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Does the American Diabetes Association work for patients or companies?

222 points by rokkitmensch 2y ago

GiorgioG 2y ago
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 2y ago
  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 2y ago
    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 2y ago
    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 https://www.virtahealth.com/research
    - UncleSlacky 2y ago
      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/#publicinformation https://www.ncl.ac.uk/magres/research/diabetes/reversal/#pub... https://www.diabetes.co.uk/news/2017/dec/newcastle-diet-achieves-type-2-diabetes-remission-after-one-year-of-direct-trial-98030767.html https://www.diabetes.co.uk/news/2017/dec/newcastle-diet-achi...
    - ksaun 2y ago
      > 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
      - nradov 2y ago
        I'm sorry for your daughter's condition, but I think you are misinformed about type 1 diabetes. Most patients still product some endogenous insulin, it's just usually not enough. Like any chronic condition, it's a spectrum and there are outliers at both ends. I've learned to be very cautious about using words like "always" or "never" because of the odd cases that occasionally come up. https://doi.org/10.1007%2Fs00125-013-3067-x https://doi.org/10.1007%2Fs00125-013-3067-x Diet and exercise are very effective at treating type 1 diabetes, just usually not sufficient. With a minimal or zero carb diet plus the right exercise regime, some patients find that they can go much longer between insulin doses while still maintaining good blood glucose control. In particular, I think a lot of people don't appreciate the necessity of doing resistance training to build enough skeletal muscle mass as a glucose sink. https://doi.org/10.1542/peds.2017-3349 https://doi.org/10.1542/peds.2017-3349
      - GiorgioG 2y ago
        You put it much more diplomatically than I did in my response (my son has T1D)
    - GiorgioG 2y ago
      You’re talking out of your ass about type 1 diabetes. Type 1 diabetics stop producing insulin entirely and are 100% dependent on exogenous insulin. My 12 year old son is a type 1 diabetic. He plays ice hockey, and his blood sugar will have a tendency to spike during games without having eaten anything for hours prior simply due to emotions/Adrenalin, whereas at practice he’s more likely to experience low blood sugars. Edit: Since I can't reply to another one of your posts below, I'm going to respond here. There's a "honeymoon period" after the initial symptoms of type 1 appear that yes you will still produce some insulin, for most patients it's about a year, but after that, no insulin is produced. Zero-carb isn't a realistic long term solution. My son was diagnosed at 18 months of age. Feeding him nothing but bacon, steak and chicken is not particularly good idea for a toddler or growing child.
- addicted 2y ago
  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 2y ago
    >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 2y ago
      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 2y ago
        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 2y ago
        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.
mustang-med 2y ago
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 2y ago
  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
- deleted 2y ago
  [deleted]
- newshackr 2y ago
  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 2y ago
    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.
guerby 2y ago
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-2020-000072 https://nutrition.bmj.com/content/early/2020/11/02/bmjnph-20... https://nutrition.bmj.com/content/early/2023/01/02/bmjnph-2022-000544 https://nutrition.bmj.com/content/early/2023/01/02/bmjnph-20... https://nutrition.bmj.com/content/early/2023/12/14/bmjnph-2023-000836 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 2y ago
  The insight being low carb can send T2 diabetes into remission?
  - throwawaymaths 2y ago
    Isn't it known that 800 kcal diet (brutal) will reverse T2D? Iirc, 90% remission, 12 patient study, nejm article
    - lambdaba 2y ago
      Yeah but low carb is sustainable. High carb diets are a misuse of human biology.
- UncleSlacky 2y ago
  Also check out the Newcastle Protocol by Prof. Roy Taylor, now adopted by the NHS: https://www.ncl.ac.uk/magres/research/diabetes/reversal/#publicinformation https://www.ncl.ac.uk/magres/research/diabetes/reversal/#pub...
  - david-gpu 2y ago
    Consuming fewer calories, especially fewer carbohydrates, will help lower your blood insulin, which is the necessary condition that allows adipose tissue to finally release its excess stored energy. Even though calorie restriction works great in lab rats as the researcher can control what the rat eats and the rat can't do anything about it regardless of how hungry it becomes, it's not that simple with humans, particularly after a year or two, once the initial willpower is lost. So, rather than fixating on lowering calories without further considerations, a more effective approach is maximizing the satiety obtained per calorie consumed. It's harder than it sounds! One might be tempted to simply consume large quantities of leafy vegetables, but that will only lead to them learning how hunger is a multidimensional experience. What do I mean by that? You can feel your stomach stretched out and full, and still feel hungry, because satiety isn't only triggered by how far your stomach has stretched, nor by the precise number of calories you have consumed. In practice, in order to maximize satiety one must strike a balance between the volume of the food consumed, its protein content, and the amount of insulin-raising carbohydrates it contains. That's the reason so many people find success in low-carbohydrate diets, which emphasize these three satiety factors rather than the excessively simplistic calorie count approach.
renewiltord 2y ago
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 2y ago
  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 2y ago
    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 2y ago
      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).
  - Dylan16807 2y ago
    > "don't do your own research" Does anybody say that? I see a lot of "some guy making a convincing-seeming argument on youtube is not doing your own research unless you fact check it by legitimately looking for omitted or incorrect statements, because there's a million crazy echo chambers out there". "Do your own research" can be a red flag, but only because so many people are bad at research, not because research is bad. It's important to look for comprehensive information and not just search for what you already think is correct. other comment> 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). It's not that you need it, it's that you'd better put serious effort in to make up for it, and you need to take scientific consensus very seriously (Which is not the same as listening to the most prominent voices. But if almost every expert top to bottom is saying the same thing, they're almost certainly right.) And for 95% of things, you're not going to put in enough research to understand from base principles. So if you're outsourcing, outsource to someone competent.
riknos314 2y ago
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-association https://www.irs.gov/charities-non-profits/definition-of-an-a...
not2b 2y ago
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 2y ago
> 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-epidemic-that-never-was-and-shouldnt-be/ 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/1g3Icgu0ixLtYCjscYoiCydS4xGZRznJ9bBopHcJwpsw/edit?usp=sharing 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 2y ago
  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 2y ago
    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.
underseacables 2y ago
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.
- 0xcde4c3db 2y ago
  That group has rubbed me the wrong way for a long time, ever since I saw one of their publications (ca. mid-2000s, I think?) and found it full of glossy food stylist photos, magazine-like layouts, and stock vacuous advice like eating "smaller portions" and a "varied diet". For all of its shortcomings and the undeniable political swamp it has to ford through editing and publication, I bet you'd very much get more specific, actionable, and evidence-based dietary advice from the Dietary Guidelines for Americans than from whatever that rag was. There's a chance that I'm misremembering this or confabulating details from multiple publications from different organizations, but skimming the current website ("eatright.org", lol) has done nothing to make me doubt the general vibe.
  - underseacables 2y ago
    It's an awful organization. They push dietetics licensure preventing people from getting nutrition information from a provider of their choice, because the organization depends on dietitians paying yearly for the Registered Dietitian credential. You can't get a license without being an RD. It is the most useless form of government regulation, but thankfully they have lost a lot of states. Now you only need a license in about 14 states. If you want to see something really hilarious, look up Pepin Tuma, their former government affairs guy. Total jerk. There are countless videos of him threatening and berating government committees over their skepticism of the license. He was finally fired a couple of years ago.
gumby 2y ago
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 2y ago
  So the actuaries decided to unironically "sugar coat" the truth to gain a small measure of compliance?
someonehere 2y ago
[flagged]
- awful 2y ago
  actually, a Wall Street industry analyst said and wrote approximately that, in what, the 1980s.
- deleted 2y ago
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Animats 2y ago
Cures are nice, but the money is in chronic conditions.
- deleted 2y ago
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- kevinmchugh 2y ago
  Health insurers, who buy quite a lot of diabetes treatment, would much rather buy a cure. And they really don't want to pay for untreated diabetes. I've heard from an insurance CEO who wishes their plan could pay the electric bill for diabetes patients to ensure they don't lose power and refrigeration, which would make their insulin get too warm
User23 2y ago
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 2y ago
  If you look around, that happens often on several different industries. Somehow both people consuming and producing stuff are powerless nowadays.
- fransje26 2y ago
  I'll leave this little perl here: https://arstechnica.com/tech-policy/2018/04/curing-disease-not-a-sustainable-business-model-goldman-sachs-analysts-say/ https://arstechnica.com/tech-policy/2018/04/curing-disease-n...
  - Nasrudith 2y ago
    Since when do publically traded corporations care about sustainability of business models? They'll cheerfully destroy a business for short term gain and then leverage the funding elsewhere.
- rustcleaner 2y ago
  [flagged]
user_7832 2y ago
> 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 2y ago
  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 2y ago
  Associations aren't typically governmental entities are they?
- citizen_friend 2y ago
  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.
  - dingusdew 2y ago
    [dead]
- crazygringo 2y ago
bhelkey 2y ago
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 2y ago
  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 2y ago
  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.
  - deleted 2y ago
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  - epcoa 2y ago
    > There is type of diabetes that is simply hereditary and that is all there is to it. This is a common misconception. Type 1 diabetes cases are more often acquired with no family history, there are some genetic associations but it is actually less strong than Type 2 (insulin resistance/diet related diabetes) where family history is a substantial risk factor. Pregnancy (gestational) diabetes isn’t just pregnancy related either as it is more likely in those with metabolic syndrome/obesity and is associated with type 2 as well, so it is also partially diet related. > Not all diabetes is from sugar. I would go further and just say no diabetes is “from sugar”, it’s just a completely uselessly simplistic way of looking at it (I know this was in response to GP comment). It’s not like low carb diets even prevent some people from getting type 2. Type 2 diabetes is a disease of acquired insulin resistance for which excessive consumption of high glycemic index food (eg processed food with high sugar content) is a major risk factor, but not the only one.
johnfernow 2y ago
Here's a great PDF I found on the ADA's website from fall 2023: https://professional.diabetes.org/sites/default/files/media/fall_2023_erp_news.pdf 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® 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 > entrées and desserts. > Check out the ADA's Diabetes Food Hub® 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-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline 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.
- gloryjulio 2y ago
  I thought Splenda has almost nonexistent calorie and I am not sure what makes it different from aspartame functionally. Any reputable research on the direct damages caused by Splenda?
siliconc0w 2y ago
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 2y ago
> 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 naïve 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.
umvi 2y ago
I feel like diabetes will be difficult to cure because it's like tobacco: you need to buy expensive consumables at regular intervals (needles, cgms, insulin, etc). Stem cell therapy to restore beta cell functionality (for T1) would threaten and disrupt that sweet regular cash flow. So I imagine companies will fight hard to keep diabetics purchasing their regular consumables until the end if time if possible
- gumby 2y ago
  Doing this would be worth so much money that if you can do it, you should. You’ll make a mint. Currently, islet cell transplants are possible, but barely available. The insurance companies that pay for a lot of the supplies you talk about would prefer a one stop solution if it costs less. The big expense due to diabetics for insurance companies is not those consumables, it’s the consequences of dialysis and amputations.
- m463 2y ago
  with respect to type 2 diabetes - which most americans are at risk for - you're arguing about something too far into the process. If you don't get T2 diabetes in the first place, because you got good advice, you will never get to the needles and insulin stage at all.
blackeyeblitzar 2y ago
The best guidance on avoiding diabetes or living with it is found on YouTube and not the ADA. The ADA guidance and standards of care are often incorrect or outdated or very conservative. For example standard care says you can’t reverse insulin resistance, which is just plain wrong.
GrantMoyer 2y ago
From the article, it looks like the ADA didn't give dangerous advice, and the doctor accusing them has views about diabetes opposed to the current medical consensus. For example, the Dr. claims the ADA is surpressing that a low carb diet can reverse type 2 diabetes. However, it isn't a low carb diet specifically which can "reverse" type 2 diabetes, it's a low calorie diet in general and the resulting weight loss.
LeroyRaz 2y ago
I am surprised that 1 million allegedly buys that level of corruption and influence. It seems strange it would only cost 1 million to make the association a corporate shrill for Stevia when diabetes as an issue costs billions to the US. If you're going to forgo your princibles and be corrupt then at least get higher price for doing so!

222 points by rokkitmensch 2y ago

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 2y ago
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 2y ago
  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 2y ago
  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 https://www.virtahealth.com/research
  - UncleSlacky 2y ago
    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/#publicinformation https://www.ncl.ac.uk/magres/research/diabetes/reversal/#pub... https://www.diabetes.co.uk/news/2017/dec/newcastle-diet-achieves-type-2-diabetes-remission-after-one-year-of-direct-trial-98030767.html https://www.diabetes.co.uk/news/2017/dec/newcastle-diet-achi...
  - ksaun 2y ago
    > 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
    - nradov 2y ago
      I'm sorry for your daughter's condition, but I think you are misinformed about type 1 diabetes. Most patients still product some endogenous insulin, it's just usually not enough. Like any chronic condition, it's a spectrum and there are outliers at both ends. I've learned to be very cautious about using words like "always" or "never" because of the odd cases that occasionally come up. https://doi.org/10.1007%2Fs00125-013-3067-x https://doi.org/10.1007%2Fs00125-013-3067-x Diet and exercise are very effective at treating type 1 diabetes, just usually not sufficient. With a minimal or zero carb diet plus the right exercise regime, some patients find that they can go much longer between insulin doses while still maintaining good blood glucose control. In particular, I think a lot of people don't appreciate the necessity of doing resistance training to build enough skeletal muscle mass as a glucose sink. https://doi.org/10.1542/peds.2017-3349 https://doi.org/10.1542/peds.2017-3349
    - GiorgioG 2y ago
      You put it much more diplomatically than I did in my response (my son has T1D)
  - GiorgioG 2y ago
    You’re talking out of your ass about type 1 diabetes. Type 1 diabetics stop producing insulin entirely and are 100% dependent on exogenous insulin. My 12 year old son is a type 1 diabetic. He plays ice hockey, and his blood sugar will have a tendency to spike during games without having eaten anything for hours prior simply due to emotions/Adrenalin, whereas at practice he’s more likely to experience low blood sugars. Edit: Since I can't reply to another one of your posts below, I'm going to respond here. There's a "honeymoon period" after the initial symptoms of type 1 appear that yes you will still produce some insulin, for most patients it's about a year, but after that, no insulin is produced. Zero-carb isn't a realistic long term solution. My son was diagnosed at 18 months of age. Feeding him nothing but bacon, steak and chicken is not particularly good idea for a toddler or growing child.
addicted 2y ago
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 2y ago
  >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 2y ago
    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 2y ago
      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 2y ago
      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.

mustang-med 2y ago

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 2y ago
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
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newshackr 2y ago
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 2y ago
  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.

guerby 2y ago

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-2020-000072 https://nutrition.bmj.com/content/early/2020/11/02/bmjnph-20... https://nutrition.bmj.com/content/early/2023/01/02/bmjnph-2022-000544 https://nutrition.bmj.com/content/early/2023/01/02/bmjnph-20... https://nutrition.bmj.com/content/early/2023/12/14/bmjnph-2023-000836 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 2y ago
The insight being low carb can send T2 diabetes into remission?
- throwawaymaths 2y ago
  Isn't it known that 800 kcal diet (brutal) will reverse T2D? Iirc, 90% remission, 12 patient study, nejm article
  - lambdaba 2y ago
    Yeah but low carb is sustainable. High carb diets are a misuse of human biology.
UncleSlacky 2y ago
Also check out the Newcastle Protocol by Prof. Roy Taylor, now adopted by the NHS: https://www.ncl.ac.uk/magres/research/diabetes/reversal/#publicinformation https://www.ncl.ac.uk/magres/research/diabetes/reversal/#pub...
- david-gpu 2y ago
  Consuming fewer calories, especially fewer carbohydrates, will help lower your blood insulin, which is the necessary condition that allows adipose tissue to finally release its excess stored energy. Even though calorie restriction works great in lab rats as the researcher can control what the rat eats and the rat can't do anything about it regardless of how hungry it becomes, it's not that simple with humans, particularly after a year or two, once the initial willpower is lost. So, rather than fixating on lowering calories without further considerations, a more effective approach is maximizing the satiety obtained per calorie consumed. It's harder than it sounds! One might be tempted to simply consume large quantities of leafy vegetables, but that will only lead to them learning how hunger is a multidimensional experience. What do I mean by that? You can feel your stomach stretched out and full, and still feel hungry, because satiety isn't only triggered by how far your stomach has stretched, nor by the precise number of calories you have consumed. In practice, in order to maximize satiety one must strike a balance between the volume of the food consumed, its protein content, and the amount of insulin-raising carbohydrates it contains. That's the reason so many people find success in low-carbohydrate diets, which emphasize these three satiety factors rather than the excessively simplistic calorie count approach.

renewiltord 2y ago

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 2y ago
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 2y ago
  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 2y ago
    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).
- Dylan16807 2y ago
  > "don't do your own research" Does anybody say that? I see a lot of "some guy making a convincing-seeming argument on youtube is not doing your own research unless you fact check it by legitimately looking for omitted or incorrect statements, because there's a million crazy echo chambers out there". "Do your own research" can be a red flag, but only because so many people are bad at research, not because research is bad. It's important to look for comprehensive information and not just search for what you already think is correct. other comment> 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). It's not that you need it, it's that you'd better put serious effort in to make up for it, and you need to take scientific consensus very seriously (Which is not the same as listening to the most prominent voices. But if almost every expert top to bottom is saying the same thing, they're almost certainly right.) And for 95% of things, you're not going to put in enough research to understand from base principles. So if you're outsourcing, outsource to someone competent.

riknos314 2y ago

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-association https://www.irs.gov/charities-non-profits/definition-of-an-a...

not2b 2y ago

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 2y ago

> 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-epidemic-that-never-was-and-shouldnt-be/ 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/1g3Icgu0ixLtYCjscYoiCydS4xGZRznJ9bBopHcJwpsw/edit?usp=sharing 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 2y ago
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 2y ago
  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.

underseacables 2y ago

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.

0xcde4c3db 2y ago
That group has rubbed me the wrong way for a long time, ever since I saw one of their publications (ca. mid-2000s, I think?) and found it full of glossy food stylist photos, magazine-like layouts, and stock vacuous advice like eating "smaller portions" and a "varied diet". For all of its shortcomings and the undeniable political swamp it has to ford through editing and publication, I bet you'd very much get more specific, actionable, and evidence-based dietary advice from the Dietary Guidelines for Americans than from whatever that rag was. There's a chance that I'm misremembering this or confabulating details from multiple publications from different organizations, but skimming the current website ("eatright.org", lol) has done nothing to make me doubt the general vibe.
- underseacables 2y ago
  It's an awful organization. They push dietetics licensure preventing people from getting nutrition information from a provider of their choice, because the organization depends on dietitians paying yearly for the Registered Dietitian credential. You can't get a license without being an RD. It is the most useless form of government regulation, but thankfully they have lost a lot of states. Now you only need a license in about 14 states. If you want to see something really hilarious, look up Pepin Tuma, their former government affairs guy. Total jerk. There are countless videos of him threatening and berating government committees over their skepticism of the license. He was finally fired a couple of years ago.

gumby 2y ago

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 2y ago
So the actuaries decided to unironically "sugar coat" the truth to gain a small measure of compliance?

someonehere 2y ago

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awful 2y ago
actually, a Wall Street industry analyst said and wrote approximately that, in what, the 1980s.
deleted 2y ago
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Animats 2y ago

Cures are nice, but the money is in chronic conditions.

deleted 2y ago
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kevinmchugh 2y ago
Health insurers, who buy quite a lot of diabetes treatment, would much rather buy a cure. And they really don't want to pay for untreated diabetes. I've heard from an insurance CEO who wishes their plan could pay the electric bill for diabetes patients to ensure they don't lose power and refrigeration, which would make their insulin get too warm

User23 2y ago

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 2y ago
If you look around, that happens often on several different industries. Somehow both people consuming and producing stuff are powerless nowadays.
fransje26 2y ago
I'll leave this little perl here: https://arstechnica.com/tech-policy/2018/04/curing-disease-not-a-sustainable-business-model-goldman-sachs-analysts-say/ https://arstechnica.com/tech-policy/2018/04/curing-disease-n...
- Nasrudith 2y ago
  Since when do publically traded corporations care about sustainability of business models? They'll cheerfully destroy a business for short term gain and then leverage the funding elsewhere.
rustcleaner 2y ago
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user_7832 2y ago

> 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 2y ago
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 2y ago
Associations aren't typically governmental entities are they?
citizen_friend 2y ago
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.
- dingusdew 2y ago
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crazygringo 2y ago

bhelkey 2y ago

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 2y ago
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 2y ago
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.
- deleted 2y ago
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- epcoa 2y ago
  > There is type of diabetes that is simply hereditary and that is all there is to it. This is a common misconception. Type 1 diabetes cases are more often acquired with no family history, there are some genetic associations but it is actually less strong than Type 2 (insulin resistance/diet related diabetes) where family history is a substantial risk factor. Pregnancy (gestational) diabetes isn’t just pregnancy related either as it is more likely in those with metabolic syndrome/obesity and is associated with type 2 as well, so it is also partially diet related. > Not all diabetes is from sugar. I would go further and just say no diabetes is “from sugar”, it’s just a completely uselessly simplistic way of looking at it (I know this was in response to GP comment). It’s not like low carb diets even prevent some people from getting type 2. Type 2 diabetes is a disease of acquired insulin resistance for which excessive consumption of high glycemic index food (eg processed food with high sugar content) is a major risk factor, but not the only one.

johnfernow 2y ago

Here's a great PDF I found on the ADA's website from fall 2023: https://professional.diabetes.org/sites/default/files/media/fall_2023_erp_news.pdf 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® 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 > entrées and desserts. > Check out the ADA's Diabetes Food Hub® 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-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline 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.

gloryjulio 2y ago
I thought Splenda has almost nonexistent calorie and I am not sure what makes it different from aspartame functionally. Any reputable research on the direct damages caused by Splenda?

siliconc0w 2y ago

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 2y ago

> 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 naïve 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.

umvi 2y ago

I feel like diabetes will be difficult to cure because it's like tobacco: you need to buy expensive consumables at regular intervals (needles, cgms, insulin, etc). Stem cell therapy to restore beta cell functionality (for T1) would threaten and disrupt that sweet regular cash flow. So I imagine companies will fight hard to keep diabetics purchasing their regular consumables until the end if time if possible

gumby 2y ago
Doing this would be worth so much money that if you can do it, you should. You’ll make a mint. Currently, islet cell transplants are possible, but barely available. The insurance companies that pay for a lot of the supplies you talk about would prefer a one stop solution if it costs less. The big expense due to diabetics for insurance companies is not those consumables, it’s the consequences of dialysis and amputations.
m463 2y ago
with respect to type 2 diabetes - which most americans are at risk for - you're arguing about something too far into the process. If you don't get T2 diabetes in the first place, because you got good advice, you will never get to the needles and insulin stage at all.

blackeyeblitzar 2y ago

The best guidance on avoiding diabetes or living with it is found on YouTube and not the ADA. The ADA guidance and standards of care are often incorrect or outdated or very conservative. For example standard care says you can’t reverse insulin resistance, which is just plain wrong.

GrantMoyer 2y ago

From the article, it looks like the ADA didn't give dangerous advice, and the doctor accusing them has views about diabetes opposed to the current medical consensus. For example, the Dr. claims the ADA is surpressing that a low carb diet can reverse type 2 diabetes. However, it isn't a low carb diet specifically which can "reverse" type 2 diabetes, it's a low calorie diet in general and the resulting weight loss.

LeroyRaz 2y ago

I am surprised that 1 million allegedly buys that level of corruption and influence. It seems strange it would only cost 1 million to make the association a corporate shrill for Stevia when diabetes as an issue costs billions to the US. If you're going to forgo your princibles and be corrupt then at least get higher price for doing so!