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Friday, March 15, 2019

Science in my iPhone inbox

"That's Debatable"? Recall my post on "Selling Science"? See also "Selling pseudoscience to the gullible." Additionally, there are my "Anthropocene Denial" posts.


My latest hardcopy arrived.


The war on ‘prediabetes’ could be a boon for pharma—but is it good medicine?
A questionable condition

Sweeping diagnosis In 2004 and 2010, the American Diabetes Association (ADA) expanded the blood sugar range it considers a sign of prediabetes, creating tens of millions of potential patients in the United States. The U.S. Centers for Disease Control and Prevention joined ADA in raising the alarm, portraying the condition as a first step toward frank diabetes.

Little risk Prediabetes does little or no harm on its own, and fewer than 2% of prediabetics in the ADA range progress to diabetes each year. Many studies suggest that for most people the usual treatments for prediabetes, diet and exercise, do little to further reduce the risk of diabetes.

Strong medicine Industry is developing at least 10 classes of drugs targeted to prediabetes. ADA also lists existing diabetes and weight loss drugs as options for people with prediabetes, and doctors are prescribing them “off label.” Many of those drugs can have serious side effects.

Money trails ADA and some of its physician advisers who have discussed drug treatments for prediabetes receive extensive financial support from pharmaceutical companies. The organization and its advisers say the payments have not affected their recommendations.

Again, you have to read Seamus O'Mahony's "Can Medicine Be Cured?" (specifically chapter 6, "How to invent a disease.") Pay particular attention to his trenchant observations on the depressingly widespread misapprehension of clinical "risk" (some of it willful). How much money are we wasting inventing and "treating" specious "diseases?" It's not a trivial question.
Q: "What's the definition of a 'well person'?"
A: "a patient who has not been adequately worked up."
Iconoclastic psychiatrist Thomas Szasz once jibed irascibly about the ultimate medical px, the "humanectomy."

More to come...

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