Potential Gains in Life Expectancy Associated with Diabetes Treatment Goals [pdf](jamanetwork.com)
jamanetwork.com
Potential Gains in Life Expectancy Associated with Diabetes Treatment Goals [pdf]
https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2791200/kianmehr_2022_oi_220242_1649453574.65092.pdf
21 comments
Life expectancy gains of ”3.9, 3.8, 1.9, and 0.9, respectively,” seem low for a major intervention, but mean age was 65.6. Not sure how gains stack when combined, if at all.
> We then estimated the LE for patients from each quartile and the LE if patients from each quartile improved 1 of their biomarker levels to the next lower quartile while keeping other biomarkers constant.
Sounds like its additive, so potentially up to 10 years if you're going from the worst quartiles in everything to the best, though I suspect that is extremely difficult. I am a bit surprised by the relative unimportance of HbA1C. I guess mortality is different that QALYs, which losing toes/eyes definitely affect, even if they don't kill you.
Sounds like its additive, so potentially up to 10 years if you're going from the worst quartiles in everything to the best, though I suspect that is extremely difficult. I am a bit surprised by the relative unimportance of HbA1C. I guess mortality is different that QALYs, which losing toes/eyes definitely affect, even if they don't kill you.
I'm sure the amount of stress I've been exposed to from being yelled at by my physician "that i need to change or die young" at my diagnosis is pretty on par with this decreased life expectancy.
Not to mention I now have a general dislike for doctors and avoid them as much as possible, because inevitably everything I'd complain about would be blamed on excess weight or trans broken arm.
Love to see how empathetic doctors affect life expectancy. I'd assume quite a lot.
Not to mention I now have a general dislike for doctors and avoid them as much as possible, because inevitably everything I'd complain about would be blamed on excess weight or trans broken arm.
Love to see how empathetic doctors affect life expectancy. I'd assume quite a lot.
In their defense, if you're very fat that's probably going to cause most of your issues. Perhaps after a while repeatedly diagnosing things with the same root cause is going to frustrate your doctor as well.
How about a little empathy for them? No need to lose weight, but also no need to bother them with it then. Which is essentially what you're doing, a net win for everyone :)
How about a little empathy for them? No need to lose weight, but also no need to bother them with it then. Which is essentially what you're doing, a net win for everyone :)
They call it "trans broken arm syndrome" because this shit includes things that are obviously NOT hormone/obesity related. Things anyone else would get an immediate MRI for.
Exactly the kind of thoughtless answer that presumes I'm just angry about being told the hard truth or something I needed.
Being obese does NOT IN FACT lower your risk of every disease (except apparently heart failure?) that is not caused by obesity. Obese people need doctors for non-obesity related issues too.
Exactly the kind of thoughtless answer that presumes I'm just angry about being told the hard truth or something I needed.
Being obese does NOT IN FACT lower your risk of every disease (except apparently heart failure?) that is not caused by obesity. Obese people need doctors for non-obesity related issues too.
I mean being obese affects so much of your body negatively that it's almost certain that fixing that will fix many of your underlying issues even if they don't appear to be because of obesity.
I asked you to try to think about it from your doctor's point of view and you just repeated that they're not doing what you want them to do. Yes, they probably made mistakes due to their own emotional state.
Responding to this from an entirely egocentric place is just going to make the problem worse. Why not approach such things with compassion; at least you may get somewhere with this person. It is hard to make diverse friends if you cannot do so.
Responding to this from an entirely egocentric place is just going to make the problem worse. Why not approach such things with compassion; at least you may get somewhere with this person. It is hard to make diverse friends if you cannot do so.
Your comment makes no sense to me.
Failing to treat me is a professional failing with severe adverse effects for me. And it's entirely based on the judgemental assholeness of such doctors. If you can't stop blaming people for their conditions, find another job. I'm not my GPs therapist.
Also, they've been dead for close to a decade.
Failing to treat me is a professional failing with severe adverse effects for me. And it's entirely based on the judgemental assholeness of such doctors. If you can't stop blaming people for their conditions, find another job. I'm not my GPs therapist.
Also, they've been dead for close to a decade.
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Well I’m sure once you’ve seen enough type II diabetics with chronic sores on their feet, bone infections, amputations, diabetic retinopathy, it can be hard not to warn people of the consequences of obesity.
Warning is fine.
Cursing at me and telling me I will literally die in 10 years (I survived the guy by at least 10 years by now) and assuming the shock from that will get lazy me off the couch or something just put me into an extremely anxious state loop that didn't help me whatsoever. I didn't need to be told to eat less, I needed any coping mechanism that wasn't overeating. And I needed coping mechanisms a lot back then, the anxiety just contributed to that. I went through life for almost a decade just accepting my imminent death because I couldn't fix it.
Cursing at me and telling me I will literally die in 10 years (I survived the guy by at least 10 years by now) and assuming the shock from that will get lazy me off the couch or something just put me into an extremely anxious state loop that didn't help me whatsoever. I didn't need to be told to eat less, I needed any coping mechanism that wasn't overeating. And I needed coping mechanisms a lot back then, the anxiety just contributed to that. I went through life for almost a decade just accepting my imminent death because I couldn't fix it.
It sounds like you are maybe eating as a stress reaction. I think a therapist might be a better healthcare professional to help you than a GP. They can then also ascertain if you need to be referred to a psychologist so that you can get the proper medication to help with your anxiety related conditions.
It sounds like the delivery could have improve, but the message was right.
The problem is with attribution of the problem to you directly.
People almost universally know that severe obesity is bad for them. You don't need to tell them.
There are many reasons people are obese. For me it was mostly a psychological issue. Doctors need better training in this regard, because telling someone to stop being lazy and eat well will almost never lead to them to improvement. Dieting, in the long term, it almost universally a failure. It just doesn't work. It doesn't address the right issues.
Yet, for doctors and those unaffected it seems like such a trivial thing that any deviation seems self-inflicted. They must be doing it willingly. They must be shamed. But it is never is that simple.
It is an attitude they constantly carry into conversations with patients. They need to take that attitude and throw it into the trash, because all it does is make the patient feel horrible about the lack of control they have over their condition that they supposedly should have, according to their doctor.
People almost universally know that severe obesity is bad for them. You don't need to tell them.
There are many reasons people are obese. For me it was mostly a psychological issue. Doctors need better training in this regard, because telling someone to stop being lazy and eat well will almost never lead to them to improvement. Dieting, in the long term, it almost universally a failure. It just doesn't work. It doesn't address the right issues.
Yet, for doctors and those unaffected it seems like such a trivial thing that any deviation seems self-inflicted. They must be doing it willingly. They must be shamed. But it is never is that simple.
It is an attitude they constantly carry into conversations with patients. They need to take that attitude and throw it into the trash, because all it does is make the patient feel horrible about the lack of control they have over their condition that they supposedly should have, according to their doctor.
IKR? Like they can't get past that one thing. I think it even blinds them to help you with other things. Like they'll probably miss a cancer diagnosis.
Hah, yeah. I had a big AFH tumor on my hand. "Probably ganglion". Thankfully these things rarely turn into full blown cancer and I got someone to take it serious (but only after it started necrotizing) before it did.
only one mention of metformin, and it's a title to a paper in the references. however, diabetics who take metformin live longer than diabetics who didn't and nondiabetics in general. the paper didn't take that in consideration that some of the people could be on this seemingly diabetic drug
I'm skeptical about your statement - diabetics who take metformin '.. live longer than non-diabetics in general'. I don't believe that is true. There is lots of research about metformin helping people, but making diabetics live longer than non-diabetics seems too far a reach. Can your provide a citation for this? I am not a diabetic, I tried to convince my doctor to let me take metformin but she thought there were some risks (such as a the recent papers on it causing birth defects in the children of men who were taking it - https://www.cnn.com/2022/03/28/health/paternal-metformin-use...
I'm not sure this is the best of sources, but it's a piece of information David Sinclair tends to bring up:
https://pubmed.ncbi.nlm.nih.gov/25041462/#:~:text=Conclusion....
https://pubmed.ncbi.nlm.nih.gov/25041462/#:~:text=Conclusion....
I'm skeptical of the benefits claimed for non-diabetics: the 15% difference in median survival time between metformin-using diabetics and control "non-diabetics" may just indicate undiagnosed diabetes in the control population. The abstract doesn't say how the controls were selected, whether they were verified to not have diabetes or were simply people with no diabetes diagnosis.
Just search Hacker News for metformin: it is actually discussed quite a lot, and there are tons of posts about this effect (whether it is actually true or not I don't know, but like: the citations you seek are extremely easy to find if you just take a few seconds to look).