Re: Diet, testing, and DA
- From: Jenny <lottadatacarbs@xxxxxxxxxxx>
- Date: Sun, 07 Aug 2005 20:16:23 -0400
Chris J. wrote:
As I mentioned, I still have my little quibbles about the wording of
that one sentence, but even a nit-picker like me loves the rest of
your paper. I especially like the way that you look into their basis
and original studies. For me, using the Pima study as a major part of
anything is just bad scientific methodology. You simply cannot use an
atypical group (which the Pima certainly are) and apply the results to
forecasts for the general population. That's one of the first things
any first-year biology student learns!!
Bad enough to base the diagnosis on the Pima data from 1978--but far worse to base the current FBG standards on data from Pacific Islanders who are another genetically isolated group where the relationship of FBG and GTT do not match that found in American and Western European populations. Even worse to blatantly state that you did this on purpose precisely because the Pacific Islander data gave you the number that diagnosed the least new patients.
However, when you the continuing ed courses written for doctors you continually run into the idea that people with Type 2 can't do anything to control it, that they deteriorate no matter what, and that the only effective treatment most will tolerate is to take oral drugs which only bring the A1c down by 1 or 2% (in a population that is at 10% or higher at diagnosis.)
Doctors do not know or believe that patients using meters intelligently and limiting their carb intake can achieve the kinds of dramatic improvements in control that we have seen hundreds of people report to this newsgroup. Until they do, they won't be motivated to diagnose.
.
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