| No it's not.
|
| From https://www.ncl.ac.uk/magres/research/diabetes/reversa
| l/#bac...
|
| "We now know that type 2 diabetes is caused by excess fat
| inside liver and pancreas. ... The Twin Cycle Hypothesis
| described how it might be possible to explain the cause of
| type 2 diabetes in a very simple way. ... It was clear from
| that time onwards that type 2 diabetes is caused by too
| much fat building up within the liver, then overspilling to
| the rest of the body - including the pancreas. This starts
| up a second vicious cycle inside the pancreas, with the fat
| actually switching off normal insulin production...One of
| the most important discoveries is that of the Personal Fat
| Threshold. Type 2 diabetes is not caused by 'obesity'.
| Different people have different levels of tolerance of fat
| within liver and pancreas. But if you have type 2 diabetes,
| you have crossed your 'personal fat threshold'.
| mlhpdx wrote:
| > There is nothing about carbs themselves that is bad for
| diabetics.
|
| That is untrue. A Type 1 diabetic requires insulin
| proportional to the amount of carbohydrates they eat. The
| larger the insulin dose, the higher the potential error in
| the dose compared to the carbs (it's inexact). If the error
| is on the "too much" side it can drive blood sugar fatally
| low. This happens, unfortunately often.
| pimeys wrote:
| Nowadays the artifical pancreas software can quite nicely
| counteract the carb spikes. It's not very hard, just take
| all your basals for the next two hours and then have no
| insulin delivery for that time. Especially if you eat fast
| carbs, this is the right strategy.
|
| More complex is to dose for fat, protein and carb mixture.
| You basically need almost no insulin first, but in the next
| four hours you need 1.3-1.4x your basal to cope with the
| raising sugar.
| mustang-med wrote:
| My hard and fast rule in america is that everything aside from
| unions do not work in the interest of the people. The sooner this
| is taught to our kids, the better off they'll be from being
| indoctrinated from the trash on instagram/tiktok.
| aardvarkr wrote:
| That's... honestly not a bad take. If we're not paying for it
| then we're the product, not the customer. Need to clarify that
| unions aren't for ALL PEOPLE, just the people who pay for them
| newshackr wrote:
| Unions also don't always work in the interest of everyone they
| represent. For instance, they tend to be protective of older
| and longer working members in exchange for limiting upward
| mobility of younger members. Or building policies that
| encourage the growth of the union as an organization, despite
| potential costs.
| CSSer wrote:
| It's true. My first job was as a cashier at Kroger. I
| remember looking at the pay tables and being shocked. You
| could make impressive money as a cashier at Kroger... if you
| worked there for 30 years. Virtually no one I worked with had
| even worked there for more than a few years either.
| Meanwhile, I earned just above the federal minimum wage and
| multiple hours of my weekly earnings went to little more than
| protecting my "right" to "no-call, no-show" for six straight
| days in a row before being fired. I never did this. It seemed
| unfair. Others did and I had to work that much harder on
| those days.
|
| One day a union rep stopped by. He was very well-dressed, and
| he had this beaming smile. He gave me a t-shirt. That pretty
| much summed up the benefits I experienced.
|
| I remain pro-union, but every time the subject comes up I
| think there's a lot more nuance there than people would like
| to admit. My Dad, for example, has worked at a union job for
| over 30 years. Ironically, he's a Republican. He makes decent
| money now, but the job is very labor intensive, and the
| healthcare sucks. He's repeatedly turned down a promotion
| into management because he'd be out of the union and earning
| a salary that is not that much higher than what he currently
| earns per hour. He's also told me repeatedly that kids just
| don't want to work anymore because the turnover rate is high.
| Many starting out, especially those with dependents, complain
| that it's not worth it for what they earn. He holds that
| although it's not great it's enough. Recently, in an attempt
| to persuade him to take a promotion, he learned that the
| healthcare plans offered to management are 2-3x cheaper for
| better benefits than what the union has negotiated. It's been
| pretty crazy to watch his opinion slowly begin to shift.
| ipaddr wrote:
| He is staying in for protection. The extra money doesn't
| make up for having your experience count as added
| protection (they can't fire him, they can reduce those jobs
| and employees with more service time will keep the job
| first).
|
| If a company can fire quickly and replace with cheaper
| options no one is going to last more than a few years. Many
| software shops do this (meta, Amazon, generic local
| company, etc.
|
| I share your experiences working in a union environment
| when younger and having family have live long jobs. In one
| case I felt the union was against me or my class of worker
| (student employee) because we took away from regular union
| jobs. Still had to pay dues. The other union job just took
| a few dollars from my paycheck but gave me a wage I
| couldn't earn elsewhere.
| crmd wrote:
| When you become an older worker, and experience firsthand the
| vulnerability of seniority, you realize why your union was
| always so protective of older workers. I would think many
| tech workers over ~35 can relate.
| akira2501 wrote:
| The fundamental idea of most unions seems to be, that once
| labor recognizes that it is working for a monopoly, instead
| of working to break up that monopoly, they decide to form one
| of their own in order to gain some power of negotiation with
| their employer. Typically to the detriment of the consumer
| market and the labor market.
|
| For new entrants into the labor market, as you've flagged,
| now they have to successfully negotiate between two overly
| large entities with predictably unfortunate results. Labor is
| best served as a competitive market and unions should only be
| used in the few limited circumstances where they are
| otherwise unavoidable.
| swatcoder wrote:
| The more complete and histocally evidenced rule is that all
| institutions eventually just work to continue and/or expand
| their existence in itself.
|
| They can get founded in the genuine interests of some cause
| (and often are), but each transition in leadership tends to
| find itself more professionalized in some way and more divorced
| from the founding cause, with process (and/or corruption)
| becoming their effective mandate instead.
|
| Unions, sadly, have shown no exception, which is what allowed
| public opinion to eventually swing against the post-war batch
| of them. We could use some fresh unions in many industries for
| sure, but there's no truth in putting them on a pedestal.
| They're prone to devolve and corrupt just like everything else,
| and there are people who still carry the experience of having
| seen them do so.
| zoidb wrote:
| "First, there will be those who are devoted to the goals of
| the organization. Examples are dedicated classroom teachers
| in an educational bureaucracy, many of the engineers and
| launch technicians and scientists at NASA, even some
| agricultural scientists and advisors in the former Soviet
| Union collective farming administration.
|
| Secondly, there will be those dedicated to the organization
| itself. Examples are many of the administrators in the
| education system, many professors of education, many teachers
| union officials, much of the NASA headquarters staff, etc.
|
| The Iron Law states that in every case the second group will
| gain and keep control of the organization. It will write the
| rules, and control promotions within the organization. "
|
| It's the Iron Law of Bureaucracy
| https://www.jerrypournelle.com/reports/jerryp/iron.html
| 7thaccount wrote:
| I found this revelatory at one point in my career, but this
| shouldn't have been a surprise as the administrators
| literally control all promotions and will thus turn the
| organization into one that serves the managerial class over
| actual technical ability and knowledge.
|
| As a technical worker, your best option is to try to become
| extremely valuable and make it known that your continued
| employment is predicated upon promotions when they should
| be due. For example, if senior engineer is available at 5
| years and you're working your butt off, you need to make it
| known that you're expecting it or they may just push it out
| to 6 years if they think they won't lose you. If you're
| really good at your job and it would be difficult to
| replace you and put your manager behind schedule, they'll
| be incentivized to take care of you. It's all a game.
|
| On the flip side... don't try this if they're trying to get
| rid of you. Be prepared to walk away if you can if they're
| not taking care of you.
|
| Another thing I learned is that if you want to join
| management, you have to pretty much stop acting technical.
| They usually don't like adding technical staff to
| management as 1.) it may make them look incompetent, 2.)
| you provide more value to the company doing technical work
| at a lower salary, and 3.) it shows you might actually not
| be a good fit for that kind of work, although this isn't
| necessarily true.
| bobthepanda wrote:
| Not all unions are perfect and there are certainly issues.
| That being said, the American solution of getting rid of them
| entirely is throwing the baby out with the bathwater.
| Individual employees just do not have the negotiating heft of
| a corporation, particularly in the US with employer provided
| healthcare and whatnot.
| mistrial9 wrote:
| this has lots of "real" in it but details matter. At a
| formative time, American politics specifically substituted
| "safe" leadership in union upper management.. either
| connected to party politics or just directly from old-Right
| Europe who had lots of experience dealing with workers and
| systems. Yes, there were real Mafia families in the
| Teamsters, in other words. The fiery and violent revolutions
| across the world did have their impacts on America.
|
| Since the 1980s, evolution via bureaucracy and golf clubs,
| court cases and election results seem to have been more the
| driving force.. people can only get so fat before their eyes
| start to glaze over and trivial concerns take the airtime.
| keybored wrote:
| > The more complete and histocally evidenced rule is that all
| institutions eventually just work to continue and/or expand
| their existence in itself.
|
| This isn't more complete and historically evidenced. This is
| a Law Named After Person/Dilbert Quip, which is the pit of
| cliches that a lot of HN comments fall into on sociology.
|
| What, other than just cynicism,[1] have these Stated Truisms
| contributed to? These rules are so rigid (so they can be
| pithy, snappy) that they sound immutable. Is the point only
| to, say, feel smug about how the manager directly above you
| has been promoted to his level of incompetence?
|
| [1] Cynicism is fine and good. But just-cynicism has no way
| of moving beyond itself to a better state. The difference
| between critique and throwing your arms up.
|
| > They can get founded in the genuine interests of some cause
| (and often are), but each transition in leadership tends to
| find itself more professionalized in some way and more
| divorced from the founding cause, with process (and/or
| corruption) becoming their effective mandate instead.
|
| Nothing in history is ever just a downward spiral of
| corruption and rigidity. Outside things happen, revolts
| happen, things are replaced, systems are overturned.
| watwut wrote:
| That quip is a cynic joke, not a statement of historical
| fact. There are many organizations that simply kill
| themselves and die out via people leaving as the original
| purpose don't matter anymore.
| swatcoder wrote:
| Quip? Joke? I don't know what you mean.
|
| It's an extensively treated paradigm in sociology. With
| sociology being a "soft" science and not having access to a
| methodology as rigorous as physics, it's certainly
| _contestable_ and there are of course many sociologists who
| have made arguments against it or that simply don 't
| consider it convincing, but it's not just some casual
| insight and certainly not someone's "joke".
|
| The reason I mentioned it, in any case, was to relate it to
| previous commentor's supposition that unions were excluded
| from their "rule" (which _was_ a casual insight). You needn
| 't take either this perspective nor theirs as true
| yourself, but there's not much case to exempt unions if
| you're going to start looking through the world from that
| lens in the first place.
| hawkice wrote:
| Unions aren't acting in the interest of the people generically,
| often not even the members of the union. Otherwise they
| wouldn't go to court to force people who don't even want to be
| in the union to pay dues, even when the dues go to political
| campaigns unrelated to the purpose of the union, as in Janus v.
| AFSCME (where the support for political causes by the union
| meant it violated _public sector workers_ freedom of speech if
| they are compelling fees from non-members, a relatively narrow
| ruling not impacting most unions).
| elicash wrote:
| I strongly disagree with you about Janus.
|
| The point of that decision by a right-wing court was to make
| it harder for public sector workers to stand together in
| unions. Unions are democratic institutions, with dues and
| leadership decided by the membership, and the idea that some
| people pay and some don't even though the entire unit is
| represented doesn't make a ton of sense. Just like it
| wouldn't make sense if 2 people in a unit of 1000 wanted to
| be in a particular union to just say those 2 can bargain
| collectively.
|
| The weird "speech" argument was basically that their worksite
| issues are inherently political. I disagree. Unions have
| separate political funds from the worksite stuff that are
| optional.
| beryilma wrote:
| > 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 in lieu of an agency fee shall be
| dismissed. If the Union makes such a request, the Employer
| shall comply... If the Part-time Faculty Member fails to pay
| within that time period, and the Union so verifies, the Part-
| time Faculty Member's employment will be terminated at the
| Union's request".
|
| If anything, unions are only acting in their own interest.
| sircastor wrote:
| 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 a concept, but not
| necessarily any union members.
|
| It's weird.
| goto11 wrote:
| There is no "the interest of the people". There are lots of
| different people with different and often conflicting
| interests.
| hn_version_0023 wrote:
| There's a movie clip I've seen with Brad Pitt of all people,
| explaining how America isn't a nation, it's a business. A
| business you don't own and can't escape. And you're on your
| own. Something to that effect anyway. I'd love to know the
| movie or show! Its such a perfect example of a truth we all
| know but that never gets spoken aloud.
|
| The Founding Fathers would be deeply ashamed of us, I think.
| 7speter wrote:
| >The Founding Fathers would be deeply ashamed of us, I think.
|
| Sorry, but the founding fathers who held other humans in
| bondage for all sorts of free labor?
|
| Those founding fathers, or did I wake up in a parallel
| universe this morning? Let me check wikipedia...
| mistrial9 wrote:
| > the founding fathers who held other humans in bondage for
| all sorts of free labor
|
| Actually, slavery was a bitter dividing line among the
| founders of the USA. It is intellectually lazy to ascribe
| slavery to all of the founders of the USA. It also insults
| those who were vocally and politically against slavery,
| from the very earliest days. You can find many examples
| with any effort at all.
| sapphicsnail wrote:
| Almost all of the founding fathers either owned slaves or
| weren't willing to stick their necks out to stop it. We
| absolutely should question their judgement.
| mistrial9 wrote:
| less than ten seconds of research:
|
| $googlesearch "how many signers of the US Constitution
| were slave owners?"
|
| 25 Of the 55 delegates to the Constitutional Convention,
| about 25 owned slaves. Many of the framers harbored moral
| qualms about slavery.
|
| Historical Context: The Constitution and Slavery
| beepbooptheory wrote:
| Is there anything at all to be said about the fact that
| slavery ended up being permissible anyway? Or is that
| just lazy?
|
| Like, doesn't the sheer magnitude of the inhumanity that
| actually existed in these times kind of overshadow
| whatever armchair-enlightment some guys voiced?
|
| How could you be aware of what they did in those times
| even the slightest bit, and yet still be concerned that
| one might "insult" guys who have been dead 200 years? How
| can that even make sense?
| mixmastamyk wrote:
| Slavery wasn't invented in America. It was common during
| the Roman Empire and thousands of years before that.
| Blaming 18th century folks for not righting every wrong
| up to their time is lazy, as it would be to attribute
| full-responsibility to you today for something improved
| and looked down upon in the future.
|
| (None of us are fully independent but gain and suffer
| inertia from history and society at large.)
|
| Still, we can learn from Ancient Greece, American
| Founders, as well as folks today.
| beepbooptheory wrote:
| I apologize, this is such a strange way to be positioned
| to all this. The point of bringing up something like the
| practice of slavery in early America is not about
| "blaming" people about anything. They are already dead!
| Many generations over. This conceit that the bare
| acknowledgement of history itself should merely serve to
| assign blame or culpability to certain people or another
| feels just so wrong.
|
| The point is that it happened. It was determined and
| sustained by countless totally mechanical and impersonal
| conditions and tendencies. Just as the operative
| ideologies in play in the minds of all our fave founding
| fathers can only be viewed from our purview as some
| composite of factors, not as some collection of good guys
| and bad guys. To point out that maybe they should not be
| a moral compass to us today is not scapegoating them in
| some grand moral court of human existence! Its just
| making a point, and urging historical context as a tool
| to maybe be a little more rational about our world today.
| There is nothing at stake but that.
| rawling wrote:
| Killing them softly?
| AmVess wrote:
| Yep. Quote is at the end.
| adhamsalama wrote:
| Fight Club?
| sircastor wrote:
| I think the founding fathers would be confounded by us more
| than anything else.
|
| Probably by federalism, the focus on the presidency, Senate
| elections by the general populace, the role and power of the
| Supreme court, and a pile of other things.
| citizen_friend wrote:
| What property do unions possess that makes them different?
| rpmisms wrote:
| Unions work in their own favor, not necessarily the workers'.
| That's the real rule: everything tries to benefit itself.
| guerby wrote:
| 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
| voisin wrote:
| The insight being low carb can send T2 diabetes into remission?
| UncleSlacky wrote:
| Also check out the Newcastle Protocol by Prof. Roy Taylor, now
| adopted by the NHS:
|
| https://www.ncl.ac.uk/magres/research/diabetes/reversal/#pub...
| renewiltord wrote:
| Classic principal-agent problem. It's why you can't usually trust
| experts who aren't aligned with you. One way is skin in the game.
|
| But I suppose "if you aren't paying, you're not the customer"
| applies as well to nutrition and medicine as it does to free
| webmail.
| cempaka wrote:
| In light of this news, how should we reevaluate some of the
| recent admonishments to "trust the experts" and "don't do your
| own research"?
| marcosdumay wrote:
| Are you talking about doing your own research or sheepishly
| believing on what some random person you like preaches to
| you?
|
| One of those work, the other is what people that say they
| "did their own research" usually do.
| cempaka wrote:
| The "trust the authorities" perspective currently en vogue
| is certainly _not_ that "doing your own research works."
| It's that one needs an MD or PhD in a medical field in
| order to evaluate research, and hence should defer judgment
| on personal decisions to such qualified individuals (or
| more often, in practice, to institutions which purport to
| speak for them like the AMA, AAP, or American Diabetes
| Association).
| riknos314 wrote:
| Worth noting that the only requirements to be recognized as an
| Association by the IRS is that there must be a dated, written
| document showing its creation, signed by at least two people. [1]
|
| [1] https://www.irs.gov/charities-non-profits/definition-of-
| an-a...
| not2b wrote:
| My diabetic wife has long been horrified at the dietary
| recommendations coming from the ADA, they are worse than useless.
| I don't blame the whistleblower for settling but it's a shame
| those people won't take consequences for actively harming people
| in exchange for corporate contributions. Their nonprofit status
| doesn't keep them from paying the top officers fat salaries out
| of those donations.
| AlbertCory wrote:
| > Over 100 million Americans have diabetes or prediabetes
|
| These two are not the same. It is dishonest to combine the two.
|
| https://www.chicagotribune.com/2016/07/29/prediabetes-the-ep...
|
| I'm not quite ready to publish my hypothesis that prediabetes is
| a scam. I need to research it a little more. But a statistician
| friend of mine responded:
|
| _A handful of years ago, I looked into the National Health and
| Nutrition Evaluation Survey, NHANES. To first order, the 1AC
| level defining pre-diabetes, 6.5, is rather close to the median
| level. So that 's scam-adjacent. Every once in a while, my doctor
| thanks me for giving him this NHANES table. _
|
| https://docs.google.com/spreadsheets/d/1g3Icgu0ixLtYCjscYoiC...
|
| As soon as you say this, someone will respond "My father has
| diabetes and he had his foot amputated!" This is not minimizing
| diabetes; it's questioning whether _prediabetes_ is a thing.
|
| How is it different from saying "Men over 60 have pre-prostate
| cancer?" Or, "we all have pre-death?"
|
| You should have a regular blood test and your doctor should be
| monitoring a lot of things, including blood sugar. If the level
| is close to diabetes, he or she should warn you. But that's
| different from saying, "you have a disease."
| LiquidPolymer wrote:
| I switched health providers and got a physical recently. One of
| my labs came back with "pre-diabetic" check marked. I asked my
| doctor about this and I was .1% into the metric. It could have
| been either side of the line. I'm very fit because I enjoy
| hiking and exploring.
|
| I already avoid sugar and bread. I work out nearly every day.
| I'm very active and my BMI is on point. My blood sugar was
| fine. It was another metric that I can't recall at the moment -
| but it seemed weird. Regardless, a very obese nurse sat me down
| and gave me tips for changing my diet.
| borski wrote:
| This was likely your A1C, or a metric of the last three
| months or so of your sugar levels.
|
| Just because you feel healthy doesn't necessarily mean you
| are healthy. You may have, for example, a pancreas condition.
| Or it may be nothing at all, and just something to track,
| which is why you never base any medical decisions off a
| single test.
|
| Your last sentence is nonsense. People can provide
| exceptional (and correct) advice without necessarily
| following it themselves, and for all you know this nurse has
| spent the last year actively trying to improve their health.
| AlbertCory wrote:
| It's strictly a question of his likelihood P for developing
| diabetes. If his P is the same as that of other people with
| lower A1C, then "prediabetes" is nonsense.
| borski wrote:
| > Or it may be nothing at all, and just something to
| track, which is why you never base any medical decisions
| off a single test.
| thefifthsetpin wrote:
| I have no credentials here, but I'm often working in this space
| and your take is the polar opposite of what I normally hear
| from the endos and diabetes researchers that I've worked with.
| More accurate terms might be diabetes and morbid diabetes.
|
| That the cutoff for prediabetes is close to the median level is
| a statement that much of the population is actually unhealthy
| in this regard.
| AlbertCory wrote:
| No, it's a statement that the "cutoff" was chosen on
| questionable grounds. Defend it.
| guerby wrote:
| Did you check the litterature?
|
| https://pubmed.ncbi.nlm.nih.gov/20697688/
|
| Hba1c 6.0 to 6.5 (so called prediabetic range) has 2.5
| times the hasard ratio of below 6.0.
|
| Increasing Hba1c is the leading indicator of future health
| issues and by far.
| AlbertCory wrote:
| This comes closer to a cogent answer, which is what I was
| after.
|
| > future health issues
|
| like?
|
| As I said, I'm not ready to publish this, but I wanted to
| hear some arguments that made sense. So thanks.
|
| To me, "probability of progression from pre-diabetes to
| diabetes" is the only reason to say it's a real condition
| rather than just a risk factor.
|
| Furthermore, it would be the _derivative_ of the level,
| rather than the level itself.
|
| And finally, it would have to be separated from other
| unhealthy conditions. Meaning, if they drink too much AND
| have pre-diabetic A1C, ERROR! Otherwise, how do you know
| it's not the alcohol?
| mlhpdx wrote:
| Get peer review and publish; let's see what happens.
| mlhpdx wrote:
| According to what I understand from researches in this area
| is that even a slight increase in A1C is highly correlated
| with later progression. You may not like the term, but it
| effectively communicates the situation.
| AlbertCory wrote:
| > You may not like the term
|
| I like numbers. Where are yours?
| tptacek wrote:
| _Converse curiously; don 't cross-examine_
|
| https://news.ycombinator.com/newsguidelines.html
| AlbertCory wrote:
| that begins with "Be kind. Don't be snarky. "
|
| I don't think that was snarky. You made some non-
| quantitative statements.
| pvg wrote:
| Those also end at their full stops, it's not 'you can act
| like an interrogator as long as it's not a snarky
| interrogator'.
| Hello71 wrote:
| > pre-diabetes [...] is rather close to the median level
|
| but according to the NIH, 30.7% of Americans are overweight,
| and 42.4% are obese. as the median American is overweight, it
| doesn't seem a stretch to claim that the median American is
| also pre-diabetic? I don't know whether it's true or not, but
| your evidence seems a bit thin.
| AlbertCory wrote:
| > it doesn't seem a stretch to claim that the median American
| is also pre-diabetic
|
| No, it's your evidence that's thin. You seem to have started
| from the premise ("Americans are unhealthy") and derived a
| pre-diabetes level from that.
| nradov wrote:
| If you're going to try an appeal to authority, then at least
| come up with a plausible authority instead of some random
| statistician who likely doesn't know the basics of physiology.
| The first thing you need to understand is that normal [?]
| healthy. For example, a resting heart rate of up to 100 bpm is
| considered "normal" in the sense that it doesn't require urgent
| medical intervention. But of course anything over 60 bpm for an
| adult usually indicates some underlying pathology with a risk
| of premature morbidity and mortality.
|
| The essence of type 2 diabetes is insulin resistance. Like many
| medical conditions it exists on a spectrum. The specific HbA1c
| thresholds of 5.7% for pre-diabetes and 6.5% for diabetes are
| inherently arbitrary and serve mainly to make communication
| easier. But there is a clear correlation between elevated HbA1c
| levels and higher all-cause mortality.
|
| https://doi.org/10.1136/bmjopen-2017-015949
|
| Also note that HbA1c tests aren't perfect for diagnosing type 2
| diabetes and can have false positives or false negatives. If
| there is reason to suspect diabetes then it would be wise to
| conduct additional tests to get a better understanding of the
| patient's metabolic condition.
|
| https://peterattiamd.com/ama15/
| AlbertCory wrote:
| > some random statistician who likely doesn't know the basics
| of physiology.
|
| since you know nothing about him, that's hardly called for. I
| could doxx him but he didn't consent to that. And he said his
| doctor thanked him for it.
|
| And you have fuzzed the difference between "a disease" and
| "something to watch for." If ~50% of the US population needs
| to be watched, the doctor learns nothing by having a label
| put on their HbA1c level. The word added nothing to their
| understanding.
|
| > If there is reason to suspect diabetes then it would be
| wise to conduct additional tests to get a better
| understanding of the patient's metabolic condition.
|
| And finally, you just confirmed what I said. It's not "a
| disease" -- it's a risk factor. Like smoking, drinking,
| obesity, or sedentariness.
|
| The more everyone objects without any logical argument, the
| more it's confirmed:
|
| "if that biomarker, _all by itself_ , predicts type 2
| diabetes better than random chance, in the absence of any
| other risk factor, we're entitled to call it a disease."
| underseacables wrote:
| Like most associations and trade groups, they are beholden to
| whatever gives them money. It's like when the Academy of
| nutrition and dietetics was sponsored by Pepsi and Mars.
| gumby wrote:
| I was shocked by the ADA's nutritional training (required by my
| insurance company) but I figured that the actuaries had decided
| they'd delay amputation better by encouraging people to eat a
| small slice of cake rather than no cake at all.
| akira2501 wrote:
| So the actuaries decided to unironically "sugar coat" the truth
| to gain a small measure of compliance?
| Animats wrote:
| Cures are nice, but the money is in chronic conditions.
| User23 wrote:
| The entire American medical system manages to act against the
| interests of both patients and doctors, the two essential classes
| of participants. It's a rather remarkable achievement.
| marcosdumay wrote:
| If you look around, that happens often on several different
| industries.
|
| Somehow both people consuming and producing stuff are powerless
| nowadays.
| fransje26 wrote:
| I'll leave this little perl here:
|
| https://arstechnica.com/tech-policy/2018/04/curing-disease-n...
| user_7832 wrote:
| > 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 regulations against such stuff? For eg in some
| countries you cannot use the name of the city/state/country
| unless you're a government entity.
| johnfernow wrote:
| I agree, it seems extremely misleading, especially for medical
| organizations. The US government doesn't make consumer clothes,
| so I don't think anyone's too confused with American Eagle
| Outfitters not being government-ran, but the US does have
| several government-ran Health and Human Services divisions and
| U.S. Public Health Service agencies (e.g. the Centers for
| Disease Control and Prevention (CDC), the National Institutes
| of Health (NIH), etc.)
|
| I wonder what percent of Americans think that the American
| Diabetes Association is a government-ran organization. My guess
| is that it's quite high. You'd have to design a poll correctly
| (e.g. "From the following list, select which ones are
| government-ran organizations") to not give the answer away, but
| I imagine it's a high percentage.
| im3w1l wrote:
| Associations aren't typically governmental entities are they?
| citizen_friend wrote:
| Nobody has your interest in my mind, except in so far as aids
| their interests. Doesn't matter how many regulations or labels
| or non profit signals there are.
| crazygringo wrote:
| I've been baffled by this for the longest time.
|
| Why does "Bank of America" get to call itself that? Growing up
| there was a "USA Federal" credit union [1] too, with a stylized
| American flag logo.
|
| Similarly there's a historic "New Yorker" hotel in New York
| City, and the totally separate "New Yorker" magazine, neither
| of which have any official affiliation with the city.
|
| The short answer is that no, there don't seem to be regulations
| against it. Why any business seems to be able to take the name
| of a country or state or city, and therefore gain an aura of
| authenticity or approval, and then prevent any other from doing
| the same (since the name got taken, you can't have _two_ Bank
| of Americas) -- I 've never understood why the government
| allows these things.
|
| [1] https://en.wikipedia.org/wiki/USA_Federal_Credit_Union
| nradov wrote:
| America is a pair of continents, not the name of a country.
| The US federal government doesn't hold a trademark. The
| notion that companies shouldn't be allowed to name themselves
| after geographic features or political regions is absurd.
| crazygringo wrote:
| In the US, if you ask 100 people what "America" is, they'll
| tell you it's the name of the country they live in. And
| since language is defined by use, yes -- America is the
| name of a country. The shortened version, of course, just
| like "Mexico" is the shortened version of the "United
| Mexican States". Surely you're not going to claim that
| Mexico isn't the name of a country either?
|
| And no, "America" is not a pair of continents in standard
| usage -- that's "the Americas" you're probably thinking of
| (plural and with the definite article). Which is a rare
| term to come across, essentially unused in regular
| conversation, reserved for some highly specific contexts.
|
| And I'm saying that companies being able to name themselves
| after political regions _is_ absurd. How is that fair? I
| don 't get to name my company "Google Bank" (and make it
| seem falsely associated with Google), so why should I get
| to name my company "New York Bank" (and make it seem
| falsely associated with New York)?
| jodrellblank wrote:
| Why would it be "falsely" associated if you actually are
| in New York?
|
| What if you change your name to John New York then named
| the company after yourself, is that bad?
| lupusreal wrote:
| In America, the pair of continents are know as "the
| Americas". Every American knows singular 'America' refers
| to America.
|
| > _But in other countries we say-_
|
| Other countries exist?
| verisimi wrote:
| Even the federal reserve is privately owned though.
| deegles wrote:
| maybe someone should start the American Anti-Diabetes
| Association.
| bhelkey wrote:
| 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 artificial sweeteners.
| kwhitefoot wrote:
| Sugar does more than one thing. It's mere presence triggers
| hormone related actions in the body and its energy content is
| what the reaction is supposed to deal with.
|
| If a sweetener behaves like sugar as far as taste is concerned,
| that is it fools one part of your body into reacting as though
| it is sugar, it seems plausible that it might also fool other
| parts of the system.
| watwut wrote:
| There is type of diabetes that is simply hereditary and that is
| all there is to it. It is not rare. Then there is also
| pregnancy diabetes that comes and goes with pregnancy (they
| make routine test for it).
|
| Not all diabetes is from sugar.
| McP wrote:
| 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-...
| johnfernow wrote:
| Here's a great PDF I found on the ADA's website from fall 2023:
|
| https://professional.diabetes.org/sites/default/files/media/...
|
| > This content is brought to you by Splenda, a proud supporter of
| the American
|
| > Diabetes Association
|
| > A Message from Splenda
|
| > Splenda(r) is committed to helping people achieve their health
| goals by making it
|
| > easier for people to reduce the amount of added sugar in their
| diet. You likely know
|
| > Splenda Original Sweetener ("the yellow packet"), but did you
| know we also make
|
| > Splenda Stevia? Splenda Stevia is a plant-based sweetener made
| from the
|
| > sweetest part of the leaves of the stevia plant. And just like
| Splenda Original,
|
| > Splenda Stevia contains zero calories and zero sugar. The
| people you see can use
|
| > Splenda Stevia to make a variety of delicious recipes from
| appetizers and drinks to
|
| > entrees and desserts.
|
| > Check out the ADA's Diabetes Food Hub(r) for recipes that use
| Splenda Stevia, like
|
| > these Slow-Cooker Sweet & Spicy Turkey Meatballs, which are
| perfect for a football
|
| > party, and these Gluten-Free Mini Eggnog Cupcakes which add
| cheer to any holiday
|
| > gathering!
|
| WHY??!!! I get upset enough with tech YouTubers making misleading
| claims about VPN sponsors, but the American Diabetes Association
| allowing sponsors that sell products that several studies link
| with causing and worsening diabetes to write parts of their
| newsletters is an entirely different degree of unethical
| behavior. No, the link between artificial sweeteners and diabetes
| has not been firmly established and more research is needed, but
| it's a likely enough connection that the CDC and WHO[1] have
| expressed concern and have noted the potential links.
|
| [1.] https://www.who.int/news/item/15-05-2023-who-advises-not-
| to-...
|
| I get it, organizations have to get funding somehow. But if the
| American Lung Association started allowing vape companies to
| write part of their newsletters, I think people would rightfully
| be outraged. Sure, vaping is less bad for you than cigarettes,
| and may even be a helpful way of quitting for some, but allowing
| them to be a sponsor is a major conflict of interest and causes
| you to lose credibility.
| siliconc0w wrote:
| Endless capture of our intuitions by entrenched incumbents.
|
| I'm pretty convinced that unless you're an athlete, everyone
| should be on a low carb diet (<100g a day for moderately active).
| Our bodies aren't equipped to deal with the speed-ball you get
| each meal with the standard american diet. Aside from diabetes
| and obesity, the is growing data on keto-diets improving
| psychiatric, neurological, or even cancer outcomes.
| johnfernow wrote:
| > My view is that diabetes is an urgent national scandal. Over
| 100 million Americans have diabetes or prediabetes, and 100,000
| die from the condition annually. In addition, every year hundreds
| of thousands of people with diabetes have limbs amputated or
| suffer blindness or kidney disease. Diabetes costs our country
| $400bn annually to treat.
|
| So about 4x as many deaths per year as homicide, twice as many as
| suicide, twice as many as car crashes, twice as many as
| accidental falls, and a multiple of plenty of other preventable
| causes of death. Obviously some of these other types of deaths
| take far more years off people's lives than diabetes, but I think
| the author is right to call it an urgent national scandal.
|
| > Her meticulous account depicts the world's most important
| diabetes patient advocacy organization as a cynical fund-raising
| machine, anxious to please its corporate overlords at the expense
| of the millions of people with diabetes it is supposed to be
| trying to help. "The defendant's conduct shows that they were
| party to a scheme to defraud the American people by approving and
| endorsing recipes submitted by Splenda to be lauded by the ADA as
| a healthy choice for people with diabetes, when the ADA knew that
| those recipes were contrary to the ADA's guidelines and well-
| established and emerging scientific principles," the complaint
| reads. 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.
|
| I really wish this could have gone to the discovery phase.
| Hopefully there will be investigations.
|
| > And although type-2 diabetes is often reversible through a low-
| carbohydrate diet, the ADA and the pharmaceutical industry don't
| seem very interested in acknowledging that. Instead, they promote
| a laundry list of corporate deals and pharmaceutical treatments
| that have failed to stem the disease's lethal and expensive
| impact on American life.
|
| I'm not naive enough to think that all (or even most) of the tens
| of thousands of people dying from type 2 diabetes each year would
| be saved if the ADA didn't give poor advice, but I also think
| it's wrong to think that it'd have had no impact: insulin has
| been infamously expensive for many years in the US, and insulin
| pumps are thousands of dollars. I certainly think some of the
| millions of people who ended up dying from type 2 diabetes would
| have made lifestyle changes had it been made clear that it's
| often reversible with diet changes, if for no other reason than
| to save money. If you don't have a pump, having to take insulin
| shots throughout the day is a pain the ass, so again, I think
| some people would have made lifestyle changes to avoid that had
| it been made clear that it was an option.
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