Talk:Diabetes

Archives
Chronological archives
Archive 1 - Prior to 2005 Archive 2 - Through the first half of 2005 Archive 3 - Second half of 2005 though the end of January 2006 Archive 4 - First four months of 2006 Archive 5 - Second four months of 2006 Archive 6 - Last four months of 2006 Archive 7 - First four months of 2007 Archive 8 - Second four months of 2007 Archive 9 - Final four months of 2007 Archive 10 - First four months of 2008 Archive 11 - Second four months of 2008
Topical archives
Article Structure Discussions

Messing about with the introduction

The introduction to this article has already been labeled "too long" and containing far too much detail. Over the last few days there have again been numerous edits to the intro, and I feel some of them are duplicative (e.g. intimating again and again that type 1 is due to hyposecretion of insulin) and overly detailed (e.g. wanting to state that DM1/2 are polygenic and MODY is monogenic). I have done some rejigging.

In general, this shockingly important article is still in an abysmal state. I have previously tried to interest some editors in a short-term collaboration, including MCOTW. In my mind, the following problems exist:

1. We need a couple of great, widely accessible sources
2. We need to decide what needs to go in subarticles, and what doesn't
3. We need to discuss recent evidence-based guidelines, such as the 2008 NICE guideline in the UK

Any more wisdom? JFW | T@lk 07:44, 5 August 2008 (UTC)

Dear User:Jfdwolff, your point of view on the INTRO is not supported by WP:LEAD; deletion with a frivolous explanation (e.g. yours "I really think...") qualifies as Blanking of WP:VANDALISM, because it was based on a private opinion, and additionally it contradicted the guidelines provided by WP:LEAD, because MODY is a distinctive type and monogenic diabetes is a distinctive group, without which diabetes is not presented completely; I divided the lead (intro) by adding a new chapter, because the complications were mentioned at the beginning and treatment is not strictly the disease, but only... the remedy. Sincerely, (162.84.184.38 (talk) 03:46, 6 August 2008 (UTC))

Firstly, please be good enough to await consensus here before redoing your edit. If you're unfamiliar with this, please have a look at WP:BRD.

I tried to explain that presently MODY is regarded as an unusual form of diabetes. Your insistence of a 1300 byte chunk of text to clarify its existence in the lead is, in my mind, a WP:WEIGHT problem. I will settle for a single sentence that notes the existence of several rare forms of diabetes, which apart from MODY would need to include Wolfram syndrome, myotonic dystrophy, Friedreich's ataxia and numerous others. But all this distracts from the fact that DM2 (and DM1) are the main forms, and together affect many more people than the rare forms. Lead sections simply need to be selective, and I think this is something that is best left outside the lead. I know you disagree, so please propose a solution that will make us both happy. I'm happy asking WP:MED to give comments. JFW | T@lk 06:24, 6 August 2008 (UTC)

Very well, instead of discussing (why to waist time), just, please, put in your sentence in front of the paragraph with (irrelevant) 1921 and I will figure it out, what you meant and why (appreciating people's intelligence is polite); my concerns, expressed above, will be satisfied by just three words: monogenic diabetes (with the reference) and MODY (hyperlinked), though, it is up to you, how to do without polygenic; the proposed and justified division into 2 chapters made the lead (intro) easier to overview at one glance; I have no attachment (see WP:OWN), but do not like exclusions of minorities (it smells like a discrimination) especially inconsistent with WP:LEAD (162.84.184.38 (talk) 15:26, 6 August 2008 (UTC)).

I'm one of those who have edited the intro in recent days. My motive in this recent spate of edits was to clarify some poor English, not to add to the intro length. My edits have been followed in at least a couple of cases by redits which have reintroduced odd English. The insistence on peculiar English is itself somewhat odd.

A point had been introduced in the intro about the genetic origins of DM, and I simply left it in (with a bit of rephrasing). I'm not entirely certain it belongs in the intro, but it is after all an issue of origin and so has some claim to inclusion in an intro.

Editor JDW has been a long time contributor to this article and has, in every instance of which I'm aware, made reasonable edits which have had at least the effect of stopping lower quality, and most of the time, increasing quality. So the objection about that his edit was based on a private opinion (what others are available in re style, after all?) and that his edit is / was frivolous, is simply not credible.

JDFW's point about the abysmal state of the article is correct. Cruft has been added, bit by bit, for some time. A cruft clearance copy edit is certainly overdue. His point has been made, in one form or another, for a long time (see prior talk archives). One problem with his suggested program for this article is one of coverage and good style. We can have an article of first resort (as this one is) which essentially consists of a series of pointers to subarticles. If so, we will be requiring the Reader to consult many sources to compile a summary account of the disease(s). If so, we editors will have failed in our obligation to provide a summary in this article. The line between enough detail to summarize and too much referral to subarticles is not an easy one, but if it were easy, responsible Wikipedia editing would be trivial. ww (talk) 16:00, 6 August 2008 (UTC)

Formal logic problems: I wrote "frivolous explanation" (of arbitrary deletion), not "edits" (themselves); official opinions, which do exist beside "a private opinion (what others are available in re style, after all?)", belong to WP:LEAD; the fact that "JDW has been a long time contributor" is irrelevant (see WP:OWN), the "the abysmal state of the article" and "cruft" are not the issue here, but a placement of just 3 words in the lead to make it complete, as WP:LEAD suggests; the rest of the 4th par. is a private opinion, not an argument (e.g. he likes red, and she - blue), and discussing taste is pointless, as already the Romans noticed (de gusibus non est disputandum); and thanks for the style corrections, but I created the compact and logical structure of the lead's 1st par., because... you were not able to do so (162.84.184.38 (talk) 22:56, 6 August 2008 (UTC)).

IMO the content of the introduction as it stands at the moment is about right. The changes I would make are primarily stylistic: Why did we wikilink i.e.? Why are there so many parenthetical comments in the third paragraph? Do you think we need to instruct the reader -- with remarkable imprecision -- that a complication is a side effect? Why not simply link to Complication (medicine)?

Since it's apparently been the source of some contention, I do not think that we need to go into details of cause in the intro for this article, as every subtype has a different cause. MODY should mention its cause in its intro; Diabetes mellitus would have to discuss all the causes for all the types in its intro, and this is too much information for the lead. (Compare the decision you would make for Heart disease.) WhatamIdoing (talk) 18:23, 6 August 2008 (UTC)

It is not about mentioning causes of MODY in the lead, but just its name and 2 other words: MODY (wiki-linked) and monogenic diabetes (with the reference to the NIH's article) to make the intro complete per the WP:LEAD's guidelines. Obviously, parenthetical comments are an indication of deficiency in processing the syntax, which otherwise would require much more effort and maybe capacity; not everyone is a born editor, e.g. my style sucks, but there are many people, who can correct style, and only a few, who can synthesize for it is quite difficult, so "cruft" grows (162.84.184.38 (talk) 22:56, 6 August 2008 (UTC)).

Please, check out the minuscule addition (162.84.184.38 (talk) 23:08, 6 August 2008 (UTC)).

I think we're getting dangerously close to personal comment on other editors here; this would be a good place to chill. As has been pointed out, tastes differ (and consensus is the standard under that rubric), and no one owns an article, including this one. All edits are subject to ruthless revision per WP policy. Doffed defense of particualar phrases is out of place accordingly. ww (talk) 23:49, 6 August 2008 (UTC)

No, we are not (do not take it personally), and we have a good lead thanks to the common and constructive contributions unlike the discussion, which seemed to be a waste of time and effort, so making it aggressive shortened such waste; very often editing Wikipedia is a compensation for missing parts of life and once 6 such "nice" persons lacking advanced skills (maybe high school students) asked a 12 year old administrator to protect an article for 2 weeks under a pretext of a vandalism constituted by mere 2 meaningless pranks, and he did it closing the article for 2 advanced editors, but it took a complaint to a senior administrator to bring them to order and to remove the protection, because WP: CONSENSUS in not necessarily a result of a democratic vote or - in other words - a majority is not necessarily right; I am not going to edit anymore, because my objective was just to add monogenic diabetes and MODY, and fixing the lead just happened by chance; I did not want to add them to a badly written paragraph full of logical mistakes, so we fixed it; good luck fellows (162.84.184.38 (talk) 03:36, 7 August 2008 (UTC)).

I've checked out the "miniscule addition" and I think it unnecessary promotion of a rare form. WhatamIdoing (talk) 05:02, 7 August 2008 (UTC)

162.84, I looked at your new version and while I appreciate your attempts to shorten it, this still smacks of WP:WEIGHT in the sense that it still places undue weight on a single type of non-1 non-2 diabetes. You also added it in a place where it is completely out of context (unless the symptoms of MODY are radically different from other forms of diabetes, which they are not).

It's a shame that you have chosen to bid us goodbye, because I'd prefer to settle this pleasantly. Generally, there is no need to use boldface (it is interpreted as shouting). Also, making random jibes at other editors for not having "advanced skills" will not endear you to anyone. JFW | T@lk 05:46, 7 August 2008 (UTC)

This is not a popularity contest, the monogenic diabetes and MODY sentence was placed properly just after 3 most popular types, as monogenic diabetes is the fourth most popular one, and your fifth abrupt and destructive deletion (06:08, 3 August 2008; 07:24, 5 August 2008; 15:40, 5 August 2008; 06:17, 6 August 2008; 05:36, 7 August 2008) does NOT support your good-faith claim "I'd prefer to settle this pleasantly" (you declare one and do the opposite); a resolution request at Administrators' noticeboard. (162.84.184.38 (talk) 15:35, 7 August 2008 (UTC))

JFW has provided a more than reasonable explanation of his reverts. Please be kind enough to review them before reinstating the information. It is not him reverting your edits which is the problem, it is you readding the information before consensus from other editors has been sought after. —Cyclonenim^T@lk? 17:41, 7 August 2008 (UTC)

His explanation is not humanitarian, but arbitrary and inconsistent, because who said that you list only 3 most popular types, and not four, please? If only 3, then why already 6 acute signs of diabetes are listed in the 1st paragraph, please? They are also not equally popular!

Monogenic diabetes constitutes 1-5% of all diabetes ([[1]]) 18 M cases in US; see [[2]] (230 M worldwide; see [[3]]), so - 180,000-900,000 cases in US (2.3-11.5 M worldwide), and he claims that it does not deserve a mention in the lead. So, how many millions of cases are needed for it to deserve the lead, please? The number is rapidly rising, and it may be appropriate let say in 2011 or 2013!!! Like to play God: you are good, and you are not good enough, please? 162.84.184.38 (talk) 21:18, 7 August 2008 (UTC)

It is indeed not a popularity contest, but if you repeatedly assume bad faith, make incivil comments or edit disruptively you are unlikely to achieve your desired outcome.

MODY is rare. So are numerous other forms of non-1 non-2 diabetes. If we were to devote space to these forms in the lead, we would have to cover all of them, thereby exceeding the reasonable length for the intro. JFW | T@lk 19:04, 7 August 2008 (UTC)

All three your accusations are false!

The lead after years of editing and before my first 00:12, 29 July 2008 contribution was a disgrace full of repetitions and logical errors. The 1st paragraph now is more meaningful than the previously two. Every my edit was constructive and accommodative to edits by the others. There was not a single deletion. How does it qualify as assuming bad faith (WP:AGF) by me, please?

Your argument of me making incivil comments (WP:CIVIL) contradicts your initial statistical reason: "this still smacks of WP:WEIGHT". That WP:CIVIL argument means that your application of WP:WEIGHT was NOT based on merit, but depended on the tone of my comments. In other words, by listing WP:CIVIL among arguments in support of your position for WP:WEIGHT, you admit that my comments (and not merit) influenced your consideration of WP:WEIGHT, so your editing is about you, and not Wikipedia, which is not considered a social club by everyone!

As far as the third argument, would you give one example of my disruptive edit of diabetes, just one, please. 162.84.184.38 (talk) 21:18, 7 August 2008 (UTC)

Characterizing other editors positions as accusations is not helpful. We are enjoined here to assume good faith, if not to agree on every point. Further, a demand to demonstrate in detail how the supposed accusation is justified is, essentially, an invitation to detailed dispute. We are enjoined to find consensus by WP policy.

The situation here can be summarized as an idea that MODY and its genetic difference from more common forms of DM should be in the introductory lead in. Opposition to that position notes that MODY is only one of a number of rare varieties of diabetes, even of dibetes mellitus and that as such it doesn't justify such special treatment. Such a difference of view certainly doesn't justify claims of accusations and demands the accusations be demonstrated in even one detail.

"Loaded words" aren't helpful in discussions of how to improve any article, much less one which is as important to so many people as this one. Everyone should take a deep cleansing breath... 67.86.173.246 (talk) 17:19, 10 August 2008 (UTC) oops, this was actually me and WP helpfully had logged me out it seems sorry I didn't notice it before. ww (talk) 00:03, 7 September 2008 (UTC)

Sorry 67.86.173.246, but the facts do not support the premise of the summary above, and with a false premise, the conclusion not credible. The key is an actual frequency represented by hard numbers, and not a feeling of commonality.

Monogenic forms (or "MDM"), constituted by frequency almost entirely by MODY and accounting for 1-5 % of all DM, are in comparison to the 3 most popular forms (type 1, 2, and gestational), or "PDM", less frequent by an order of magnitude, at 1 %, and up to the same order of magnitude at 5 %. So they cannot be called "rare", which means "not frequently encountered; scarce; unusual" or "uncommon, i.e. singular, extraordinary". The hard numbers, as quoted and argued in [[4]]), illustrate it:

"Monogenic diabetes constitutes 1-5% of all diabetes ([[5]]) 18 M cases in US; see [[6]] (230 M worldwide; see [[7]]), so - 180,000-900,000 cases in US (2.3-11.5 M worldwide). If not included in the lead, how those hundreds to millions of people will find its existence otherwise, please? Just one little sentence reading "Less common (1-5 %) are monogenic forms of diabetes, e.g. MODY.". Why from 180,000 people with monogenic diabetes in US to 11.5 M worldwide have to be discriminated against in easy access to a basic info in Wikipedia, because a few people selected such fate for them (not popular enough), please? Is the eugenics back or worse?"

The second argument, even more important, is that MDM are grossly "under-diagnosed" causing also a false impression of their (un)commonality. Many, if not most, physicians are not able to distinguish MDM from PMD, so they may falsely claim that MDM are rare. Because of prevailing misdiagnosing in from hundreds of thousands to millions of cases, MDM and MODY belongs to the intro to make people aware of their existence and to give them a chance to inquire.

On the other hand, all other forms of diabetes are actually rare, i.e. less frequent than the most common PMD by approx. two orders of magnitude, and - so - they really do NOT belong to the WP:LEAD. 162.84.184.38 (talk) 19:52, 6 September 2008 (UTC)

The point I was making had to do with tone, not facts. Granted all of the facts you cite re MODY frequency as compared to others types, there is still an issue with the intro. Stylistically, it's not possible to include even brief mention of all aspects of DM. Consensus has established the intro you came to, and your edits to it have not won consensus on mostly stylistic grounds. I'd like to see the reference you cite mentioned in the body of the article where less common types are covered, though. ww (talk) 00:03, 7 September 2008 (UTC)

You practically admitted that you are wrong! The WP:LEAD says:

"The lead serves both as an introduction to the article below and as a short, independent summary of the important aspects of the article's topic. The lead should be able to stand alone as a concise overview of the article."

I have proven statistically, numerically, and on the humanitarian ground (see my second argument above) that mentioning monogenic forms (MDM), incl. MODY, in just one short sentence belongs to the intro, because it meets the criterion of important aspects required by WP:LEAD, and also the criterion of allowing the lead to be a complete overview (stand alone), because without MDM other forms are NOT represented in the lead, and they are a significant part of the article.

On the other hand, your stylistic argument, contrary to mine, has NO base in the principals of WP:LEAD what so ever, because it is purely esthetic and emotional, though popular!!! Please, note, that WP:CONSENSUS is NOT WP:POLLING, and that logic is, what matters, and not popularity! 162.84.184.38 (talk) 18:19, 7 September 2008 (UTC)

Practically isn't the same as actually. And in any case, this is not about the 'facts'. It's about the style of the intro section in light of multiple WP policies admonitions, all of which is to be settled by consensus per WP policy. You have mis taken my comments here and hared off on a wild goose chase. Please reread them and consider that I was talking about something other than your interpretation. In the meantime, I've reverted again, as it seems to me beyond clear that consensus had been reached on this point (see the discussion above, if you will). ww (talk) 20:49, 7 September 2008 (UTC)

(1) You have missed that I also corrected a serious logical error in the intro (see [8]);

(2) There is no substance in your above argument full of the indeterminate forms: a style, policies, admonitions, all of which, per a policy, a wild goose chase, something other, this point;

(3) "Practically" means "for all practical purposes; in effect; virtually" and is an equivalent to "actually"; the way you wrote above indicates carelessness or serious problems with English and/or formal logic; please, treat the discussion seriously!

(4) Your revert again, without a serious consideration of my correction of the logical error, may be close to vandalism, because WP:CONSENSUS (please, read there) is not a popularity contest, and formal logic takes president over a point of view of a majority; 162.84.184.38 (talk) 14:13, 8 September 2008 (UTC)

162.84..., This long siege has degenerated to the extent that it requires external intervention.

I have accordingly requested such. ww (talk) 16:20, 8 September 2008 (UTC)

Could I encourage 162.84.184.38 not to make any further edits to the lead until the mediation is underway? The case is at Wikipedia:Mediation Cabal/Cases/2008-09-08 Diabetes mellitus. To remain with the issues: current statistics show that MODY and other monogenic forms of diabetes are rare. Therefore, to emphasise them against the must more common forms of diabetes amounts to overemphasis. That has nothing to do with discrimination, and inflammatory language (as well as boldface and endless lawyering of policies) is unhelpful. You have been encouraged to make contributions to the article body, where there is plenty more scope for discussing the rarer types of diabetes, all of which are encyclopedic and need to be mentioned in full detail - especially if the diagnosis or treatment is radically different from the usual forms. JFW | T@lk 20:35, 8 September 2008 (UTC)

Not true: (1)"Monogenic diabetes constitutes 1-5% of all diabetes ([[9]]) 18 M cases in US; see [[10]] (230 M worldwide; see [[11]]), so - 180,000-900,000 cases in US (2.3-11.5 M worldwide)."

and

(2) Because the WP:LEAD says:

"The lead serves both as an introduction to the article below and as a short, independent summary of the important aspects of the article's topic. The lead should be able to stand alone as a concise overview of the article."

so I have proven statistically, numerically, and on the humanitarian ground (see my second argument above) that mentioning monogenic forms (MDM), incl. MODY, in just one short sentence belongs to the intro, because it meets the criterion of important aspects required by WP:LEAD, and also the criterion of allowing the lead to be a complete overview (stand alone), because, without MDM, other forms are NOT represented in the lead, but they are a significant part of the article.

(3) The sentence "The two most common forms of diabetes are due to either a diminished production of insulin..." illogically introduces arbitrary and unnecessary "forms", when it actually refers there to the two main causes, etc. 162.84.184.38 (talk) 03:39, 9 September 2008 (UTC)

I will not respond to your arguments here, because the case has been referred for mediation. JFW | T@lk 18:48, 9 September 2008 (UTC)

But, your 8 September 2008] reversal - of my correction in WP:CONSENSUS ("the logic may outweigh the logic" screemed false, because nothing can outweigh itself; see the discussion) - summarized by your insinuation, that the revision by me was "used for wikilawyering on Talk:Diabetes mellitus", seems to be a bit too much. 162.84.184.38 (talk) 19:36, 9 September 2008 (UTC)

...and Wikipedia:Mediation Cabal/Cases/2008-09-08 Diabetes mellitus seems to be a good idea; thanks! 162.84.184.38 (talk) 19:44, 11 September 2008 (UTC)

Will you please stop reverting to your version, which has no support at present, until the mediation case is completed? I face the decision of asking for the page to be protected or asking an administrator to consider blocking your access to Wikipedia. JFW | T@lk 20:15, 13 September 2008 (UTC)

multiple edit revert this date

I have just reverted multiple edits by an anon poster, all of them based on claims that Type 2 is curable (80% was the citation) by special diets. In addition, the edits also deleted useful content. As they were not discussed here, and were a kind of POV in any case, I judged deletion was indicated.

Since the reversion didn't preserve my edit summary, I thought it useful to explain here.

Anon poster, if you would like to include those claims, please source them and include them in the cure for Type 2 section along with the bariatric surgery which has recently made such a splash. Otherwise, I suspect your edits will be found POV in future as well. ww (talk) 19:06, 5 September 2008 (UTC)

archiving clashes with mediation

This article has been referred to the Mediation Cabal (see tag at the top of this page), and just as that happened, Coro did one of his period archive sweeps of this page. This has changed the easily available e record of this page to the inconvenience of the Mediation process. Coro has been requested to unarchive for the duration of the mediation.

Mediators, please stand by... ww (talk) 16:45, 9 September 2008 (UTC)

The archived discussions for the end of 2007 have been restored to the top of the page for easy re-archival. --Coro (talk) 21:33, 9 September 2008 (UTC)

MEDCAB mediator

Hi all! :-) Can all parties please give me a quick version of their view of the matter? Please keep to less than 400 words if you can (each). Thanks! Fr33kman^{talk APW} 04:47, 14 September 2008 (UTC)

MEDCAB

I am sorry but due to personal events I have to leave for a short while. I have relisted the case on MEDCAB. Thanks and Good Luck! :-) Fr33kman^{talk APW} 01:29, 17 September 2008 (UTC)

Hypertension

In DM1, poor glycaemic control is associated with an elevated risk of hypertension, again confirming the role of insulin in blood pressure regulation. http://archinte.ama-assn.org/cgi/content/full/168/17/1867 JFW | T@lk 20:55, 22 September 2008 (UTC)

MEDCAB (2nd go)

Hello all! I a going to retake this case (if that is acceptable to everyone). I need a quick overview of the dispute in order to understand it better. Could each person involved please fill in their view (less than 250 words) in the relevant section below. Please do not respond to or edit another editor's response. There will be ample opportunity to discuss this, I just need to know each editors position. You can be technical in this mediation, I am a medical student. Thank you - fr33kman -s- 22:08, 29 September 2008 (UTC)

Editor 1

See Wikipedia:Mediation Cabal/Cases/2008-09-08 Diabetes mellitus for my account of the business which has gottne us here. In the period since submission to Med Cab, the back and forthing has subsided. Perhaps it will not resume? ww (talk) 18:40, 30 September 2008 (UTC)

Should we close the case, and open it again if needed? fr33kman -s- 20:06, 30 September 2008 (UTC)

In my opinion, no. There were several instances after I thought consensus reached, but was disabused of my optimism in short order. Let's carry the process through, now that you're back on the case. My pious hopes for settlement shouldn't influence anybody; my delusions are my own, not to be taken seriously. Welcome back, incidentally. ww (talk) 21:21, 30 September 2008 (UTC)

Editor 2

The following changes (also just added to the lead) have been opposed without a cause. The 3rd sentence of the lead:

The two most common forms of diabetes are due to either a diminished production of insulin (in type 1), or diminished response by the body to insulin (in type 2 and gestational).[4]

is faulty, because it unnecessarily refers to types of diabetes (1 & 2) as forms, which they are not; they are types, as their names indicate it. So it was replaced by the following sentence avoiding the word "forms" and saying practically the same:

Diabetes develops due to a diminished production of insulin (in type 1) and resistance to its effects (in type 2 and gestational).[4]

The 4th sentence remained unchanged.

The 5th sentence:

Monogenic forms[5], e.g. MODY, constitute 1-5 % of all cases.

was added, because:

(1)"Monogenic diabetes ("MDM") constitutes 1-5% of all diabetes ([[12]]) 18 M cases in US; see [[13]] (230 M worldwide; see [[14]]), so - 180,000-900,000 cases in US (2.3-11.5 M worldwide)."

and

(2) MDM are grossly "under-diagnosed" causing also a false impression of their (un)commonality. Many, if not most, physicians are not able to distinguish MDM from type 1 or 2, so they may falsely claim that MDM are rare. Because of prevailing misdiagnosing in from hundreds of thousands to millions of cases, MDM and MODY belongs to the intro to make people aware of their existence and to give them a chance to inquire.

and

(3) The WP:LEAD requires:

"The lead serves both as an introduction to the article below and as a short, independent summary of the important aspects of the article's topic. The lead should be able to stand alone as a concise overview of the article."

and it has been proven statistically, numerically, and on the humanitarian ground (see the 2nd argument) that mentioning monogenic forms ("MDM"), incl. MODY, in just one short sentence belongs to the intro, because it meets the criterion of important aspects required by WP:LEAD, and also the criterion of allowing the lead to be a complete overview (stand alone), because, without MDM, other forms are NOT represented in the lead, but they are a significant part (a chapter) of the article.

My 162.84.184.38 (talk) ID changed to 71.247.12.83 (talk) 08:30, 2 October 2008 (UTC).

Editor ...

---

Thank you in advance! :-) fr33kman -s- 22:08, 29 September 2008 (UTC)

Mediator

I think that the lead section should contain any form of DM that affects at least 2% of the population of patients. 2% (indeed less) is a medically significant figure (if 2% of patients a surgeon . If this were an article about religion in Unnameistan then a 2% population of adherents to a minority religion might not qualify for inclusion in the lead, but it's not; it's about a medical condition. The various type should be called "types" and not forms. The reason for this is that this is an encyclopaedia, the reader is what matters, not the editors! We (experts) don't write Wikipedia for our own use, we write it for the layperson. This article must be understandable by the non-expert reader. Experts shouldn't be coming to Wikipedia for sources: frankly it would be professionally weak to do so and no peer reviewer would look kindly on a researcher using a Wikipedia article as "evidence" in any publication of note (indeed at my university, citing Wikipedia is an automatic failure for any piece of work submitted to med-school!). This place is for the high-school student, the worried new patient, the news reporter looking for a quick snippet to include in an article: the layperson. As such, we have to keep it understandable by that audience. Also, the only mention of a cure should be surgical (although endocrinologists and other physicians would not call such a cure per se, but a surgeon would [just as a surgeon calls a removal of a tumour a cure, even though it might not be ultimately]). Any true, medical, cure for DM would need to be peer reviewed and would earn the discoverer a Nobel prize and would be so widely reported in the lay-press that there would be no question here as to its validity! Comments? fr33kman -s- 15:52, 6 October 2008 (UTC)

I'd also ask if people are ready to propose compromises? fr33kman -s- 17:55, 6 October 2008 (UTC)

• Thanks ...man for the clarification, which is exactly, what I have been suggesting for months; monogenic forms constituting 1-5 % of DM (average = 2.5 % per the best estimation from NIH) seem to pass the min. 2 % criterion, and nothing rearer. I hope, the little sentence will not be removed again. 71.247.12.83 (talk) 21:44, 7 October 2008 (UTC)

Re cure: there is a long discussion on exactly this point in the talk above. Clearly there are different views (even among the medical folk contributing) regarding the exact definition.

Re form v type: pretty much a distinction without a difference in this context. Plato's not involved after all, and we're using English, a language in which there are multitudes of synonyms or near synonyms. And in a non technical article not meant for professionals perhaps it's being too over careful.

Re compromise. I personally have little trouble with whatever style derision on this point is established by consensus amongst editors. I may disagree, but my opinion is not determinative. In this case, there being on the order of 50 sorts of diabetes and many sorts of DM, it's not clear where the line should be drawn in the lead. I think, attempting to speak on behalf of our Average Reader, that the lead should definitely be about establishing that DM is not just one thing, that the dominant type/form is <xx> (and maybe the second most common too as reinforcing the pint about non singularity), but no further, as it is the 'lead' not the body. But without consensus, WP policy does not favor campaigning for content or style consensus has deemed inappropriate. Hence this mediation, no?

Sorry to hear about your med school's policy re WP. Surely there's something here an embryo doc can usefully learn from!

Re technical language surplusage. Yes I agree, Each of the diabetes articles I partol has been becoming more and more specialized -- partly I suspect due to fear of fact tag bombing -- and so less readable to our target audience, the average Reader. Without personally rewriting them every so often, I don't see a good way out of this trend. All articles should, of course, regardless of the high (or lower) proportion of technical terms, be accurate. This requires a general quality of prose not usually available in the technical fields (would that all were as scintillating as Lewis Thoms or Peter Medawar! Als, not likely.) and hard to find on WP after edits from all against whatever might have been present at one time. ww (talk) 17:53, 7 October 2008 (UTC)

Of course it's semantics regarding "type" versus "form", but again, I feel that the reader is the important person here. They will be more familiar with the term "type" as this is what most clinicians will refer to them as. Cure, there will always be controversy on that term (for all diseases, not just DM); but again it's the reader that's important. The term "cure implies (rather strongly in an encyclopaedia) that the disease is curable (as in "I don't have it any more and have no symptoms or treatment at all; ie: it's gone!") Regarding the lead, it should be a stand-alone mini-version of the article (as much as is practicable) and I do think that any type that has a significant number of patients should be listed: very rare types should probably be left for the article with a pointer in the lead such as; "Although there are many types of DM but the most common forms are ... [those that affect at lest 2% of patients ..." As for my med-schools policy; I think that it is understandable. Students, especially those whom the public are going to trust with their lives, need accurate, reliable sources, and as we can see on many articles on Wikipedia, they change often, sometimes incorrectly. Wikipedia may, one day, become as well respected and cited as mainstream publications, but it's not there yet. The shear number of edit wars prevent it. It's why I've chosen to spend most of my time here doing DR and mediation, to try and protect it from harmful practices. fr33kman -s- 22:46, 7 October 2008 (UTC)

• There is a difference between type and form especially in application to DM. Type is close to a specific illness, and form refers to a group with a common feature, e.g. monogenic form or polygenic form. Not everyone is proficient in the proper terminology, but it was provided (by myself) and the only burden there was NOT to oppose it... for months... with a benefit to everyone and no cost. Btw, I do edit Existentialism.
• The inclusion of relatively new MODY has been on a humanitarian (statistical) ground. Percentages of the three main types of DM are in double-digits, MODY - single-digit, other types - in fractions of 1 %. The unsupported argument held for months of drawing somewhere a line excluding MODY was shared by just a few (maybe only 3) conservative editors. The one minuscule sentence inclusion has been balanced by a reduction in size of the 3rd paragraph causing the total size of the lead to actually decrease. I did the work and its acceptance would be a kind of professional courtesy.

• Sometimes you need to fight for what you believe on Wikipedia (or indeed any area of life). There are loads of people with a vested interest in an article such as DM: physicians, naturopaths, homoeopaths, Christian Scientists, herbalists, patients, families of patients etc., with such a diverse group of editors (and beliefs or needs), there is bound to be contention: sometimes months after the initial edit, when that contending editor first sees it. fr33kman -s-

• Obviously, Wikipedia is NOT a scientific source especially in the lead part of articles, but it can be written properly, with respect to types and forms, and in a simple language, which requires more effort than convoluted one. The argument: "Each [...] article [...] has been becoming more and more specialized" sounds more like entitlement than a lame excuse that the articles became complicated by themselves. And the conclusion after opposing for months the simplification: "I don't see a good way out of this trend." calls for the answer: Do not block advanced edits by using consensus among a few friends, please! Or, do work harder and not block for months edits, like mine, when I am willing to put an additional effort to simplify text and make it more available to average reader, please! How many articles could have I simplified instead of wastefully arguing for months here about one little sentence, please? 71.247.12.83 (talk) 10:06, 9 October 2008 (UTC)

• I agree that I don't see a quick way out of the complex creep that is occurring all over Wikipedia. As a challenge to any of you, or all of you: try expanding the article over at simple wikipedia whilst keeping to their rules over the use of Simple English! That's quite a challenge, especially when the article over there is actually too complex as it stands today! :-) fr33kman -s- 14:11, 9 October 2008 (UTC)

• Wikipedia needs more experts, who are not available, in addition to dedicated editors it already has, who sometimes get "too focused", but they actually create the bulk of articles. Sometimes, editing goes smoothly and appreciative, like with microprocessors, where each lead got fixed within just a few hours without a single word of discussion, but just by constructive contributions and compacting trivia by myself and without reverting or deleting anything by others, who did not feel offended by my effort, but happy that the article they like will be simpler and complete; adding a TDP rating was my motive. Unfortunately, almost nobody has a capacity and patience to compact, so the complex creep grows. I have not given up with DM, because my friend got it prompting to make the lead better for millions, like her, to have something simple and comprehensive up front, but I do not have such motive for poor Existentialism; do read the 1st sentence and tell, if you understand anything, but the editors there are very dedicated too... . 71.247.12.83 (talk) 22:49, 9 October 2008 (UTC)

Status?

Do we feel that we have a solution at this point? Are there other concerns remaining? fr33kman -s- 14:11, 9 October 2008 (UTC)

I think so; after compacting the 3rd par., the MODY addition has not increased volume of the lead. Thanks! 71.247.12.83 (talk) 22:49, 9 October 2008 (UTC)

I do not, on stylistic grounds, agree that there is a solution. Form v type I think is mere quibble and I don't care much about that either way as I think there is little risk of losing/confusing our Reader. However, introducing the idea that monogentic types (or forms, whatever) are 1-5% of cases in the lead raises the question in the Reader's mind of what is 'monogenetic'.

"Must be important because it's in the head paragraphs, above the TOC. From the word form used here I suppose there must be 'bigenetic' or 'polygenetic' types, but they're not mentioned. Why not? And does it matter? I've no idea since the mention has no context I can see. ..."

The cost (in words) of providing the context is too much to expend in an intro and so inappropriate. The lead says there are lots of types (two most prominent are mentioned to illustrate that point) and the discussion continues with other general issues regarding diabetes all of which are appropriate in an intro. Nothing else belongs in a brief lead -- it's a point about writing style, about clarity, about serving the Reader, ... NOT a point about content.

So there's still no real reason to add this to the introduction, and most especially not in the particularity brief form it now has. If MODY is to be in the intro, there must be sufficient context there for it to be understood. Thus, I object to the current status of its inclusion on stylistic grounds. A prior version of that edit was more satisfactory on these grounds, but objectionable on other stylistic grounds in not being appropriate to the intro (too long).

Since contentious edits were to have been suspended during the Mediation, I shall not correct the problem, but it shouldn't have been added anyway, which is another aspect of the problem. Consensus was reached, the editor immediately above ignored it, characterizing it derisively with a good bit of policy lawyering -- not collegial WP behavior. Re-inclusion during the Mediation process is illustrative. There has been non-collegiality, degenerating to personal attack on occasion, in re this aspect of the intro. It continues, in somewhat muted form; eg, it is wholly irrelevant re WP editing participation whether I, or JDFW, or anyone else, was, are, might be, ought to be, or should not be, "conservative" as claimed. And whether the editor in question is admirably and virtuously advanced, liberal, radical, or whatever, in contrast. It's equally irrelevant. Furthermore, whether those who disagree are merely a 'few friends' conspiring together is merely poisoning the well: I know personally no other WP editor at all, do not correspond with any outside of WP talk pages (with one exception re password strength where the issue was primarily technical, not stylistic), have never been to the Netherlands (JDFW's practice location per his User page) and have been in Iowa only once in my life (Alterprise' practice location per his User page -- actually, without re-reading the entire business, I can't now remember whether Alterprise was involved). The claim is demagoguery and false to fact, certainly with respect to myself.

The article matters, the Gentle Reader matters, and WP matters; the personal, and suspicions of conspiracy against one, and rules lawyering do not. There has been trouble on all these fronts. ww (talk) 23:40, 10 October 2008 (UTC)

Case has been Closed

It would appear that the case has been closed as of December 16, 2008. Assuming no objections, I intend to archive the last of 2007 over the weekend.--Coro (talk) 01:21, 30 January 2009 (UTC)

ayurvedic medicine missing -- it has cures for DM

Why is Ayurveda not mentioned anywhere as an alternative treatment? This is shocking, that there is not mentione of ayurvedic cure. Yes it cures diabetes. I see atleast 2-3 people getting cured every month in a Yoga camp in my city. They are just cured by doing pranayama yoga and following a diet of raw vegetables for 18 days. After that there is a 3 day detox treatment. Forget all that Himalaya Company is selling diabetec management capsules made from herbs in the USA too. There are enough research papers available on the net. I am not adding it becuase i have tried adding information before to wikipedia and someone edits it out because they say it is "POV". Even if there is a link they say that the way I am writing it is "POV". These "editors" just delete the content, they make no attempt to remove any "POV" reference. This article makes wikipedia one big joke. —Preceding unsigned comment added by 122.167.227.4 (talk) 15:29, 14 November 2008 (UTC)

Well, I think the answer to this question has to do with evidence based medicine -- of whatever type. Have any of these claims been credibly investigated? Is there as credible source which can be cited?

Second, if there were an ayurvedic cure, I have to think that the rapidly rising rates of DM type 2 in India would not be the problem it has become.

The only way these can be reconciled is, I think, to posit a conspiracy among conventional (ie. "Western scientific") medicine to suppress the results achieved by ayurvedic practice. And this is an extraordinary claims whihc requires extraordinary support, which appears to me to be lacking.

Finally, it's important to note that Wikipedia has no censor board keeping out such claims. It does have policies forbidding POV and original research, and they are enforced by the editors generally, including the anon poster, should he/she care to participate. If these claims are either personal opinion / evaluation of the virtues of ayurvedic medicine in the context of DM, or original research, then they don't belong here. They should be sourced to a credible third party source in order to be included; this was the import of the first paragraph above. ww (talk) 16:47, 19 November 2008 (UTC)

There currently is no known cure for DM, so claims of ayurvedic medicine being a "cure" are scientifically and anecdotally spurious. End of discussion! Bigdumbdinosaur (talk) 16:38, 11 December 2008 (UTC)

Effect of Diabetes on Male Sexual Performance

In the article is was stated that DM may result in male impotence. Technically this isn't quite true. DM, if sufficiently progressed, may prevent one from achieving an erection of any kind, let alone one sufficient for sexual penetration, which condition we would refer to as erectile dysfunction (ED). It does not mean, however, that said individual cannot experience sexual arousal, orgasm and ejaculation. I have not been able to determine in researching available literature whether true impotence is directly related to DM itself.

The term impotence refers to the inability to sexually perform, and while many dictionary definitions simplistically consider impotence the same as ED, the relationship is not that cut–and–dried. Impotence often has psychological origins that have nothing to do with the general health and well-being of the subject person. For example, during periods of high stress—due to money problems, acrimonious breakup with his girl friend or wife, etc.—a man may become temporarily impotent. He can't relax and "let loose," which is a necessary precursor to sexual arousal. His ability to achieve an erection has not been physiologically impeded in any way, so by definition, this would not be a case of ED.

Impotence could also result from episodes of pedophilia experienced in childhood, causing one to experience apprehension or outright fear when the possibility of sexual activity looms. In such a case, all the Viagra or Cialis in the world will be of no help.

It may be that other factors that are responsible for impotence are aggravated in some fashion by DM. Again, there is an apparent paucity of research on that matter. Obviously, the medical community's focus on DM has been one of attempting to control the disease and thus mitigate the damage it can cause, rather than that of addressing its annoying but otherwise "harmless" effects. Although younger readers might be inclined to think that inability to have an erection is indeed harmful, I can assure you—speaking from personal experience—that relative to the other things DM can do to you, not being able to get it up when sexually aroused is a minor consideration in the scheme of things.

I edited the article to remove the reference to impotence and instead directly reference ED.

Bigdumbdinosaur (talk) 17:46, 11 December 2008 (UTC)

Sorry you are wrong, diabetes is caused mainly from cortisol excess, impotence too. Low testosterone levels can causes diabetes and impotence. Therefore there is a tight correlation between impotence and diabetes. —Preceding unsigned comment added by 158.194.199.13 (talk) 22:53, 17 October 2009 (UTC)

Pls add this topic to the article

Diabetic retinopathy--165.228.190.54 (talk) 03:38, 16 December 2008 (UTC)

Already in the article. See the chronic complications section. ww (talk) 16:07, 16 December 2008 (UTC)

I'd love to see more information on the CD4T+ cells response and similar pathway for destruction of beta cells in the article. At a minimum, could we have a small section listing autoimmune response? My Doctor, 30 years ago, stated my diabetes was due to an autoimmune response. I think providing the root cause of the immune response to beta cell destruction would be beneficial. —Preceding unsigned comment added by 98.67.81.17 (talk) 16:38, 26 February 2009 (UTC)

Diabetes Is Reversible! per the webpage: [15] Can a doctor look into this and make this news helpful to all?Bold text —Preceding unsigned comment added by Robertisonline (talk • contribs) 19:09, 10 July 2009 (UTC)

Cancer mortality

Owgh. Having diabetes increases the risk of a cancer patient dying by 40%. http://jama.ama-assn.org/cgi/content/abstract/300/23/2754 JFW | T@lk 22:50, 16 December 2008 (UTC)

Yes, and "butter will kill you..." Statistical data applies, but don't take it as law. Individual results will vary.  :) —Preceding unsigned comment added by 98.67.81.17 (talk) 16:40, 26 February 2009 (UTC)

"dietary treatment" link in the introduction

The current link to diet (nutrition) is not very useful and a dead end. Please change it to Diabetic diet. Thanks.76.97.245.5 (talk) 01:17, 19 December 2008 (UTC)

beta blockers

should something be mentioned about using beta blockers with caution in diabetes? —Preceding unsigned comment added by 24.99.86.24 (talk) 15:36, 29 January 2009 (UTC)

Possibly, but it's not a solidly established result as I understand it. And in any case, we'll need a citation for it. At most a line or two, I'd think. ww (talk) 09:22, 20 April 2009 (UTC)

removal of 'Benefits' section

This text was removed from the article today:

Benefits

Diabetes and the use of insulin is a huge benefit to body builders. It is very dangerous to use insulin if not a diabetic, but is still abused in the sport of body building. Insulin is sought after and used much like anabolic steroids. It is used to control blood glucose ranges, so that the body cannot store elevated glucose as fat. Type 1 diabetics usually have a normal bmi and if bulk up easily with minimal weight training. Having diabetes is not always a bad thing.

This is factually wrong (the reference to storing elevated glucose as fat) and clinically wrong (diabetes mellitus is dangerous and the drugs used in its treatement are not benign). If you want this to remain in the article, please discuss it here. ww (talk) 09:22, 20 April 2009 (UTC)

ww, you are absolutely right to remove this section. The paragraph, as written, has no business being here. If there is a reliable citation for this information, it belongs under an "Abuse" heading in the Insulin therapy article (without the positive spin shown here). But if we're going out on a limb to call it a Benefit of diabetes, we might as well add some other so-called benefits (easy access to syringes, can't be drafted in the military, etc) - an addition I also strongly oppose.-Sme3 (talk) 12:33, 20 April 2009 (UTC)

Contradiction in worldwide numbers

From the first paragraph: "Diabetes affects aproximately 18,000,000 children and adults in the United States, and perhaps 420,000,000 persons worldwide."

From the second under "classification": "The World Health Organization projects that the number of diabetics will exceed 350 million by 2030."

It seems that one of these figure must be in gross error.

Felosele (talk) 19:28, 6 May 2009 (UTC)

Mechanism of Damage

I added section about AGEs with explanation. KeithBeltham (talk) 05:47, 4 June 2009 (UTC)

I have removed it temporarily. I think this is relevant but should probably be discussed in the context of the complications and it needs some jolly good sources (there was a review in JAMA a few years ago). JFW | T@lk 07:17, 7 June 2009 (UTC)

Image gone awry

In Signs and Symptoms, there is presently an image of a torso with various locations of complications and such, mixed with presenting symptoms and signs. Aside from mixing apples and oranges (a presenting symptom or sign might not (and isn't in some present cases) a complication), the image leaves out one of the most common and dangerous complications, diabetic ulcers, especially on the feet. This is a major cause of amputation even in the developed world with diabetics under treatment. Perhaps the image can be expanded, added to, or even replaced by a stick figure with appropriate annotations? Not satisifactory as it stands. ww (talk) 00:40, 25 June 2009 (UTC)

Try and persuade the chap in the image not to plaster himself over large numbers of pages. The images have no merit; nobody can alter them directly, the words are not clickable etc etc. JFW | T@lk 09:50, 5 July 2009 (UTC)

Treatment

In the treatment section, please mention the drug AR9281 (originally found by Bruce Hammock) —Preceding unsigned comment added by 91.182.203.223 (talk) 16:23, 2 July 2009 (UTC)

Not unless it is about to be approved by the FDA. We couldn't possibly list all experimental diabetes treatments, as the majority will fall by the wayside rather than get marketed. JFW | T@lk 09:50, 5 July 2009 (UTC)

A proposal

Please see Wikipedia talk:WikiProject Medicine#The diabetes quagmire for a proposal on how to organise the diabetes content on Wikipedia. Comments invited on that page please. JFW | T@lk 09:59, 5 July 2009 (UTC)

Need to link to all diabetes-related articles:

An explanation of why the top of the article is now very crowded. Article "Diabetes Mellitus" is the "main" article to which a search on "Diabetes" links. Additionally, there are over 15 related articles on diabetes. Most of them now appear in Template:Diabetes. That template needs to be at the top of the article so a user can see what other articles exist.

To accommodate many with diabetes and impaired vision (see WT:ACCESS) will have ramped up 800x600 resolution and/or have an electronic reader device. Only in very high resolution does the Diabetes template even begin to stand out unless it is placed at the top.

An alternative is to move down the article series box with the large diabetes blue circle (which should be smaller). However, that move was reverted on 7/3/09. Other suggestions welcome. Afaprof01 (talk) 04:54, 7 July 2009 (UTC)

Not only does the template make the top crowded, it is also very ugly now. I think you should stop trying to shove absolutely everything in the first few inches of article, and appreciate that this article is meant to be a stepping stone to all diabetes content rather than a disambiguation page.

I think the template should be positioned at the right margin, and I would strongly encourage its placement in the first section (i.e. "Classification"). The interested reader will not object to reading a few lines if this will enlighten them in the process. Please await the opinion of other contributors before making any further change. JFW | T@lk 18:45, 8 July 2009 (UTC)

While I think many of Afaprof01's edits have been improvements to the article, I agree with Jfdwolff on this one -- the template doesn't belong at the top. Either a hatnote of some sort linking to the template or a disambig (disambig-like) page, or moving the template lower, would be a better option. -Sme3 (talk) 20:10, 8 July 2009 (UTC)

Whilst I appreciate Afaprof01's point, his idea doesn't really work for cosmetic reasons. I might try and ask someone to make a drop-down box (like the one already there) for the bottom of the article to include all the Diabetes articles, they're much more common than these weird templates being shoved around at the top. They're more common in usage too. The idea to have it at the top is hardly a life saving one, if anyone needs immediate information on diabetes they should be contacting there physician, and that's that in my honest opinion. An infobox at the bottom would be more suitable, equally accessible and better looking cosmetically. Regards, --—Cyclonenim | Chat  23:04, 12 July 2009 (UTC)

intro changes

I know I havent looked at this article for years, and perhaps some of these have already been thrashed out, but what I just changed included some flatly false statements or major omissions, even for a brief intro. If I have stepped on toes or upset a delicate consensus, I apologize. If anyone needs more detail as to why a change was more accurate, please ask and I will be happy to explain. PS, I agree with keeping links to the far left or the end. alteripse (talk) 00:36, 13 July 2009 (UTC)

Insulin resistance and saturated fat

I made small changes to the intro to mention resistance. Searching google ect ... looks like consumption of saturated fat (cells saturated with saturated fat are insulin resistant) is a key problem ... lead me to "Dr. Neal Barnard's Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes Without Drugs" Cites peer reviewed studies ect ... as many as 80% of type 2 diabetics can come off medication if they cut out fats. Any comments?Zinbarg (talk) 16:21, 31 July 2009 (UTC)

Globalization/USA template

This article has unrepresentative examples specific to the USA. The article is about a particular medical condition not a single nation. 95% of human population is not covered by these examples and also the USA has, amongst developed countries, a uniquely corrupted and socially primitive health care system and unusual population health demographics. Examples included such as the following

The American Diabetes Association reported in 2009 that there are 23.6 million children and adults in the United States—7.8% of the population, living with diabetes. While an estimated 17.9 million in the US alone have been diagnosed with diabetes, nearly one in four (5.7 million) diabetics are unaware that they have the disease

are interesting and informative but not global. What for instance are these figures internationally and how do they vary. Why should a specific locale have such prominence that the statistics stated distort the articles integrity. The articles subject is Diabetes mellitus not Diabetes mellitus in the United States. --Theo Pardilla (talk) 08:49, 5 September 2009 (UTC)

your political opinions on US health care are neither pertinent nor constructive to any such discussion.--Reedmalloy (talk) 09:32, 18 September 2009 (UTC)

Testosterone and cortisol

It is sure that cortisol and testosterone are the most important hormones for insulin response, I do not know why it is not possible to say that in the article? It is an essential information for readres.

Because all information must be accompanied by a reliable source. The only source which you have provided, is to a site which requires payment to view it. Please find better sources for your information before adding it. The standard for inclusion to Wikipedia is verifiability and not truth. What you have added may in fact be true. Wperdue (talk) 19:23, 14 October 2009 (UTC)

The article is completely free, it is possible to watch the HTML and the PDF version of it. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T3G-4RRFNGH-1&_user=990403&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000049942&_version=1&_urlVersion=0&_userid=990403&md5=ca14e56fabff9a1c70229fddab292929

It is an article, it is a reliable source.

I think it is very important to insert that information in order to give a correct and complete information to the readers. I hope you are agree. —Preceding unsigned comment added by 158.194.199.13 (talk) 20:51, 15 October 2009 (UTC)

In trying to verify, I have found that the article itself is not available on a free basis. What is free is the abstract. The abstract seems to suggest a role for cortisol, but I couldn't find any mention of testosterone in the abstract. At present I am not committed enough to willingly spend the $31.50 required for access to the actual article itself, and will have to leave that for someone else. --Coro (talk) 19:10, 16 October 2009 (UTC)

It's about metabolic syndrome, not diabetes.[16]--Nutriveg (talk) 19:47, 16 October 2009 (UTC)

No, ALL article is free (indeed the link is the COMPLETE article in HTML form, it is possible to download the PDF version too). No money for the full article. The article is focused on subclinical Cushing's syndrome (the main cause of diabetes mellitus) and not testosterone. If you want I may find citations about testosterone too.

You're not allowed to make your own conclusions from the article.--Nutriveg (talk) 19:56, 16 October 2009 (UTC

It is not my own conclusion...it is strange that you do not know that diabetes mallitus is one of the symptoms (the main) of metabolic syndrome, it is strange that you are speaking about another article. Speaking about metabolic syndrome means speak about diabetes too. You should know that. Wikipedia should say that. Without speaking about tight cortisol-diabetes relationship, the article is misleading and it lacks of essential arguments, instead it is rich of nonscientific arguments. It is completely false and misleading to speak about diabetes mellitus without speaking about cortisol and testosterone (which is much more effective than metformin agianst diabetes, you should say that).

It is clear that you do not want to say the truth, before you invented the story of expensive article (instead it was clearly free of charge), then the story of metabolic syndrome (instead diabetes mellitus is the main symptoms of diabetes mellitus, moreover you spoke about another article). You know it is clear that diabetes mellitus is caused by subclinical Cushing's syndrome, but in order to disinformate readers (in order to buy metformin, which is unuseful against diabetes and it has also many side effects) you say it is false. When our society will be full of diabetic people you will continue with the story of metformin and diet...

Of course, in order to helps industrial pharmaceutical industries to sell unuseful drugs (as metformin in example) you do not say nothing about testosterone therapy, which completely readily recover diabetes mellitus (try and you will see it). It is clear the metformin is sold just for economic issues (testosterone is just one injection per month, common "anti-diabetic" drugs many per day).

Wikipeida articles about diseases should contain the generally accepted treatment regimes, and it appears that testosterone treatment is at best frontier science. Also please note the distinction between the different types of diabetes, for surely you don't mean that testosterone is a treatment for every type of the disease?Sjö (talk) 08:49, 17 October 2009 (UTC)

Yes, testosterone can be used for every kind of diabetes because it decreases insulin resistance, of course in case of diabetes mellitus type 1 is always necesary to use insulin too. The use of testosterone against diabetes is not frontier science, but it is a verified therapy. Since 1932 we know that low testosterone/cortisol ratio can easily cause diabetes mellitus type 2.

For the reasons explained upward, I've edited the articli in order to make it more correct and complete. —Preceding unsigned comment added by 158.194.199.13 (talk) 08:24, 18 October 2009 (UTC)

I'm sorry, but I have failed to find any mention of testosterone replacement therapy in any overview or information material about diabetes. It seems to be used very little or not at all in the treatment of diabetes. Also, the mention of diabetes type 2 as subclinical Cushing's syndrome doesn't seem to be supported by the part of the source that's available without subscription. Thirdly, your last edits undid several improvements to the article. For those reasons I will revert them. May I suggest that you reference textbooks, overviews of treatment options, treatment recommendations and the like, to show that what you say is generally accepted to be true?Sjö (talk) 17:17, 23 October 2009 (UTC)

you are completely wrong! There are two citations about testosterone replacement therapy (53, 54). Look better please! the article about subclinical Cushing's syndrome speaks clearly: the subclinical Cushing's syndrome can cause diabetes mellitus type 2. You reverted citations, for that reason I revert too! Stop with vandalism please! If you ewant to add informations do it, but do no delete valid informations as testosterone replacement therapy. Before reverting, control better please! And if you do not say that testosterone replacement therapy is not the best anti-diabetes therapy...study a boook of basic endocrinology instead than reverting things that you do not know (without offence). If YOU DELETE THESE INFORMATION YOU DAMEGE WIKIPEDIA AND ITS READERS! Let's stop vandalism, ok?—Preceding unsigned comment added by 158.194.199.13 (talk) 00:55, 24 October 2009 (UTC)

It is not up to us to "study a book". The burden is on you to provide the sources for your claims. If you continue to add unsourced information without regard to consensus, your edits will be marked as vandalism. Wperdue (talk) 06:02, 24 October 2009 (UTC)

Look the citations 22, 53, 54. You really can not claim about citations deficiency! If you want I can insert more citations of course, but i really think that 3 scientific articles published in higly scientific reviews are enough. I also remember you that deletion of scientific article is vandalism, so stop with vandalism please. —Preceding unsigned comment added by 158.194.199.13 (talk) 09:38, 24 October 2009 (UTC)

Testosterone raplacement therapy

I do not understand why it is not possble to write that testosterone replacement therapy is very efficient to cure diabetes mellitus and to normalize glucose blood levels.

Testosterone censorship

It is sure that usually diabetes is due to low testosterone/cortisol ratio. I do not understand why you cancel the fact that testosterone is the most safe and effective cure against diabetes mellitus —Preceding unsigned comment added by 158.194.199.13 (talk) 16:54, 23 October 2009 (UTC)

Sjo is damaging the article deleting correlations between Cushing's syndrome and diabetes mellitus type 2. I ask to the administrators to stop his vandalism in order to improve Wikipedia.

You stated "The main cause of diabetes mellitus type 2 is subclinical Cushing's syndrome". This is completely unsupported by the reference. Please add sources that support your claims. This has nothing to do with censorship and everything to do with providing reliable sources for your claims.Sjö (talk) 08:05, 24 October 2009 (UTC)

The citation number 22 is an article intitled:" Is the metabolic syndrome an intracellular Cushing's state?", so the artcle confirm that the main cause of diabetes mellitus type 2 is subclinical cortisol excess then it says that cortisol play an important role in sugar absorption and diabetes, I also remeber that one of the (probably the main) symptom of metabolic syndrom is diabetes.The article later speaks about the enzyme that convert the inactive cortisone into the active cortisol, but that's not important for our discussion. If you want I can insert other articles.--158.194.199.13 (talk) 10:21, 24 October 2009 (UTC)

Now it is written:"Subclinical Cushing's syndrome is associated with diabetes mellitus type 2". Exactly like the article.--158.194.199.13 (talk) 11:11, 24 October 2009 (UTC)

Two of the three sources you added require registration and/or payment to view. These are not acceptable sources under the reliable sources policy of Wikipedia. Please read that section. The last source you added [17] links to a home page of journals and references with no specific information. I would have to search thousands of publications to find the reference. The proper procedure is as outlined in Wikipedia policy is to be bold and add the information, revert it if someone disagrees, then discuss it on the talk page to gain consensus before re-adding it. You have skipped the third step, just adding your reasons and then putting the information back in the article before gaining a consensus. Please let others weigh in on the issue before re-adding the information. Thank you. Wperdue (talk) 17:16, 24 October 2009 (UTC)Wperdue (talk) 17:05, 24 October 2009 (UTC)

It is absolutely false!!!!Again this story... All the article ARE COMPLETELY FREE! Indeed the link are already complete article which link to the PDF version too. Read better instead than making vandalism and removing COMPLETELY FREE SCIENTIFIC ARTCLES!--158.194.199.13 (talk) 17:37, 24 October 2009 (UTC)

As you seem insistent to harass, accuse, and ignore policy, I have asked for a third opinion on the matter as 2 of the 3 sources ask to purchase a membership to view the source. I have tried both the HTML and PDF links. In the meantime, please tone down your uncivil comments while we wait for an answer. Thank you. Wperdue (talk) 18:05, 24 October 2009 (UTC)

Third opinion

Hi, I come from WP:3O. I am a molecular biologist (even if I do not work at all in endocrinology), so I hope to give a helpful opinion. My impressions are:

• The article is, technically, a RS: it is an academic paper and such sources are generally accepted as RS
• The article is, indeed, not free. I guess the IP above writes from an academia that has access to the paper (whois tells me it is from a Czech university), but here at home I can only access the abstract.
• The free access/non free access is however, in my opinion completely irrelevant -all WP scientific article source non-free academic journals, and rightly so.
• I think there are two serious issues with the position of the IP above. First: is the article cited expressing an opinion which is scientific consensus? Citing WP:RS: The statement that all or most scientists or scholars hold a certain view requires reliable sourcing. Without a reliable source that claims a consensus exists, individual opinions should be identified as those of particular, named sources. Editors should avoid original research especially with regard to making blanket statements based on novel syntheses of disparate material. The reliable source needs to claim there is a consensus, rather than the Wikipedia editor. This seems to be the biggest problem with the position of the IP above.
• Second, if there is no evidence of scientific consensus, the article can be cited, but without giving undue weight to it.

Hope it helps giving a correct frame to the dispute. I feel that the additions of the IP editor cannot be accepted as such, but it could be interesting to look for consensus about the opinion of the paper and then arrive at a correct wording for its inclusion. --Cyclopia^talk 18:21, 24 October 2009 (UTC)

Thank you for your opinion. I was unaware of the non-free scientific journal use as a source, but it makes sense. I would be happy to work with the IP editor to come to an agreement to include some of this information that would not violate undue weight. As someone who has more knowledge on the subject than I, can you make any suggestions? Thank you. Wperdue (talk) 19:07, 24 October 2009 (UTC)

What I would do would be: looking on Pubmed and Google scholar and see:

• if there is a broad consensus on the hypothesis or not (e.g. presented in some review)
• if the paper above is well cited by other papers, and how -this is indication of how recognized is the work in the scientific community
• from searches above, understand how strong is the hypothesis and if there are competing hypothesis in the literature
• eventually, including a brief sentence like "It has been proposed that...".

I'd say that, given the probably enormous amount of literature and research on the subject of diabete endocrinology, the main problem is that one can find papers supporting more or less everything possible -I know of that firsthand in other fields. Being published on academic journals does not mean you are not doing fringe research. I would evaluate taking into account this. While I'm not going to do the search myself now, I will be happy to help in the discussion. --Cyclopia^talk 19:29, 24 October 2009 (UTC)

First af all this is not academy but it is student dormitory...however concerning to the testosterone/cortisol issues you should know that there is full scientific consensus about it. If you do not believe: study more! You are molecular biologist, it means you should know that cortisol is the main antagonist of insulin...if you want to make professional and serious argumentations ok, if you want to say completely false and wrong things as you did: no. —Preceding unsigned comment added by 158.194.199.13 (talk) 03:16, 25 October 2009 (UTC)

I have inserted citations, if you remove them you make vandalism and you damage wikipedia and its readers. Study more instead than make vandalism! —Preceding unsigned comment added by 158.194.199.13 (talk) 03:20, 25 October 2009 (UTC)

It's obvious you plan to ignore everyone and revert against consensus. I have asked for and received a third-opinion which is the next step in the dispute resolution process. You have chosen to ignore this editor's advice as well. I am more than happy to work with you to resolve the dispute yet you continue to make accusations here and on my talk page. I will escalate this to the next step of the dispute resolution process. I hope that you choose to change your attitude and work with the community to reach a consensus on what should and should not be included in this entry. Thank you. Wperdue (talk) 06:09, 25 October 2009 (UTC)

Why so much vandalism about testosterone?

It is clear that low testosterone/cortisol ratio causes diabetes mellitus type 2, it is clear that testosterone repalcement therapy is the most safe and effective cure against this desease, it is clear some user like cyclopedia and wp...have not good faith because thay make vandalism by SCIENTIFIC ARTICLES REMOTION because probably they are paid form industries of medicines that are interested to sell low effective (but economically convenient) therapy as metformin.

In order to protect the freedom and the quality of informations and the NPOV content I ASK THE ADMINISTRATOR TO BAN OR TO STOP THAT USERS.

I also remember to the administrators that a diabetes mellitus article without cortisol/testosterone argoments is false and low scientific. If my sentences will be removed wikipedia reliability will slow down and the vandalistic remotion of articles will win... —Preceding unsigned comment added by 158.194.199.13 (talk) 03:43, 25 October 2009 (UTC)

158.194... poster -- I am an administrator on this Wikipedia and so one of the folks to whom you appeal just above.

I've reviewed the discussion, and the Third Opinion, and must disagree with your evaluation of the situation. WP does not reflect TRUTH (there are a considerable number of views on what constitutes that about a great many subjects). What it aims to reflect is a balanced account of reliable sources (ie, competent opinion) on subjects. which is the extent of its own reliability. That's the reason for the "undue weight" policy. There are lots of fringe science opinions which have managed to get into print, even in referred scientific journals.

You have made several hostile and derogatory statements about the actions and/or motives of other editors here, which itself violates various WP policies about "civility" and "assume good faith". The business you cite about testosterone and other steroids and their interaction with diabetes may indeed be correct, but at this point in the discussion it seems that it is one of several alleged causes of (or cures for) one or another type of diabetes, and somewhat at odds with the standard view of causation or cure.

If continued, your tone here will continue to draw reaction, with which you will almost certainly not agree, on past form. And until you can cite more than an article or two, your edits along the line you've adopted will continue to be evaluated as one of the many exotic claims as to diabetes' causation or cure and will, I expect, be revised to reflect that evaluation.

You have not, thus far been treated harshly or specially, despite your reaction, but rather in accordance with WP standards, and thus your have few grounds on which to complain of ill treatment, either here or as to your edits. The other editors you've interacted with here have not earned a ban or block, and I cannot do so without evidence, so I must refrain from implementing your request to do so.

Your suspicions as to the motives of the pharma industry and its interest in continuing to sell expensive pills and injections to the rapidly increasing numbers of diabetics (and parallel lack of interest in less remunerative alternative treatments) may be correct, but probably belongs in an article here on the distortions in medicine caused by profit seeking suppliers. And will also require reliable sources, not your or my or any other editor's personal opinions. And will be subject to editing by others, perhaps not to your taste. WP in not a Platonic ideal enterprise with respect to content, but may be with perhaps to collaboration. Your distress is likely to be lessened if your can come to see it thus.

And finally, may I suggest that you avail yourself of a free account on this Wikipedia? It makes several things rather easier and more pleasant. ww (talk) 07:19, 25 October 2009 (UTC)

I've appreciated your comment, but I think you did a basic mistake: the extreme importance of low testosterone/cortisol (or also IGF-I/cortisol) ratio on diabetes mellitus type 2 development is a fact accepted from ALL SCIENTISTS AND DOCTORS! No discussion! It is not frontier science or fringe science! It is an undisputed fact since 1932. You will never find some article that denies this fact.

In order to understand this extreme importance of testosterone/cortisol on diabetes, let's consider other facts:

• if you give testosterone to a diabetic individual (in the right dosage of course) you can see that him/her sugar blood levels get normal.
• if you remove surrenal glands (which synthesize cortisol too) from diabetic people you can see that they lose completely insulin resistance (phenomenon at the base of diabetes mellitus type 2) (but they have a lethal hypoglycemia without corticosteroids treatment)
• one of the main symptoms of cortisol excess (Cushing's syndrome, does not matter if clinical or sub-clinical) is indeed diabetes mellitus type 2
• long time treatment with corticosteroids causes diabetes mellitus.

Fot the upward reason I really think that deleting testosterone/cortisol issues in the diabetes mellitus article is against the wikipedia pillars, because it is a lack of freedom and correctness of contents.--Testosterone vs diabetes (talk) 10:27, 25 October 2009 (UTC)

Testosterone, I probably need to study more about the subject, since my field of expertise is protein folding and not endocrinology. However I hope you're not going to shout like that at the other postdocs you will meet in your student career, otherwise I guess your career will be quite hard.

Now, basicall all you have to do for your claims to be taken seriously is giving us a couple of papers which state explicitly and uncontroversially that -to use your words- the extreme importance of low testosterone/cortisol (or also IGF-I/cortisol) ratio on diabetes mellitus type 2 development is a fact. Also, read WP:RS#Academic consensus which I am quoting below for your use:

“ The statement that all or most scientists or scholars hold a certain view requires reliable sourcing. Without a reliable source that claims a consensus exists, individual opinions should be identified as those of particular, named sources. Editors should avoid original research especially with regard to making blanket statements based on novel syntheses of disparate material. The reliable source needs to claim there is a consensus, rather than the Wikipedia editor. For example, even if every scholarly reliable source located states that the sky is blue, it would be improper synthesis to write that there is a scientific consensus that the sky is blue. ”

.

I hope it helps. --Cyclopia^talk 12:32, 25 October 2009 (UTC)

Sorry the artcles that you vandalistically removed speak clearly: cortisol excess (even subclicical) causes diabetes mellitus, testosterone replacement therapy is very effective versus diabetes mellitus type 2. There is full scientific consensus on it. It is excatly what I wrote in the article. The articles are very reliable, if you say no it means you have no good faith.

PS: Here we do not talk about ourselves, it is not important who you are or who I' am, what I do or what you do. We do not care if you study protein folding or glucocorticoid's receptor because it is not a forum.--158.194.199.13 (talk) 13:44, 25 October 2009 (UTC)

Please stop personal attacks and behave in a civilized manner. I am not doing anything "vandalistically" -I am reverted changes that you are pushing in disregard of the objections on this page. Now, please post here links to the articles that you say claim scientific consensus on the subject, as required by the policy quoted above. I am at university now so I should be able to check. --Cyclopia^talk 14:32, 25 October 2009 (UTC)

• That said, our fellow -provided he/she stops edit warring-, may have a point. One of the articles he cites indeed says:

“ Cross-sectional studies have demonstrated an association between low testosterone and T2DM since the early 1990s (Ding et al., 2006a;Corona et al., 2008e, 2009a). Some authors (Simon et al., 1997) have questioned this association because of the reduction in sex hormone binding globulin induced by the condition of insulin resistance, observed in diabetic subjects. However, others have demonstrated not only a reduction of total testosterone but also a decrease of both bioavailable and free testosterone in patients with diabetes mellitus (Barrett-Connor, 1992; Kapoor et al., 2007a; Corona et al., 2008e, 2009a). Following these studies, several longitudinal studies reported that a lower androgen milieu increased the risk of developing diabetes and vice versa (Tibblin et al., 1996; Haffner et al., 1996; Stellato et al., 2000; Oh et al., 2002; Laaksonen et al., 2004; Corona et al., 2008e, 2009a; Kupelian et al., 2006; Derby et al., 2006; Laaksonen et al., 2005; Rodriguez et al., 2007). Furthermore, it has been reported that, in T2DM, androgen deficiency is commonly associated with an impaired gonadotropin response, leading to hypogonadotropic hypogonadism (Dhindsa et al., 2004; Corona et al., 2006a).

from [18]

”

Not exactly what the IP is pushing for (it doesn't say that it is "the most important hormone" involved), but it seems there is a wide discussion on the subject and a broad consensus on the involvement of the hormone. --Cyclopia^talk 14:42, 25 October 2009 (UTC)

Yes, but they confirm what I say, they also confirm the high importance of the cortisol and testosterone levels on the diabetes development. You will never find something like:"testosterone and cortisol are not involved in the sugar absorption", "cortisol excess can not cause diabetes mellitus"... If you want to change the words in my edits in the article, do it without deleting the basic meaning and the citations of course. --Testosterone vs diabetes (talk) 15:25, 25 October 2009 (UTC)

You will never find something like "Americium is not involved in sugar absorption", FWIW -it is obvious that you won't find a lot of negative sentences like that. What we need is proof of broad scientific consensus, and the quote above provides proof of consensus of the association (not causation!) between low testosterone and diabetes mellitus.

Also, your edits changed a lot of small stuff here and there without citation. Since we still have not reached a consensus, and since debate is still ongoing, I am going to revert it for the last time: please note that a further revert of yours would make you violate WP:3RR, and this could lead to blocking of your account. We are showing good will to collaborate; please do the same. Then, since we're not in a hurry, we can discuss about sources and stuff on this talk page, and only after we reached satisfying consensus here, we can collaborate to put back information in the article. I hope everyone will agree. --Cyclopia^talk 15:54, 25 October 2009 (UTC)

In the (ex) citation 22 there is the sentence:"subclinical Cushing's syndrome is associated with diabetes mellitus"! It is also written that testosterone replacement therapy is very effective against diabetes mellitus. As I thought you revert citations and make this article mutilated. You make vandalism and with arogance you menace me (you can do edit war and me not? you do edit war not me). I think it is enough to write it. All this vandalism happens just because doctors are paid to prescribe noneffective (but higly remunerative, that's important for industries) drugs as metformin.--Testosterone vs diabetes (talk) 16:25, 25 October 2009 (UTC)

TvD, again, WP:AGF, WP:CIVIL, WP:NPA. Please read them. You simply cannot call other editors "vandals" just because they disagree with your edits. And I am not menacing you, I am simply stating that a further revert of yours is going to break a strict policy and this could lead to problems with your account. And I don't want this to happen. I am actually trying to help you, and I would appreciate if you could make it a little more pleasant. No one here is going to censor information, it's just that we want to be sure of what we're putting in the article and we prefer to double-check and discuss it. I think it is reasonable. Now, could you please post the link you're talking about so that I can check it and quote it for discussion with other editors? Thanks. --Cyclopia^talk 16:32, 25 October 2009 (UTC)

Here is some link, but there are many others:

http://www.ncbi.nlm.nih.gov/pubmed/18362453?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum,

http://www.ncbi.nlm.nih.gov/pubmed/18313835?ordinalpos=&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.SmartSearch&log$=citationsensor,

http://www.ncbi.nlm.nih.gov/pubmed/19444934?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum (leterally" low testosterone levels are associated with an increased risk of type 2 diabetes mellitus, dramatically illustrated by androgen deprivation in men with prostate carcinoma),

http://www.ncbi.nlm.nih.gov/pubmed/18832284?ordinalpos=9&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/18832284?ordinalpos=9&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum (title: "Low testosterone and the association with type 2 diabetes"),

http://tde.sagepub.com/cgi/content/abstract/34/5_suppl/97S

I think there is big scientific consensus about the big importance of cortisol and testosterone levels on diabetes mellitus onset, and about the high safety and effectiveness of testosterone replacement therapy versus this disease. --158.194.199.13 (talk) 17:58, 25 October 2009 (UTC)

Excellent, I will have a look as soon as I can. --Cyclopia^talk 18:11, 25 October 2009 (UTC)

Ok, I gave the links a first look. Sadly I cannot access full text of several of them. I'd say that what comes out by articles I can read and abstracts of the others is:

• Cortisol is consensually recognized as a glucose regulator and there is literature debating its relationship with diabetes, see also Cushing syndrome, even if the picture is very complex and it is not easy to figure out what is the state of the consensus.
• On testosterone, the picture from the links above looks much more fuzzy; there is consensus on the existence of a relationship between testosterone levels and diabetes, but I can't find consensus about a causative relationship, and only an abstract about the possibility of testosterone therapy.
• There is no evidence to conclude that testosterone/cortisol are consensually considered the main causative agents of diabetes, nor that subclinical Cushing is consensually considered a leading cause of it.

More sources are probably needed to get a better idea. --Cyclopia^talk 18:27, 25 October 2009 (UTC)

Ok, a quick PubMed found this which is interesting read on the subject. I am gonna read it as soon as I can. --Cyclopia^talk 18:52, 25 October 2009 (UTC)

From my point of view there is the full scientific consensus about testosterone/cortisol involvment on diabetes mellitus development. It is very clear that there is tight correlationship between low testosterone levels and diabetes mellitus, this correlationship however is not very tight (it means that castrated people run higher risks of diabetes mellitus, but they can also not have diabetes mellitus). It is sure that subclinical Cushing's syndrome is more related with diabetes mellitus (it is very difficult to have high cortisol levels for long time without diabetes, but when there is cortisol excess there is also testosterone deficiency), anyway there are discussions focused on the percentage of subclinical Cushing's syndrome on the diabetic population. It seems that this percentage is higher than previously believed.--Testosterone vs diabetes (talk) 19:32, 25 October 2009 (UTC)

First of all, I must say I am very appreciating your change in tone and your willingness to discuss. That's the right approach, and I hope we continue on this way. Now, you may be right, but our problem is that to include something in an article as scientific consensus, Wikipedia policies require that a paper explicitly states the existence of such consensus. If you read the policy I quoted above, even if all sources agree that the sky is blue, we cannot write that there is consensus on it until we found another source stating "There is consensus on the fact that sky is blue". The review found above may be (or may be not) such a source, for example. I suggest you to look for reviews in the literature and if you find something useful, report it here.

Anyway, even if consensus is not found, we can report the material in the article, if it's not violating WP:UNDUE. Only, it should not be reported as a plain fact, but as a statement of the kind "There have been studies suggesting that..." or "A study has shown that..." --Cyclopia^talk 19:40, 25 October 2009 (UTC)

From my point of view sentences like "there have been studies suggesting..." are not the maximum but it is better than nothing. Tomorrow I will write something like that, or if you want you may also start--Testosterone vs diabetes (talk) 19:52, 25 October 2009 (UTC)

I would wait for a bit more digging into sources -after all, it is entirely possible that there is a source of such consensus. If you like, you could look for further sources (especially reviews) and propose some paragraph here. --Cyclopia^talk 20:05, 25 October 2009 (UTC)

Arbitrary section break

Ok, I've had a look to the review I found above. It seems a recent and good assessment of the consensus on the matter. I quote below what I think are the most important sentences there found (T2D = type 2 diabetes, IR=insulin resistance, T=testosterone):

• "Low concentrations of T are linked with IR and implicated in hyperglycemia, hypertension,dyslipidemia, and an increased risk of vascular disease(Simon et al, 1997; Stellato et al, 2000; Oh et al, 2002; Dhindsa et al, 2004; Pitteloud et al, 2005a,b; Rhoden et al, 2005b; Corona et al, 2006; Kapoor et al, 2006, 2007;Fukui et al, 2007, 2008; Selvin et al, 2007)"
• "These observations suggest that androgen deficiency plays a central role in the various pathologies encompassing the components of MetS, including T2D, IR, obesity, and ED"
• "More work is needed to determine whether T replacement in hypogonadal men will ameliorate the parameters of T2D, IR, and MetS, as suggested above, and in doing so reduce cardiovascular risks."
• "Androgen deficiency may be central to the components of MetS, which encompasses IR, T2D, and obesity"
• "T plays a crucial role in maintaining metabolic homeostasis; thus, this hormone may play a vital role in maintaining glycemic control. The exact mechanism by which diabetes and/or IR impairs T biosynthesis and how reduced T levels increase IR and development of T2D remain poorly understood. Low T levels in men with hypogonadism or patients receiving ADT for prostate cancer are considered risk factors for IR and T2D. T therapy may provide protective effects against the onset of diabetes or may ameliorate the pathology of diabetic complications. Low T levels represent a risk factor for IR and T2D, [...] We postulate that androgen deficiency plays a central role in the pathology of MetS, T2D, and IR [...]"

The last two quotes comes from the conclusion. Emphasis mine: it seems apparent that there is considerable discussion and hypothesis on the thing, but no clear definitive consensus. It seems that what we can say is that: there is for sure some kind link between testosterone deficiency and T2D; androgen therapy has produced promising results 'in hypogonadal subjects but it is still uncertain if it is a solid therapy; the mechanism of the relationship is still being debated and while a lot of studies go in the same direction, the thing is far from being set in stone. I therefore, on this basis, support inclusion of the material in the article, in the following way:

• Declare as considered factual the existence of some kind of relationship between testosterone and T2M, IR etc. as per studies on hypogonadal men
• Declare as still ongoing investigation the mechanism linking the two
• Declare as ongoing serious consideration, but still not proven, the possibility of testosterone therapy as a therapy for diabetes 'in hypogonadal subjects.

I hope this helps in settling the issue. I invite editors which have access to the paper (which I don't think is free,unfortunately), to look it themselves to assess the situation. --Cyclopia^talk 23:28, 25 October 2009 (UTC)

I edited the page, I hope you like it. I think there are just things which are full accepted from the science.--Testosterone vs diabetes (talk) 20:42, 26 October 2009 (UTC)

Not bad, I am going to tweak something here and there. I suggest you to read that review I discussed above -if this is your field of interest, you will love it I guess. It more or less says what you suggest, but it is rightly a bit more cautious. There's however good material for the article there. --Cyclopia^talk 21:40, 26 October 2009 (UTC)

At the moment the additions made are completely overstating the possible link between testosterone and diabetes. This article aims to discuss both types of diabetes, with more information going into subarticles. On the whole, hypogonadism is not a leading cause of diabetes and diabetics are not screened for hypogonadism. The article presently lists a number of causes of diabetes, and it would stand to reason that Cushing's and hypogonadism are both mentioned there, supported by a single reference that is ranked as high-quality by WP:MEDRS. The whole concept of testosterone:cortisol ratio is really quite novel and certainly not employed widely in practice. JFW | T@lk 21:20, 29 October 2009 (UTC)

It does not matter if the diabetic peaple are screened for hypogonadism. If hypogonadism is the leading cause of diabetes is JUST your non supported opinion, because it is impossible to have diabetes with good free testosterone levels (>20 pg/ml). Moreover it is not written nothing about the "leading cause". What is important is that both hypogonadism than subclinical Cushing's syndrom can easily lead to diabetes mellitus. It is important to note that subclinical Cushing's syndrome lead to hypogonadism, it means that usually these conditions are together. The articles are clear, we have already discussed about it. I'm an italian PhD student in molecular biology, Cyclopedia is also a molecular biologist. Diabetes type 2 (type 1 or MODY are different) at this level is a very simple disease: if you have high cortisol and/or low testosterone you will get diabetic, otherwise not. I would like to do not repeat myself.--Testosterone vs diabetes (talk) 21:33, 29 October 2009 (UTC)

Please provide one good source, ideally a review in a high impact factor journal, that would support your views. Whether you're a PhD student or a member of the Russian border guard is completely irrelevant - you haven't seen my credentials either; please let facts speak for themselves. JFW | T@lk 21:41, 29 October 2009 (UTC)

Look up! Are you blind? --Testosterone vs diabetes (talk) 17:31, 30 October 2009 (UTC)

Continuing your assumptions of bad-faith and personal attacks using your IP address (the same one you have been using since before you created your username) is also not acceptable. Please read the warning(s) on your talk page regarding this behavior and work constructively with the other editors here. Thank you. Wperdue (talk) 16:12, 30 October 2009 (UTC)

I was bered...sorry. Sometimes I'm log out and I do not know why.--Testosterone vs diabetes (talk) 18:38, 30 October 2009 (UTC)

• Jfdwolff, the despicable behaviour of Testosterone_vs_diabetes notwithstanding, there is indeed some review debating (in much more cautious terms than the one pushed here) the relationship between the two. Check above. Whethere the inclusion is UNDUE or not, I am not able to decide because I don't have knowledge of the current literature and consensus on the subject. The review seems to indicate that there's substantial research on the subject, but I cannot be sure. --Cyclopia^talk 21:45, 30 October 2009 (UTC)

Conclusions from Uptodate is that the relationship between testosterone and diabetes is still tentative and if mentioned this should be what is reflected. : "Diabetes mellitus — Men who have type 2 diabetes mellitus are more likely to have low serum testosterone concentrations than nondiabetic men, but the nature of the relationship is unclear. In a review of 43 studies comprising 6427 men, the cross-sectional studies showed that men with type 2 diabetes had a mean serum testosterone concentration 76 ng/dL lower than nondiabetic men [33]. In the same review, the longitudinal studies showed that men who had higher testosterone concentrations had a lower risk of developing type 2 diabetes. The relative roles of testosterone, obesity and insulin resistance in this relationship, however, have not been delineated. Not only is the total testosterone more likely to be low in men with diabetes, but the free testosterone concentration is more likely to be low as well [34]."Doc James (talk · contribs · email) 06:03, 31 October 2009 (UTC)

Yes, there is a tight correlationshipe between low (free especially) testosterone levels and T2D (it is very difficult to find diabetic patients with good free testosterone levels). Of course the moleculr mechanisms are not well known (trasductions patways, receptor folding, receptor CAG repeats, interactions with other hormones...) of teststerone, but we can decleare that indeed this correlation exists.--Testosterone vs diabetes (talk) 14:28, 1 November 2009 (UTC)

But there is not really a difference in diabetes rates between man and women which one would expect if this relationship were causal? And fat is both an endocrine organ and associated very closely with diabetes. So if obesity causes endocrine problems such as low testosterone [19] and 65 - 75 % of diabetes is due to obesity [20] one could easily find a correlation between diabetes and testosterone were no causation exists. One would need to show that testosterone replacement works independent of weight change which studies I have seen do not. [21] I am not impressed by the number of people compared in the studies. I have not yet seen one including over 100 people but of course may have missed one. So in other words this theory is still tentative by my reading. Cheers Doc James (talk · contribs · email) 14:26, 3 November 2009 (UTC)

Why Wikipedia makes censorship about diabetes and testosterone?

It is evident that wikipedia helps profit associations and it wants to improve the business of drug industries. Otherwise there are no explanations about this incredible events:

• many users told there are not references about the evidence that testosterone deficiency can easily lead to diabetes mellitus. Even when many scientific articles were inserted.

• many users told that the relationship between testosterone and diabetes is fringe science, even when this is an undisputted fact, nobody say the contrary.

• many users (also vandalic administrators) make vandalism and remove citations related to the real causes of diabetes mellitus type 2 (subclinical Cushing's syndrome and/or testosterone deficiency)

• many users insert economically remunerative informations (never proved relationships between diet, in order to sell low fat foods, and cholesterol, to increase low cholesterol food). They do not insert scientific articles, because simply there are not.--Testosterone vs diabetes (talk) 17:50, 30 October 2009 (UTC)

Please do not refer to users whose opinion differs from yours as "vandals." Doing so is a personal attack. OhNoitsJamie ^Talk 17:53, 30 October 2009 (UTC)

Sorry deletion of scientific articles is vandalistic! For example Cyclopedia is a correct user with a good faith, he did not know about cortisol and testosterone, when I saw the article he was agree with me. Relationships about cortisol/testosterone and diabetes are NOT opinions. They are facts! And who try to delete that articles is censor! --Testosterone vs diabetes (talk) 18:06, 30 October 2009 (UTC)

• No, TvD, you are getting it wrong, and the other editors are completely right. What I did above was examining your claims and finding that some of the mechanisms you talked about are described as possible contributors of diabete when associated with hypogonadism. Read above. That's all we can say. Now, I am going to say it very clearly: You cannot toss around conspiracy theories about WP , nor you can toss around vandalism accusations to anyone who disagrees with your edits, and expect to be taken seriously (and not to get blocked soon).

About the case in point: We arrived at the conclusion that there is some interesting literature and some interesting hypothesis on the thing, and that these could be worth a mention if being within WP:UNDUE. Someone else may disagree: in this case you are expected to discuss such edits with good manners and assuming good faith. So, please, Testosterone_vs_diabetes, take a good breath and read the following documents:

• WP:NPA
• WP:NPOV
• WP:AGF
• WP:RS

Read them well, and when you finished to do it, do it again. Then read again the scientific literature above. See objectively what they claim. And then, relaxed, come back. --Cyclopia^talk 21:39, 30 October 2009 (UTC)

Chyclopia you should have some form of schizophrenia because we (me and you) were agree with the changes, so if you were coerent (it seems defenitely not) you should say that the authors (like you too) that remove citations are simply vandals. Moreover you removed sentences that WERE NOT redundant (as you told) like the hormones related with insulin respond (not cortisol and testosterone only). I reinsert that sentences. I also would like to insert a sentece taken by an italian book of hormones, but I do not know if it is possible.--Testosterone vs diabetes (talk) 14:28, 1 November 2009 (UTC)

Make another personal attack like this and you will be reblocked for a longer period. OhNoitsJamie ^Talk 14:48, 1 November 2009 (UTC)

TvD, read above. Apart that my username is Cyclopia, you're still engaging in personal attacks against me and fellow editors. Removing material is not vandalism by default. I asked you to read the pages above: did you do it? If not, please do it before further editing, otherwise contributing to Wikipedia will be difficult for you. You already earned yourself a block, and you should have learned from that. Moreover, do not simply revert stuff like you did in the latest revision, without checking revisions in between -you disrupted a lot of references doing that. Then, the part of your edits I agreed with, is still in the article -the studies etc. about testosterone involvement in diabetes are appropriately discussed, look for yourself. I gave you my email address on your talk page -feel free to write me in Italian, because I feel that also the language barrier is sort of a problem. --Cyclopia^talk 14:53, 1 November 2009 (UTC)

This article is full of false stereotypes! Must we help food industries?

Reading the article is similar to listen a mantra. Always it repeats how it is important to control cholesterol levels! But how? Are there correlations between diabetes mellitus and cholesterol levels? NO!. There are no scientific articles about it! I do not understand why wikipedia always says lies in order to help food industries to sell unnecessary and expensive products!

Are we sure that high carb diet causes T2D? There are no articles that show a significant correlation.

Are we sure that low carb diet helps insulin respond and therefore glucose blood level normalization? It is true the contrary! Low carb diet increases cortisol levels (cortisol avoid hypoglycemia) and therefore insulin resistance!

I think it is necessary to remove all the sentences like that! And whatever is not scientifically established--Testosterone vs diabetes (talk) 15:16, 1 November 2009 (UTC)

TvD, never, ever again remove other people comments from talk pages. --Cyclopiatalk 15:21, 1 November 2009 (UTC) What do you say? I've never removed comments--Testosterone vs diabetes (talk) 15:27, 1 November 2009 (UTC) You probably did it without noticing, but check this diff, you did it. Next time be more careful. --Cyclopiatalk 15:30, 1 November 2009 (UTC) I could not know. I started my edit on the latest version, during my writing you inserted your comment, then (again I was not editing your version) I have made my edit without your comment--Testosterone vs diabetes (talk) 15:50, 1 November 2009 (UTC). Just a time issue. Uh, strange. Usually the WP software detects edit conflicts. Anyway, incident solved, no problem. --Cyclopiatalk 16:18, 1 November 2009 (UTC)

If the statement relating diabestes and cholesterol is not followed by a references than tag it with .Doc James (talk · contribs · email) 04:29, 2 November 2009 (UTC)

It's my understanding that the recommendation to reduce cholesterol is not due to a supposed connection between elevated levels and diabetes but rather to avoid the additional risk factor for heart disease. ww (talk) 07:29, 4 November 2009 (UTC)

No cure

"Diabetes mellitus is currently a chronic disease with no cure" has been tagged as not cited. This source however says "benefits of gastric bypass in severely obese patients is the ability to cure diabetes" [22] So I agree with TvD this needs to be clarified. Doc James (talk · contribs · email) 20:09, 3 November 2009 (UTC)

ref added however the article contradicts itself. Says no cure than has two sections on cures?Doc James (talk · contribs · email) 20:29, 3 November 2009 (UTC)

Agree. I found a ref that effectively says that it has no cure from the abstract, and added it, but the other found by Jmh649 indeed seems to contradict it. We probably need 1)a bunch of recent reviews on therapy of diabetes to see what's going on and 2)to change the sections to "therapy", which in my understanding (I am not a native English speaker) is a more appropriate term. --Cyclopia^talk 20:47, 3 November 2009 (UTC)

Management is usually what we used for complicated conditions. This whole wiki area is rather disorganized. Jmh649 / Doc James Doc James (talk · contribs · email) 21:01, 3 November 2009 (UTC)

The question of cure has arisen here before, see the talk archive. Type 1 is curable with a pancreas transplant (not clincally rasonable in most cases), or with addition of external beta cells. The Edmonton Protocol results were encouraging but haven't borne clinical fruit. Type 1 has been cured in mice.

Type 2 is much more complex. Whatever is the cause, we have no clinical approaches which reverse it. The bariatric surgery mentioned is very suggestive, very preliminary, very encouraging and has not been reduced to clinical practice. It is not, thus, a cure in that sense. It may be the beginnings of one. Or not. There is less contradiction within the article than at first appears. Wording which doesn't fit the situation should be tweaked. ww (talk) 07:38, 4 November 2009 (UTC)

So there are sort of cures and sort of not cures that work sometimes but often not. This nuance need to be described rather than stating that there is not cure IMO. In medicine all absolutes seem to turn out wrong.Doc James (talk · contribs · email) 17:53, 4 November 2009 (UTC)

There are cures for diabetes mellitus. Testosterone in examply completely cures diabetes mellitus type 2. Diabetes mellitus type 2 is easy to cure, just testosterone--158.194.199.13 (talk) 20:05, 4 November 2009 (UTC)

Copyright

Must of the text of this page is shared with http://www.diabeticsanonymous.org/pathphysiology.html Both are under GNU copyright but it is difficult to see who originated the text. I assume they have copied from use? Either way much is unreferenced.Doc James (talk · contribs · email) 20:45, 3 November 2009 (UTC)

Map of prevalence is needed

Here is a great map of the prevalence. All we need to do is make our own. http://www.oxan.com/worldnextweek/2007-11-08/Diabetesmedicaltimebomb.aspx Doc James (talk · contribs · email) 22:11, 3 November 2009 (UTC)

Cool! If there some world map template that can be filled with colours, I can try to do that. --Cyclopia^talk 12:00, 4 November 2009 (UTC)

Found template here. I'll try to do that in the next few days. --Cyclopia^talk 12:21, 4 November 2009 (UTC)

http://commons.wikimedia.org/wiki/User:Lokal_Profil has helped me create about 6 or so maps in the past. He does a very good job. Asked if maybe he could help with this. Still not sure how to do it myself.Doc James (talk · contribs · email) 17:24, 4 November 2009 (UTC)

Shouldn't just be a matter of coloring it, following the example (maybe using a different hue), with Inkscape or Gimp? --Cyclopia^talk 19:41, 4 November 2009 (UTC)