4 ms·

Only if they _choose to_. One of the lessons in becoming a modern adult is that you have the option of telling a doctor "no, i won't take that." That's your cho

by sgbeal 3y ago

Only if they _choose to_. One of the lessons in becoming a modern adult is that you have the option of telling a doctor "no, i won't take that." That's your choice, not the doctor's. Period, end of story. There are obviously exceptional cases - diabetes immediately comes to mind - where it's a "do or die" decision, but those are the minority. Even so, it's your choice, not a doctor's.

willsmith72 3y ago
"free choice" is not that simple.
- farzinadil 3y ago
  exactly. vaccines weren't exactly a prescription drug but without taking them you were basically a second class citizen
  - sgbeal 3y ago
    > ... but without taking them you were basically a second class citizen "If you don't stick to your values when they're being tested, they're not values: they're hobbies." -- Jon Stewart
    - kelseyfrog 3y ago
      I'm curious, which values were those?
      - sgbeal 3y ago
        > I'm curious, which values were those? In this context, deciding for oneself instead of blindly accepting what one is told they should do.
        kelseyfrog 3y ago
        You're referring to the novice-expert problem in epistemology. How do you get around requiring everyone to be an expert in all things?
        sgbeal 3y ago
        > How do you get around requiring everyone to be an expert in all things? i simply hope for them to make their own choices. If that choice means following a doctor's advice, that's fine. (Admittedly, 9 times out of 10 or more, that's what i'll do - the doctor is the subject-matter expert.) Anecdote: as a recovered throat cancer patient, if a doctor were to tell me that the cancer is back and i had to undergo Treatment X or die, i'd start getting my affairs in order. In the 17 years since my cancer treatment, the only side-effects i still live with are side-effects of the _treatment_, not the cancer. e.g. i haven't slept a full night of 8 hours uninterrupted in 17 years because of side-effects of the radiation treatments, not the disease, and i'm unwilling to undergo further quality-of-life degradation caused by medical treatments. If it comes down to that, i'd choose my dignity and quality-of-(what remains of my)-life over a longer life suffering yet more side effects. Granted, not all would make such a choice, but i inherited stubbornness from both of my parents and got a double dose of it genetically, so i don't expect to represent a majority opinion.
  - jeromegv 3y ago
    We have had mandatory vaccines for kids for a century. It’s what living in a society is all about.
    - idontonowheat 3y ago
      [flagged]
    - walterbell 3y ago
      Yes we did, to stop transmission. Without needing to change the definition of vaccine during that period.
    - s1artibartfast 3y ago
      What do you mean by "It’s what living in a society is all about."? The point of society isnt to enforce your will on others. At best it is a means to an end, and hotly debated how much you should be able to force compliance from others for your own benefit.
youreinsane 3y ago
[flagged]
nradov 3y ago
Most cases of type-2 diabetes can be put into remission to the extent that they no longer require exogenous insulin. https://www.virtahealth.com/research https://www.virtahealth.com/research
- altairprime 3y ago
  If only this were the case with estradiol :/
klyrs 3y ago
Diabetes isn't that exceptional in our population. And not that exceptional as a "do or [suffer extreme consequences]" medication. Statins, antipsychotics, epilepsy medications, even sleeping pills, can literally save lives if taken on an ongoing basis.
pixl97 3y ago
>diabetes immediately comes to mind - where it's a "do or die" decision, but those are the minority. The rate of diabetes is exploding. >37.3 million people, or 11.3% of the U.S. population, have diabetes. An estimated 28.7 million people – had diagnosed diabetes. Approximately 8.6 million people have diabetes but have not yet been diagnosed. Oh, and what about high blood pressure. >About 70% of Americans will have high blood pressure in their lifetimes. What's more, only 1 in 4 patients with hypertension have their blood pressure under control. And because high blood pressure usually has no symptoms, you can have it without knowing it. Why does this matter? >About 697,000 people die of heart disease in the United States every year–that's 1 in every 5 deaths.
- NotGMan 3y ago
  Diet fixes blood pressure is many, many people. I was one of them. I eliminated processed sweets and lower my carbs and presto, from ~145 to 115 blood pressure in a few months.
  - pixl97 3y ago
    I would like to add, diet doesn't fix getting old. One thing I've not seen in this thread is demographic shifts from the majority of the population aging and the percent of youth dropping significantly.
- waveBidder 3y ago
  You're thinking about type 2. Type 1 is fairly stable around 1%. Type 2's, if they're lucky and disciplined (emphasis on the lucky), can get away without needing insulin.
NotGMan 3y ago
This. The doctor works for you. And eg most doctors will laugh at you if you said that T2 diabetes can be put into remission with diet: but it can for at least 50% of people. And the other 50% will at least drasticly lower their need for medication. Also notice the word "remission": they can't admit that you actually healed T2 diabetes, so they use the word remission to gaslight you into thinking that "you didn't even heal it, you're just lucky and it's gonna come back". Hard to take any doctor seriously nowadays.
- MattGaiser 3y ago
  You aren't healed if you need to remain on that diet to keep the T2 away. You still need to actively treat your condition. So remission seems like a reasonable thing to say about it.
  - NotGMan 3y ago
    This implies that the diet that gave you T2 was not poisonious and implies that that diet was healthy in the 1st place. So you cannot say "you're in remission" if you're eating poison. You were poisoning yourself. So obviously if you poison yourself again you're gonna go out of "remission".
  - ramblenode 3y ago
    This doesn't square with the fact that the standard American diet is known to be unhealthy and a cause of pre-diabetes. If I eat something allergenic, start experiencing a reaction, then later cut the offending food out of my diet, it doesn't mean I am in remission from my allergy; it means I am avoiding the cause of an allergic reaction.
kelseyfrog 3y ago
> if they choose to There are standard cases that any rational person would see taking the medication as a win. The most prescribed class of medication in the article is antihypertensized. Thiazides are a frontline intervention for hypertension. Thiazide's reduction in all-cause mortality is clinically significant(HR approx: 0.51). > The risk of primary outcome events[all-cause mortality] was significantly lower in patients taking thiazides (model 1: HR 0.51 [95% CI, 0.36–0.72]; P=0.0002; model 2: HR 0.56 [95% CI, 0.38–0.83]; P=0.004; [1] There are of course downsides to taking any medication or medical intervention, but a HR 0.51 in mortality is such a large reduction that the risks would need to be equally significant. I'm not sure why diabetes should get any special treatment other than there is simply more public awareness of the risks of untreated diabetes. Are the HR reduction in all-cause mortality with insulin treatments above a particular threshold of importance? Does diabetes the primary cause of mortality in more patients than hypertension? Some other factor? Happy to hear some of the reasoning behind it. 1. Thiazide Use and Decreased Risk of Heart Failure in Nondiabetic Patients Receiving Intensive Blood Pressure Treatment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340223/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340223/
- dur-randir 3y ago
  T1 kills you with 50% chance in 2 years, without insulin. With hypertension, you can leave 10+ years. Not nearly comparable.
  - kelseyfrog 3y ago
    Is there a threshold you're using for non-intervention mortality and why did you choose it as the only factor? Additionally, most people would seem to account for several inputs, HR for all-cause mortality seems like a pretty good indication, but you've chosen to reject it. Any reason?
  - pimeys 3y ago
    Wait. You can survive with T1 for two years without insulin, 50% chance? Your pancreas must be still working, but when it totally stops producing insulin, I'd give you maybe a week before going to a coma. If I unplug my insulin pump, I will feel very sick after 24 hours and probably go to a coma from ketoacidosis after a few days.

by sgbeal 3y ago

willsmith72 3y ago

"free choice" is not that simple.

farzinadil 3y ago
exactly. vaccines weren't exactly a prescription drug but without taking them you were basically a second class citizen
- sgbeal 3y ago
  > ... but without taking them you were basically a second class citizen "If you don't stick to your values when they're being tested, they're not values: they're hobbies." -- Jon Stewart
  - kelseyfrog 3y ago
    I'm curious, which values were those?
    - sgbeal 3y ago
      > I'm curious, which values were those? In this context, deciding for oneself instead of blindly accepting what one is told they should do.
      - kelseyfrog 3y ago
        You're referring to the novice-expert problem in epistemology. How do you get around requiring everyone to be an expert in all things?
        sgbeal 3y ago
        > How do you get around requiring everyone to be an expert in all things? i simply hope for them to make their own choices. If that choice means following a doctor's advice, that's fine. (Admittedly, 9 times out of 10 or more, that's what i'll do - the doctor is the subject-matter expert.) Anecdote: as a recovered throat cancer patient, if a doctor were to tell me that the cancer is back and i had to undergo Treatment X or die, i'd start getting my affairs in order. In the 17 years since my cancer treatment, the only side-effects i still live with are side-effects of the _treatment_, not the cancer. e.g. i haven't slept a full night of 8 hours uninterrupted in 17 years because of side-effects of the radiation treatments, not the disease, and i'm unwilling to undergo further quality-of-life degradation caused by medical treatments. If it comes down to that, i'd choose my dignity and quality-of-(what remains of my)-life over a longer life suffering yet more side effects. Granted, not all would make such a choice, but i inherited stubbornness from both of my parents and got a double dose of it genetically, so i don't expect to represent a majority opinion.
- jeromegv 3y ago
  We have had mandatory vaccines for kids for a century. It’s what living in a society is all about.
  - idontonowheat 3y ago
    [flagged]
  - walterbell 3y ago
    Yes we did, to stop transmission. Without needing to change the definition of vaccine during that period.
  - s1artibartfast 3y ago
    What do you mean by "It’s what living in a society is all about."? The point of society isnt to enforce your will on others. At best it is a means to an end, and hotly debated how much you should be able to force compliance from others for your own benefit.

youreinsane 3y ago

[flagged]

nradov 3y ago

Most cases of type-2 diabetes can be put into remission to the extent that they no longer require exogenous insulin. https://www.virtahealth.com/research https://www.virtahealth.com/research

altairprime 3y ago
If only this were the case with estradiol :/

klyrs 3y ago

Diabetes isn't that exceptional in our population. And not that exceptional as a "do or [suffer extreme consequences]" medication. Statins, antipsychotics, epilepsy medications, even sleeping pills, can literally save lives if taken on an ongoing basis.

pixl97 3y ago

>diabetes immediately comes to mind - where it's a "do or die" decision, but those are the minority. The rate of diabetes is exploding. >37.3 million people, or 11.3% of the U.S. population, have diabetes. An estimated 28.7 million people – had diagnosed diabetes. Approximately 8.6 million people have diabetes but have not yet been diagnosed. Oh, and what about high blood pressure. >About 70% of Americans will have high blood pressure in their lifetimes. What's more, only 1 in 4 patients with hypertension have their blood pressure under control. And because high blood pressure usually has no symptoms, you can have it without knowing it. Why does this matter? >About 697,000 people die of heart disease in the United States every year–that's 1 in every 5 deaths.

NotGMan 3y ago
Diet fixes blood pressure is many, many people. I was one of them. I eliminated processed sweets and lower my carbs and presto, from ~145 to 115 blood pressure in a few months.
- pixl97 3y ago
  I would like to add, diet doesn't fix getting old. One thing I've not seen in this thread is demographic shifts from the majority of the population aging and the percent of youth dropping significantly.
waveBidder 3y ago
You're thinking about type 2. Type 1 is fairly stable around 1%. Type 2's, if they're lucky and disciplined (emphasis on the lucky), can get away without needing insulin.

NotGMan 3y ago

This. The doctor works for you. And eg most doctors will laugh at you if you said that T2 diabetes can be put into remission with diet: but it can for at least 50% of people. And the other 50% will at least drasticly lower their need for medication. Also notice the word "remission": they can't admit that you actually healed T2 diabetes, so they use the word remission to gaslight you into thinking that "you didn't even heal it, you're just lucky and it's gonna come back". Hard to take any doctor seriously nowadays.

MattGaiser 3y ago
You aren't healed if you need to remain on that diet to keep the T2 away. You still need to actively treat your condition. So remission seems like a reasonable thing to say about it.
- NotGMan 3y ago
  This implies that the diet that gave you T2 was not poisonious and implies that that diet was healthy in the 1st place. So you cannot say "you're in remission" if you're eating poison. You were poisoning yourself. So obviously if you poison yourself again you're gonna go out of "remission".
- ramblenode 3y ago
  This doesn't square with the fact that the standard American diet is known to be unhealthy and a cause of pre-diabetes. If I eat something allergenic, start experiencing a reaction, then later cut the offending food out of my diet, it doesn't mean I am in remission from my allergy; it means I am avoiding the cause of an allergic reaction.

kelseyfrog 3y ago

> if they choose to There are standard cases that any rational person would see taking the medication as a win. The most prescribed class of medication in the article is antihypertensized. Thiazides are a frontline intervention for hypertension. Thiazide's reduction in all-cause mortality is clinically significant(HR approx: 0.51). > The risk of primary outcome events[all-cause mortality] was significantly lower in patients taking thiazides (model 1: HR 0.51 [95% CI, 0.36–0.72]; P=0.0002; model 2: HR 0.56 [95% CI, 0.38–0.83]; P=0.004; [1] There are of course downsides to taking any medication or medical intervention, but a HR 0.51 in mortality is such a large reduction that the risks would need to be equally significant. I'm not sure why diabetes should get any special treatment other than there is simply more public awareness of the risks of untreated diabetes. Are the HR reduction in all-cause mortality with insulin treatments above a particular threshold of importance? Does diabetes the primary cause of mortality in more patients than hypertension? Some other factor? Happy to hear some of the reasoning behind it. 1. Thiazide Use and Decreased Risk of Heart Failure in Nondiabetic Patients Receiving Intensive Blood Pressure Treatment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340223/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340223/

dur-randir 3y ago
T1 kills you with 50% chance in 2 years, without insulin. With hypertension, you can leave 10+ years. Not nearly comparable.
- kelseyfrog 3y ago
  Is there a threshold you're using for non-intervention mortality and why did you choose it as the only factor? Additionally, most people would seem to account for several inputs, HR for all-cause mortality seems like a pretty good indication, but you've chosen to reject it. Any reason?
- pimeys 3y ago
  Wait. You can survive with T1 for two years without insulin, 50% chance? Your pancreas must be still working, but when it totally stops producing insulin, I'd give you maybe a week before going to a coma. If I unplug my insulin pump, I will feel very sick after 24 hours and probably go to a coma from ketoacidosis after a few days.