3 ms·

> 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

> 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.
  - dur-randir 3y ago
    That's data from early 20th century, so take it with some grain of salt. Nobody would redo proper double-blinded trials nowdays :) Maybe it was measured from the onset, when you still had some b-cells active? Furthermore, people live with 20-30 mmol/L, so it might be not a week even with zero production - our body's adaptability is huge.

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.
- dur-randir 3y ago
  That's data from early 20th century, so take it with some grain of salt. Nobody would redo proper double-blinded trials nowdays :) Maybe it was measured from the onset, when you still had some b-cells active? Furthermore, people live with 20-30 mmol/L, so it might be not a week even with zero production - our body's adaptability is huge.