4 ms·

While this article is technically correct, I think it is actively harmful to the landscape of general public knowledge. A lot of this article is just playing "

While this article is technically correct, I think it is actively harmful to the landscape of general public knowledge. A lot of this article is just playing "gotcha", where she's pointing out technically a lot of cultural glosses about diabetes only applies to type-2 diabetes. However type 2 diabetes occurs at a rate >10x as much as type 1 diabetes [1], and it's the type that is more preventable by behavior and diet change. Statements close to the "myths" she's debunking is approximately true, while her "technical facts" if not handled with care will lead to far worse wrong beliefs. Approximate myth that we want: "Generally, diabetes is strongly related to high BMI and bad diet which often includes diets high in sugar". Technical truth that muddies the conversation: "Actually the above relationship excludes T1D, which is a vast minority of diabetes." Approximate myth we want: "Many diabetes is preventable by eating well." Technical truth that muddies the conversation: "Actually some T1D is adult onset 2-3%, so you may not be able to prevent those!" Approximate myth we want: "Bargain hunting for medications when medically equivalent is good, especially generics." Technical truth: "Actually there are medical differences between different insulin formulations, because unlike small-molecule drugs, different formulations are not biologically equivalent. Some expensive modern formulations are good." -- A doctor with knowledge about public health and has good writing skills should reconsider writing an article like this. Why not go after real harmful myths like anti-vaxxers? Or how about rewording the article so that the myth is actually approximately bad, like "Bad diets are okay for diabetes as long as you avoid sugars". [1] https://www.cdc.gov/mmwr/volumes/67/wr/mm6712a2.htm https://www.cdc.gov/mmwr/volumes/67/wr/mm6712a2.htm

vo2maxer 7y ago
I thought the article author’s background could be of interest: https://med.virginia.edu/faculty/faculty-listing/hf4f/ https://med.virginia.edu/faculty/faculty-listing/hf4f/
dorkwood 7y ago
I would argue that the approximate truth of "diabetes is preventable by eating well" isn't useful, since members of the public often have a distorted view of what "eating well" means. I once had an obese friend of mine tell me I was going to give myself diabetes -- despite the fact that I'm not even remotely overweight -- because I regularly drank soda. To him, his diet was good, because he ate salad for lunch and snacked from the office fruit bowl, whereas my diet was bad, because I drank soda. There are likely many people out there who believe that because they eat salad for lunch they're "eating well" and reducing their risk of diabetes, when actually they're putting themselves at risk by being overweight.
- gowld 7y ago
  Something tells me you are onbscuring friend's breakfast and dinner, and perhaps what goes in the salads. A salad is better for diabetes than almost any alternative, and does reduce risk all else equal.
  - dorkwood 7y ago
    I don't have visibility of what he eats for breakfast and dinner. What I do know is that his overall diet has resulted in obesity. My point is that an underweight person who consumes sugary beverages is at a lower risk than an obese person who eats salad for lunch, whereas the general public is likely to believe the opposite.

vo2maxer 7y ago

I thought the article author’s background could be of interest: https://med.virginia.edu/faculty/faculty-listing/hf4f/ https://med.virginia.edu/faculty/faculty-listing/hf4f/

dorkwood 7y ago

I would argue that the approximate truth of "diabetes is preventable by eating well" isn't useful, since members of the public often have a distorted view of what "eating well" means. I once had an obese friend of mine tell me I was going to give myself diabetes -- despite the fact that I'm not even remotely overweight -- because I regularly drank soda. To him, his diet was good, because he ate salad for lunch and snacked from the office fruit bowl, whereas my diet was bad, because I drank soda. There are likely many people out there who believe that because they eat salad for lunch they're "eating well" and reducing their risk of diabetes, when actually they're putting themselves at risk by being overweight.

gowld 7y ago
Something tells me you are onbscuring friend's breakfast and dinner, and perhaps what goes in the salads. A salad is better for diabetes than almost any alternative, and does reduce risk all else equal.
- dorkwood 7y ago
  I don't have visibility of what he eats for breakfast and dinner. What I do know is that his overall diet has resulted in obesity. My point is that an underweight person who consumes sugary beverages is at a lower risk than an obese person who eats salad for lunch, whereas the general public is likely to believe the opposite.