Talk:Diabetes mellitus/Archive 14

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No cure

My Friend Has Diabetes. I Adore Him & His Pocket Pancreas!"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" [1] 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. --Cyclopiatalk 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 --Testosterone vs diabetes (talk) 20:19, 4 November 2009 (UTC)

A published review that supports this statement?Doc James (talk · contribs · email) 20:07, 4 November 2009 (UTC)

Are the citations good enough for the statement of testosterone as cure of diabetes mellitus? --Testosterone vs diabetes (talk) 20:19, 4 November 2009 (UTC)

It is mentioned that testosterone may help and is under study [2] but I have not seen any evidence suggesting widespread "cure" without weight loss. Please post the studies here if I have missed them. Doc James (talk · contribs · email) 20:44, 4 November 2009 (UTC)

Moment, testosterone indeed is not used to lose weight. Testosterone reduces abdominal fat (which is linked to hypogonadism and T2M) but increase muscle mass, therefore testosterone do not decrease the weight (I guess there are no correlations between weight and T2M).

Anyway, look at this: [PMID12809074]. Is it a good source?--Testosterone vs diabetes (talk) 21:29, 4 November 2009 (UTC)


Sorry will clarify. Relationship between diabetes and fat mass. It is fat mass that is the endocrine organ an obsolete weight is only a commonly used proxy.Doc James (talk · contribs · email) 21:31, 4 November 2009 (UTC)
This study was of 48 people with type 2 diabetes and visceral obesity and showed an improvement in visceral obesity and total body fat. One would thus expect an improvement in blood sugar control from this change alone. The Hba1c value was still 8.6% which is far from the normal of less than 6%. Therefore no cure of diabetes was found.Doc James (talk · contribs · email) 21:38, 4 November 2009 (UTC)

Yes, but from 10.4 to 8.6% Hba1c is a significant improvement, it means that testosterone is a cure.--Testosterone vs diabetes (talk) 17:13, 5 November 2009 (UTC)

No, as the person still have diabetes. I may be a partial treatment but is in no way a cure. Also if one was to stop the treatment I assume it would worsen again. And we need a much larger study before using this as a treatment. One that looks at long term morbidity and mortality. Hba1c is only a surrogate marker. What people really care about is am I going to go blind / die. I still treat patients with diabetes aggressively when there Hba1c is 8.6% BTW.Doc James (talk · contribs · email) 17:22, 5 November 2009 (UTC)

This study state (http://www.ncbi.nlm.nih.gov/pubmed/19712802): "The present study shows that testosterone supplementation given on top of optimal medical therapy improves functional capacity, large-muscle strength, and glucose metabolism in elderly patients with CHF". It means testosterone is a cure.

I understand you, I'am not a doctor, but I think that diabetic patiens are interested in other things (Will i get blind? Will I loose foots? Will I die?), and testosterone can avoid that.--158.194.199.13 (talk) 17:36, 5 November 2009 (UTC)

This is also not a cure. The above was 12 weeks long and involved 70 patients. Does not look at rates of blindness or amputation or death. And the key work is ON TOP OF optimal medical therapy. A cure is that you no longer need treatment for diabetes as you no longer have it. ie with gestational diabetes insulin is usually not longer needed post delivery as the patient has normal blood suger.Doc James (talk · contribs · email) 17:42, 5 November 2009 (UTC)

Yes, I understand you. It depends on what we mean for "cure". If you think to take something once and to do not have diabetes anymore...yeah...diabetes (like every chronic endogenous disease) has no cure. If diabetic people have more cortisol and less testosterone, it means that this desturbs is chronic. To cope this problem is necessary to take something that fight this tendence, always!

If for us "cure" means something that can cope with effectiveness diabetes, we may say that cure for diabetes exists: its name is testosterone.

PS: indeed bilateral adrenalectomy removes immediately and perennially diabetes mellitus. It can be a cure for the first definition, but it is not very reasonable. Anyway better testosterone--Testosterone vs diabetes (talk) 19:25, 5 November 2009 (UTC)

The definition of cure of diabetes is discussed here [3] Doc James (talk · contribs · email) 21:54, 5 November 2009 (UTC)

Problems with recent "cure is difficult" edit

A recent edit changes the text of the article to note that cure is difficult. This is incorrect. Cure is possible for Type 1 only with a pancreas transplant, and that is rarely clinically available or reasonable. All other Type 1 cures in humans are at most experimental. Including prophylactic approaches such as the vaccine proposals.

The gastric bypass surgery cure for Type 2 is not just gastric bypass, but a particular type of bariatric surgery. And it's not a cure, if by cure is meant something in routine clinical use. It is not currently understood, not approved by assorted medical bodies, etc. Might be the harbinger of something great, but...

All other alleged cures are either experimental, mythical, or fraudulent. We do not understand diabetes in sufficient detail to cure it (or them, there being several diseases) and have not found an accidental cure.

This article is read a great many people, mostly layfolk. We should NOT make claims about cure that are not real, or are based on linguistic word shaving. Cure for Diabetes, any type is not "difficult", it is currently clinically non-existent. And WP should not, in this article nor in any other, say anything which can be interpreted otherwise.

In addition, this editor removed a recent literature citation in the process of noting that cure is difficult. The reference should be returned to the article, as it was directly on point, and no citation to cure is difficult was made. ww (talk) 23:01, 4 November 2009 (UTC)

You can refer to me as James by the way rather than this editor. Noting that a cure is difficult is IMO better than stating a cure does not exist and than having entire paragraphs and pages for that matter on the "cure". There is also many peer reviewed published article which support a "cure" in a limited sense. I found a number of equal quality references that state that bariatric surgery is a "cure". For example "Although weight loss surgery generally results in a loss of 50–70% excess body weight and “cures” diabetes in 77% of patient" [4] We also have PMID 17964919.
Difficult may not be the best wording any other suggestions? A cure however is occasionally possible with a pancreatic transplant in type one, bariatric sugery in type two, and dilivery in gestational diabetes.Doc James (talk · contribs · email) 23:18, 4 November 2009 (UTC)
Here is the ref we had. Scharfmann R, Duvillie B, Stetsyuk V, Attali M, Filhoulaud G, Guillemain G (2008). "Beta-cell development: the role of intercellular signals". Diabetes Obes Metab. 10 Suppl 4: 195–200. doi:10.1111/j.1463-1326.2008.00953.x. PMID 18834447.  Unknown parameter |month= ignored (help) "Is no cure except pancreatic transplants" is not a phrase I am happy with. Either there is no cure or there is a cure but it is difficult and often does not work or in some cases is even worse than the disease.Doc James (talk · contribs · email) 23:46, 4 November 2009 (UTC)
This article from 2009 discusses the nuances of cure vs remission terminology. Unfortunately I have a three month embargo on the online complete version. Grrr http://care.diabetesjournals.org/content/32/11/2133.short?rss=1 Doc James (talk · contribs · email) 23:50, 4 November 2009 (UTC)

<-- I didn't track the editor by name, so didn't know who it was. The problem with the approach James suggests is that there are many cures in print. Exotic diets, ancient Indian supplements and meditation, magic pills from many places, exercises or some kind or other, .... A case report of the results of some kinds of surgery is very interesting, and may be a sure (for some patients, which?) or not. A mere published report is really insufficient for such a bold statement, or even several. Note it, mention the possibilities, note the early innings, ... but do not use the loaded word cure in this context. There is so much quackery, that WP should be very very careful. A check of the archives will turn up extensive discussion amongst editors here on this question within the last few months. To some extent, the editorial stance on it was settled then.

IN any case, for diseases with such large systemic effects, cure implies more than just glucose regulation improvement.

Thoughts on this issue from other editors here? ww (talk) 04:43, 9 November 2009 (UTC)

We often use the phrase the "cure is difficult" when it verges on impossible but very rare events do occur that we wish not to discount. Are you able to get a copy of the paper above on terminology of "cure". It just came out. We need to specifically state that the exotic diets and magics pills are unsupported by evidence however we have case studies of pancreatic transplants and studies of obesity surgery.
Have you seen any guidelines / reviews that state that no cure exists?Doc James (talk · contribs · email) 13:38, 9 November 2009 (UTC)
Who is this "we" you talk about, kemo sabe? It's a kind of inverted meaning to say 'cure is difficult' when there is no known cure is actually meant. We can't be so clever in our word usage in an article such as this. It's a first reference for lots of folks and so plain meaning is by far best. As for the citation, no I haven't read it. The only statements of no cure I can remember seeing in print were from such things as Joslin's Diabetes Mellitus. I'm sure quite a few ADA publications say much the same thing. There is no clinically available treatment which produce s a cure in the sense of no longer have to be concerned about those things diabetics must be concerned with: eye trouble, kidney trouble, cardiac trouble, nerve damage, wound failure, ...
The question should not be, how can you say there's no cure, but rather how can you say there is a ciure(s), albeit difficult. ww (talk) 01:03, 10 November 2009 (UTC)
Provide references and I will be happy to look at them.Doc James (talk · contribs · email) 02:09, 10 November 2009 (UTC)
Research just a few years old finds the underlying mechanisms to small studies that had found type 2 can frequently be "cured." If you fear book advertising, use this cite [[5]], or many of the cites by other articles below the text. Or this cite [[6]] Here's the book cite: [1]Zinbarg (talk) 01:46, 21 November 2009 (UTC)
It is already on the subpage and is not significant enough for the main page.Doc James (talk · contribs · email) 03:09, 21 November 2009 (UTC)

What kind of doctor are you? Recent research finds that type 2 can be usually (roughly 80% of patients in 7 studies I've found so far) cured should be in the main page!!!! You are not current with research. Please get current before you make changes. I have provided the link above. I know that it's hard to get patients to really improve their diets, but that doesn't mean it won't generally work. I just read this discussion section again, and wanted to add that there's nothing exotic about eliminating saturated fat from your diet. The underlying metabolic mechanisms are now (very recently) known, and several good research studies exist finding a high proportion of "cured" patients in less that 3 months of dietary change.Zinbarg (talk) 06:15, 22 November 2009 (UTC)

I am a medical doctor. But that of course is beside the point. Were have you shown research that demonstrates the 80% "cure"? The two papers are associations above. Not treatment. Obesity of course causes about 70% of obesity so if you could "cure" obesity you could "cure" diabetes. And this has been done to some extend with bariatric surgery.Doc James (talk · contribs · email) 19:05, 22 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)

They stole it from here. No attribution = GFLD violation. JFW | T@lk 21:01, 8 November 2009 (UTC)
Not surprised really. We need a legal team to go after sites not appropriately crediting Wikipedia. :-) Should I return the content? I was not particularly good as it was unreferenced.Doc James (talk · contribs · email) 22:16, 8 November 2009 (UTC)

At university we are not allowed to reference Wikipedia so no one does it. They tell us it's not a reliable source. —Preceding unsigned comment added by 91.106.40.120 (talk) 23:18, 10 April 2010 (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. --Cyclopiatalk 12:00, 4 November 2009 (UTC)
Found template here. I'll try to do that in the next few days. --Cyclopiatalk 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? --Cyclopiatalk 19:41, 4 November 2009 (UTC)
Like this one http://www.diabetesatlas.org/map but use reds instead of blues. One has to click on the country to get the data out. Maybe would could create a table like List_of_countries_by_traffic-related_death_rate Doc James (talk · contribs · email) 20:12, 4 November 2009 (UTC)

I think it is not possible to insert this map.

  • It reports predicted statistics which can be false or true.
  • It is not written excatly how they did the predictations.

For that reasons I think that the map is not reliable and it is necessary to find another one with real statistics.--Testosterone vs diabetes (talk) 20:20, 4 November 2009 (UTC)

This is a good point indeed. The map seems to come from an apparently not so bad source (Internal Diabetes Federation) but a map with current statistics would be better indeed. I personally would include both. It would be nice to find the original document of the IDS projections. --Cyclopiatalk 20:26, 4 November 2009 (UTC)
Yes one is a prediction by the WHO which I think is less interesting than the current rates of DM. Here is all the WHO data. http://www.who.int/diabetes/facts/world_figures/en/index.html It does given absolute numbers for 2000 and we would have to divide by the population to get percentages. The WHO is as good as we will get.Doc James (talk · contribs · email) 20:38, 4 November 2009 (UTC)

Thw WHO map is definitely better and I think it is reliable. I would suggest you to do not insert the other map.--Testosterone vs diabetes (talk) 21:31, 4 November 2009 (UTC)

Yes I agree only the current data. I do not like future trends. Believe that they are an inappropriate use of statistics in biology. Will stick with the 200 data.Doc James (talk · contribs · email) 21:40, 4 November 2009 (UTC)
Done Doc James (talk · contribs · email) 22:19, 5 November 2009 (UTC)

Nonreliable sources related with alleged relationship between diet and diabetes mellitus

I think that the sources related the alleged relationship between diet and diabetes mellitus are not faithfully, because it is not written which were the criteria they've choosen for the controls.

I'am italian and I work in Czech Republic. According to the WHO undisputted data, Czech Republic has a much minor prevalence of diabetes mellitus (less than one half) even if czech sanity is much better than italian. It is also clear that czech diet contains more fats and sugars than italian, therefore I may declare that eat huge quantity of fats and sugars (like czechs do) decreases the possibilities to get diabetes. Of course that's false, the real reasons by which czech diabetes prevalence is much minor than italian is that simply czechs are stronger than italians (it means more muscle and therefore more testosterone and IGF-I. Testosterone deficiency is highly related with diabetes mellitus).

It is alwais misleading speak about exogenous parameters without take in consideration endogenous factors.--Testosterone vs diabetes (talk) 14:50, 8 November 2009 (UTC)

We need sources that state this before we can use it.Doc James (talk · contribs · email) 15:15, 8 November 2009 (UTC

)

Is the word "almost" misleading?

Right near the beginning of the article, one can read that presently, "almost" (sic) all people with Type One diabetes need to take insulin injections. Since Type One diabetes is insulin-dependent diabetes, should we eliminate the word "diabetes" here? I would have thought that all Type One diabetics would, and that if they did not, they would be Type Two diabetics. ACEOREVIVED (talk) 21:23, 29 November 2009 (UTC)

There is inhaled insulin and pancreatic transplants.Doc James (talk · contribs · email) 22:19, 29 November 2009 (UTC)
Also, a person might be diagnosed in the very, very early stages of the disease when the only symptoms are antibodies and slightly higher blood sugar. That person would be able to manage without insulin at least for a while. Not a good choice, but possible.Sjö (talk) 06:17, 30 November 2009 (UTC)

Cure, or a better word for it

I read and see reports that type 2 can be cured with diet. Search (saturated fat diet diabetes) google scholar and the PubMed web site and you find many conclusive studies. It's mostly strictly reducing intake of saturated fat and hydrogenated oils. Cells that are saturated with fats have ~blocked receptors to insulin (resistance), and fewer mitochondria (leading to poor insulin response). Eating whole plant foods helps, possibly through lowered inflammation (CRP down). Barnard came up lots in those searches, so I bought his book [[7]], which is full of first class references; he claims a cure. Last Friday (I think), Dr. Oz on his show stated that type 2 could generally be cured, and showed a sample menu for a diet that would foster compliance. He insisted that current patients be in frequent consultation with their physicians to reduce medications properly because the change is usually rapid. Less than a month to see results. Dr. Barnard's studies found 80% success. As long as the patients stay on the "diet" (Oz said it's how we all should eat all the time ... he does), they will have normal blood glucose levels without medication. If we don't have a "cure" what should we call it, and why isn't it better represented in the article?Zinbarg (talk) 18:31, 8 December 2009 (UTC)

Please provide pubmed references... What you will find is that Oz's claims are not actually supported by research. I stated the same above. His book is not nearly sufficient evidence. Doc James (talk · contribs · email) 18:35, 8 December 2009 (UTC)
Please see this article, which is about gene expression promoted by a diet of fat and glucose as well as high levels of inflammation related cytokines found in the obese results in cells that "produce fewer and smaller mitochondria than is normal," and are thus prone to insulin resistance.[[8]] I'll past the whole text if you don't have access. Gene expression works BOTH WAYS.
Take a look at these two studies[[9]][[10]]
Here's underlying mechanism and studies[[11]][[12]][[13]][[14]]
There are no large random gold standard studies yet, but at lease one is in progress. All I know for sure is that I gave that book to my Mom's caregiver who is now cured. There's an analyst in my office who took medication for diabetes for 7 years, and now doesn't need any. Any doctor would be remiss if they didn't strongly recommend a very low saturated fat diet.Zinbarg (talk) 19:52, 8 December 2009 (UTC)
The first paper is the economist. Not a WP:RS for medical aspects pertaining to treatment. None of the subsequent papers mention cure only that it helps manage diabetes. But we already say that dietary modification improves glycemic control. And that lossing weight is good for diabetes. The papers by the way are not talking about dietary saturated fat but the saturated found in adipose tissue. They do not support the assertion that eating less fat will improve diabetes only that losing weight will improve diabetes.Doc James (talk · contribs · email) 19:59, 8 December 2009 (UTC)
What better source than the Economist? It's the best global business publication. Great editors. The article just discusses a nice piece of research. Please read that research, and don't just dismiss the Economist. Gene expression works both ways, and represents a "cure."
I don't really care about the Barnard book, just it's references. The references were generally small studies, but statistically strong. The glucose levels become normal. How do you define cure?
Dr. Oz could be source in the text as a doctor and medical writer. The huge guy on the Oz show with HORRIBLE health will be cured in a few weeks. I think he said he drank 7 gallons of water a day. Not the first to be cured on the Oz show. There are several books that could be cited (as promoting this low saturated fat cure).
The PubMed studies (I think two of them) find normal glucose levels from low fat diet. There tons of time on "management" in the wiki text, and very little on current diet research. That's back asswords.Zinbarg (talk) 20:24, 8 December 2009 (UTC)
The economist is a business journal not a medical publication. Please provide medical publications. Without a review published in a medical journal stating that this is a cure this statement is not ready to be added. Dr. Oz is not notable as a diabetes expert. From his page he appears to be an alternative medicine practitioner.
Now before we go one which study show the 80% cure rate?Doc James (talk · contribs · email) 20:35, 8 December 2009 (UTC)

I thought you would read and understand the Economist article, and check the reference, not just dismiss the whole thing because you don't think the periodical is worthy. It's a great reference in a great periodical. Please, why shouldn't that be included in with possible causes and cures?

These two studies are specifically diet (not adipose fat) and diabetes.[[15]][[16]] Why do you reject these published studies?

The 80% is in the Dr Barnard book and his second published study linked above.Zinbarg (talk) 20:50, 8 December 2009 (UTC)

I do not have easy access to the economist. Email it to me if you could. It however is still not a WP:RS for a medical article.
Ref 23 involved 49 people... It than states "Hb A(1c) changes from baseline to 74 wk or last available values were -0.34 and -0.14 for vegan and conventional diets, respectively (P = 0.43)." which mean no sig difference. These are hardly big changes. Normal is less than 6.5 many have values arround 10 for HbA1C.
Ref 22 say the the benefit is primarily due to weight lose. "Although this effect is primarily attributable to greater weight loss" and that this is a management not cure of DM. "The presently available literature indicates that vegetarian and vegan diets present potential advantages for the management of type 2 diabetes"
Barnard's book is not a reliable source. I need to see a peer reviewed publication that shows an 80% cure.
So to some up these two small studies in no way claim a cure. They also do not say anything we do not already have in the article referenced to better sources.Doc James (talk · contribs · email) 21:05, 8 December 2009 (UTC)
Here's a great study. [[17]] 89% avoided. Not a cure, but something really big lifestyle wise is going on, much of it fat intake, and Wiki misses the mark. Is is legal to email the Economist article when it's protected? Is it legal to paste it into the discussion?Zinbarg (talk) 00:19, 9 December 2009 (UTC)
I do find places in the article where this potential (case management or cure) diet is mentioned. But, there's NOTHING in Causes, Management, or Epidemiology. 89% avoided in the elderly! Again, Wiki misses the mark. I'll run changes by you here first. I guess I forget about trying to add a Cure section, but I'd like something notable.Zinbarg (talk) 00:29, 9 December 2009 (UTC)
Looks like I'm not set up to send emails here.Zinbarg (talk) 00:31, 9 December 2009 (UTC)
Yes agree with the above. Should be added to the section on prevention if it is not already discussed. It however does not say anything about treatment therefore does not belong there. Will look into the cause section more tonight. If you go to my user page on the left if you are using the beta there will be an email this user button.Doc James (talk · contribs · email) 00:33, 9 December 2009 (UTC)

(undent) This is were one would add diet related information.. Diabetic diet Doc James (talk · contribs · email) 08:17, 9 December 2009 (UTC)

Absolutely. Thanks for the heads up on another place to add research. You're right to say DR Oz (show) doesn't belong in an encyclopedia, but you have to wonder he's put this guy on the show and made a promise (if you eat this you'll be essentially cured). He'd be a fool to not be confident that it would work. When I go the you email page, it gives me an error message when I try to send.Zinbarg (talk) 22:23, 10 December 2009 (UTC)

Lifestyle

Well I agree the lifestyle section needs to be improved. What you added did not make sense.

"Low-risk lifestyle groups were defined by physical activity level (leisure-time activity and walking pace) above the median; dietary score (higher fiber intake and polyunsaturated to saturated fat ratio, lower trans-fat intake and lower mean glycemic index) in the top 2 quintiles; never smoked or former smoker more than 20 years ago or for fewer than 5 pack-years; alcohol use (predominantly light or moderate); body mass index less than 25 (calculated as weight in kilograms divided by height in meters squared); and waist circumference of 88 cm for women or 92 cm for men.[[18]]

]]Doc James (talk · contribs · email) 15:42, 17 December 2009 (UTC)

I'm sorry for the mistakes. I'll rewrite, and bring it here first. From the same study, how about:
  • ===Lifestyle===

The causes of type 2 diabetes is not fully understood, but lifestyle factors may be important to the development of the disease. In one study, group participants whose "physical activity level and dietary, smoking, and alcohol habits were all in the low-risk group had an 82% lower incidence of diabetes." Those lower risk lifestyle factors included "physical activity level (leisure-time activity and walking pace) above the median; dietary score (higher fiber intake and polyunsaturated to saturated fat ratio, lower trans-fat intake and lower mean glycemic index) in the top 2 quintiles; never smoked or former smoker more than 20 years ago or for fewer than 5 pack-years; alcohol use (predominantly light or moderate); body mass index less than 25 (calculated as weight in kilograms divided by height in meters squared); and waist circumference of 88 cm for women or 92 cm for men."..."When absence of adiposity (either body mass index <25 or waist circumference < or =88/92 cm for women/men) was added to the other 4 low-risk lifestyle factors, incidence of diabetes was 89% lower.[2]Obesity is found in approximately 55% of patients diagnosed with type 2 diabetes.[3] In another study of dietary practice and incidence of diabetes, "foods rich in vegetable oils, including non-hydrogenated margarines, nuts, and seeds, should replace foods rich in saturated fats from meats and fat-rich dairy products. Consumption of partially hydrogenated fats should be minimized."[4]

In the last decade, type 2 diabetes has affected more children and adolescents, probably in connection with the increased prevalence of childhood obesity.[5]

Environmental exposures may contribute to recent increases in the rate of type 2 diabetes. A positive correlation has been found between the concentration in the urine of bisphenol A, a constituent of polycarbonate plastic from some producers, and the incidence of type 2 diabetes.[6]Zinbarg (talk) 16:07, 17 December 2009 (UTC)Zinbarg (talk) 17:31, 17 December 2009 (UTC)

Made a few changes to the wording as the cause is mostly known. Also better to summarize the text than to quote it. Looks better though.Doc James (talk · contribs · email) 17:45, 17 December 2009 (UTC)
I started out fixing a couple typos but then added detail to "diet," and a sentence. I should have done it here to your last article version.Zinbarg (talk) 18:27, 17 December 2009 (UTC)
I am not sure we need to definte a healthy diet right there as we discuss the influence of fats two sentences down. Maybe we could just link to health diet? Doc James (talk · contribs · email) 18:42, 17 December 2009 (UTC)

I thought "diet" was too vague. There are zillions of diets out there. But you're right, it's terribly repetitious. I guess I mostly wanted the 89% finding. I'll cut out the (diet details).Zinbarg (talk) 18:48, 17 December 2009 (UTC)

We have a page on healthy diet which defines the term via the WHO. Move some of the wording around. Do not really think we need the rest of the def. Just make sure the healthy diet page has it which it does.Doc James (talk · contribs · email) 18:52, 17 December 2009 (UTC)
I think what you've done is fine. Much better. Thank you.Zinbarg (talk) 18:59, 17 December 2009 (UTC)

Insulin resistance

Here's a study linking saturated fat to insulin resistance, mitochondria, and type 2 diabetes.[[19]]Zinbarg (talk) 19:43, 17 December 2009 (UTC)

No mention is made to dietary consumption of fats. This may belong under pathophysiology somewere but does not give any indication to treatment or cause.Doc James (talk · contribs · email) 19:46, 17 December 2009 (UTC)
Not dietary consumption, but cells basically saturated with fat. "The insulin-stimulated rate of glucose uptake by muscle ... was associated with an increase of approximately 80 percent in the intramyocellular lipid content (P=0.005). This increase in intramyocellular lipid content was most likely attributable to mitochondrial dysfunction, as reflected by a reduction of approximately 30 percent in mitochondrial phosphorylation." I know you hate the book, but can't we use it to avoid NOR but speculate on probable mechanisms?Zinbarg (talk) 19:57, 17 December 2009 (UTC)
Diabetes is a huge topic with tons of published review. Using book will just makes things way to complicated. This page still needs a great deal of work to make sure it reflects current scientific consensus. This is I must emphasis determined by peer reviewed publications not books.Doc James (talk · contribs · email) 20:10, 17 December 2009 (UTC)

I agree with the peer review aspect. I was just trying to get around violating NOR. Is this OK in 1.2? of the article?:

Type 2 diabetes

Type 2 diabetes mellitus is characterized by insulin resistance which may be combined with relatively reduced insulin secretion. The defective responsiveness of body tissues to insulin is believed to involve the insulin receptor, and may involve higher intramyocellular lipid content and mitochondrial dysfunction.[[20]] Diabetes mellitus due to a known defect are classified separately. Type 2 diabetes is the most common type.

In the early stage of type 2 diabetes, the predominant abnormality is reduced insulin sensitivity. At this stage hyperglycemia can be moderated by a variety of lifestyle changes, and medications that improve insulin sensitivity or reduce glucose production by the liver. As the disease progresses, the impairment of insulin secretion occurs, and therapeutic replacement of insulin often becomes necessary.[citation needed]Zinbarg (talk) 20:17, 17 December 2009 (UTC)

MODY

I read in a recent review (McCulloch et al., "Classification of diabetes mellitus and genetic diabetic syndromes", 2010, kindly provided by Doc James): "In the new classification, the MODY subtypes have been eliminated, and replaced by specific descriptions of the known genetic defects". Does that refer to the proposed classification or has the international classification been changed to eliminate MODY? Just to ascertain.. --CopperKettle 18:46, 23 January 2010 (UTC)

Yes that is what it means. Uptodate however is not the best to reference to as people have limited access. Best to find a review that say the same thing. Vaxillaire M, Froguel P (2008). "Monogenic diabetes in the young, pharmacogenetics and relevance to multifactorial forms of type 2 diabetes". Endocr. Rev. 29 (3): 254–64. doi:10.1210/er.2007-0024. PMID 18436708.  Unknown parameter |month= ignored (help) Doc James (talk · contribs · email) 19:04, 23 January 2010 (UTC)
Thank you! I'll look into it.. So MODY itself still exists, only the old subtypes are replaced with the names of defects, as I understand. --CopperKettle 19:19, 23 January 2010 (UTC)

Our MODY article has been ahead of the curve in that respect for about 4 years. It could however stand to be updated with a couple even newer types. alteripse (talk) 19:43, 23 January 2010 (UTC)

Renaming proposal

How about renaming Diabetes mellitus and deafness to Maternally transmitted diabetes and deafness syndrome, per OMIM record? Or is it good as it is? --CopperKettle 13:19, 1 February 2010 (UTC)

New article proposal

How about creating new article for OMIM 500002, Mitochondrial myopathy with diabetes? Or is it already here under some other name? --CopperKettle 13:20, 1 February 2010 (UTC)

New Reaserch

New discoveries in stem cell reaserch have lead to the possiblity of a new cure. Could somebody possible insert a stub from http://en.wikipedia.org/wiki/Stem_cell_treatments#Diabetes —Preceding unsigned comment added by 198.166.238.141 (talk) 15:11, 23 February 2010 (UTC)

Fats and diabetes

It is not my intention to hurt feelings or cause dissension, but the following information is absolutely false:

Diets that are very low in saturated fats reduce the risk of becoming insulin resistant and diabetic.[43][44]

Saturated fat does not cause one to develop diabetes at all. A high carbohydrate diet can cause diabetes. For more information please see Gary Taubes "Good Calories Bad Calories" for a good introduction and reference to the pertinent research in this area.

Moreover, diets that are high in both carbohydrates (cereals such as wheat, oats, corn, rice, etc. and sugar in any form) and fat (particularly non natural fat such as any type of margarine) are even worse. For example, avoid foods such as hamburgers and french fries, pizza, doughnuts, muffins, cookies and candy. These food items are a combination of both fat and carbohydrate (often refined carbohydrate).

The following is only partially true:

In another study of dietary practice and incidence of diabetes, "foods rich in vegetable oils, including non-hydrogenated margarines, nuts, and seeds, should replace foods rich in saturated fats from meats and fat-rich dairy products.

There is nothing wrong with a diet that includes nuts and seeds, but it does not need to replace meat and dairy products. Instead it would be better to limit the amount of polyunsaturated fat in your diet, e.g. sunflower oil, and increase the amount of mono-saturated fat in your diet e.g. olive and Canola/rapseed oil.

The following statement is true:

Consumption of partially hydrogenated fats should be minimized."[12]

Although it would be best to eliminate margarine altogether in favor of using real butter and coconut oil instead. —Preceding unsigned comment added by 195.60.68.148 (talk) 07:53, 4 March 2010 (UTC)

Diet/Portion Symbols

I’ve just spent the past hour (admittedly not every single second, but most of it) trying to find information about the diabetes symbols (the triangles, squares, etc.) that you see on the nutrition information of some food products. It’s proving to be exceedingly difficult however. I figured that the main diabetes wiki page would ostensibly be a good place to find a reference link to the information but there is none here.

I think it would be good if someone who knows of a page that has the information could put a link on the page and/or create a Wikipedia page (if one does not exist) about diabetes diet symbols and relevant information. Synetech (talk) 16:53, 11 March 2010 (UTC)

Yes I agree that would be useful.Doc James (talk · contribs · email) 23:02, 15 April 2010 (UTC)

Edit request from Aura99, 28 April 2010

{{editsemiprotected}}

Please add the following link to the Exterbal links section

NHS Evidence - Diabetes search results

Aura99 (talk) 13:03, 28 April 2010 (UTC)

Not done per WP:EL. OhNoitsJamie Talk 14:00, 28 April 2010 (UTC)

LADA?

May I ask why there is no mention of LADA (the so-called type 1.5), the late onset variant of type 1 diabetes? --The Pink Oboe (talk) 23:53, 19 May 2010 (UTC)

Edit request from Moonshamu, 27 May 2010

{{editsemiprotected}}

'cessation' is misspelled in the sentence, "Adequate treatment of diabetes is thus important, as well as blood pressure control and lifestyle factors such as smoking cesation [sic] and maintaining a healthy body weight." and must be edited (last sentence of 4th paragraph). Thank you.

Moonshamu (talk) 03:08, 27 May 2010 (UTC)

Done Spitfire19 (Talk) 03:40, 27 May 2010 (UTC)

Reads like once you've got Type 2 the primary treatment is Meds only

Hi Doc. I provided you with two articles discussing new findings on type 2 diabetes. You seem to have dismissed both, one austensively because it was from the Economist. Both were from the Economist, but they both were reviews of recent peer reviewed published studies. I'll get those studies. Both articles/studies indicated that there is dietary causation that can potentially be reversed. Partly gene expression reversion, partly reversed metabolic syndrome, but generally due to a significant reduction in blood lipids. That reduction can be achieved most effectively by eliminating refined sugars and carbohydrates, as well as animal fats from the diet. Several small studies find significantly reduced to alleviated symptoms from diets very low in animal fat (and low in calories, especially fast carbs).

Sounds silly, but on the DR Oz show, all participants (from the audience who practice the diet) have gotten off all meds within a few months. The diet (they say) is easy and tasty. They do get lots of help from Dr Oz's medical staff (specific meals and exercise information, and motivational aid).

Why isn't at least some mention of lifestyle change included as a potential front line treatment?Zinbarg (talk) 23:46, 27 May 2010 (UTC)

One is still online[[21]]

Here's the other as text:

"The origin of diabetes

Don't blame your genes Sep 3rd 2009 From The Economist print edition

GENES are acquired at conception and carried to the grave. But the same gene can be expressed differently in different people—or at different times during an individual’s life. The differences are the result of what are known as epigenetic marks, chemicals such as methyl groups that are sometimes attached to a gene to tell it to turn out more of a vital protein, or to stop making that protein altogether.

Many researchers believe epigenetic marks hold the key to understanding, and eventually preventing, a number of diseases—and one whose epigenetic origins they are particularly interested in is type 2, or late-onset, diabetes. Juleen Zierath and her colleagues at the Karolinska Institute in Stockholm, Sweden, are trying to find out how people develop insulin resistance, the underlying cause of type 2 diabetes.

Insulin is a hormone produced by the pancreas. When all is going well, it lets cells know when they need to mop up glucose from the blood, usually just after a person has eaten. If the hormone is absent or is produced in insufficient quantities because of damage to the pancreatic cells that secrete it, the result is classical (or type 1) diabetes. But people with insulin resistance—and thus the late-onset version of the disease—do produce insulin. Their problem is that their glucose-absorbing cells cannot heed its advice. The sugar stays in their bloodstreams, where it damages the vessels, leading to ailments such as heart disease, kidney failure and blindness.

As they report in Cell Metabolism, Dr Zierath and her team decided to look at one of the main consumers of glucose: muscle tissue. They took muscle biopsies from 17 healthy people, 17 people with type 2 diabetes and eight people with early signs of insulin resistance, so-called “pre-diabetics”. They then compared the patterns of the methyl groups attached to the genes of the healthy volunteers with those of the diabetic and pre-diabetic ones.

As it turned out, they found hundreds of genes in which the patterns differed systematically, so to whittle the problem down they concentrated on those involved in the function of the mitochondria. These are the components of a cell that extract energy from glucose and use it to manufacture a chemical called ATP, which is the universal fuel of biological processes. Having fewer or less effective mitochondria causes a drop in demand for glucose, and might thus cause a cell to become insulin resistant.

Even narrowing the question down like this, though, left 44 genes to look at. Of these, Dr Zierath and her team picked one called PGC-1 alpha for further study. This gene is involved in the development of mitochondria, and the extra epigenetic marks the researchers found on it in diabetics and pre-diabetics had the effect of instructing the cells the marked genes were located in to produce fewer and smaller mitochondria than is normal.

The next question was how those marks got there. It is well known that poor diet and lack of exercise make insulin resistance more likely, so one hypothesis is that these things change the epigenetic marks on genes such as PGC-1 alpha. To test that idea, the researchers bathed cells in glucose and fats (chosen as surrogates for bad diet and lack of exercise for obvious reasons) and also in inflammation-producing proteins called cytokines. These proteins, they knew, are produced abundantly in the obese. And obesity, the consequence of bad diet and lack of exercise, is another risk factor for type 2 diabetes. Lo and behold, doses of both fats and cytokines caused PGC-1 alpha to be methylated.

Next, Dr Zierath wanted to know if she could prevent that. So, this time, before bathing the healthy cells in fats or cytokines, the team added a chemical that blocks the activity of DNMT3B, an enzyme which they found methylates PGC-1 alpha. When that was done, no extra methyl groups appeared.

These findings have two interesting implications. First, the fact the team was able to stop PGC-1 alpha being methylated suggests that a drug might be developed to do the same. Second, they show that bodily abuse can stretch all the way down to the genetic level. As Dr Zierath puts it, “we are not victims of our genes. If anything, our genes are victims of us.”"Zinbarg (talk) 00:00, 28 May 2010 (UTC)

Lifestyle changes are actually mentioned before medications in the treatment section. Obesity is the cause of 85% of diabetes. Please see WP:MEDRS for an explanation of sourcing requirements.Doc James (talk · contribs · email) 00:09, 28 May 2010 (UTC)
I'm trying to add information about treatment, not cause. "Obesity is the cause of 85% of diabetes" is not accurate. Correct to say obesity is associated with in 85%. The "cause" is (citing the studies) lifestyle driven metabolic syndrome, producing high levels of saturated fats in cells, leading to cellular insulin resistance.
Re sourcing. Those are very high-end studies that easily meet WP:MEDRS requirements inclusion in Wikipedia.
There is no "Treatment" section. There is "Management," which is misleading: "Diabetes mellitus is a chronic disease which is difficult to cure." Type 2 is evidently not necessarily a chronic disease.
There is "Lifestyle modifications" under "Management," but it doesn't say anything about diet, let alone reduced consumption of saturated fats.
There's "Support," but it doesn't even mention dietary education. I'll look into "The diabetic diet," but the main body should introduce dietary educational support.
There is "Prognosis," that wrongly treats type 1 and type 2 as one in terms of prognosis. It focuses on managing blood sugar, and ignores reducing insulin resistance via diet (and exercise, in another studies).
Finally, I find "Pathophysiology," "At this stage hyperglycemia can be reversed by a variety of measures and medications that improve insulin sensitivity or reduce glucose production by the liver. As the disease progresses, the impairment of insulin secretion occurs, and therapeutic replacement of insulin may sometimes become necessary in certain patients.[citation needed]," where treatment is inaccurately limited to medications and insulin therapy.Zinbarg (talk) 02:41, 28 May 2010 (UTC)
I missed "Genes," which ignores the recent findings about gene expression.Zinbarg (talk) 02:44, 28 May 2010 (UTC)
If you want to use medical review articles to improve it feel free. Management and treatment are however the same thing and it does not matter which one you us.Doc James (talk · contribs · email) 02:46, 28 May 2010 (UTC)

Unindent. I've got to get copies of the original studies. Looks like they will by hard copies. I'm afraid the best thing we can present (after the offical reference we can still link to Econ) to our wiki audience is the economist articles.Zinbarg (talk) 16:10, 29 May 2010 (UTC)

Which studies do you want (PMID numbers )? I might be able to help you get them.Doc James (talk · contribs · email) 17:10, 29 May 2010 (UTC)
The two in the Economist. I'll be going to the med library Tuesday.Zinbarg (talk) 01:21, 30 May 2010 (UTC
And anything you think would help. I can probably scan and email you the copies.
There's a dearth of good studies on extreme diet (essentially NO animal fats, trans fats, or ~fast carbs and sugars).Zinbarg (talk) 02:15, 30 May 2010 (UTC)

Reorganization

Currently the main diabetes page attempts to cover everything which than result in duplication on the subpages pertaining to the particular type. I am thinking of moving much of the information to the sub articles and just leaving a brief overview of each type here.Doc James (talk · contribs · email) 08:19, 29 May 2010 (UTC)

I agree. It's a jumbled mess. Put differently, diabetes is two distinct diseases; lack of sufficient insulin production, and insulin resistance. Completely different in most respects (re sections in the existing article).Zinbarg (talk) 02:09, 30 May 2010 (UTC)

Ants

Anna Frodesiak (talk · contribs) and Sjö (talk · contribs) have made edits to the effect that ants attracted to sweet urine might still be a relevant finding today. The references employed (an anecdotal report in the BMJ 1982 and a web article by a layperson) are really not sufficient, and I am not personally aware of any body that recommends the urine ant test in low-resource settings. Could I suggest that we leave this out for now, as per WP:NOR and WP:MEDRS? JFW | T@lk 17:32, 15 June 2010 (UTC)

I restored my last edit. The BMJ ref was also a reference to Madhumeha, so removing that was certainly uncalled for.Sjö (talk) 19:09, 15 June 2010 (UTC)
There is more than anecdotal evidence, see http://whqlibdoc.who.int/bulletin/1976/Vol54/Vol54-No1/bulletin_1976_54%281%29_97-99.pdf www.academicjournals.org/ijmms/PDF/pdf2009/Sept/Okolie%20et%20al.pdf - Predatory open access journal, not a reliable source. http://www.africanjournalofdiabetesmedicine.com/articles/may_2009/National%20diabetes%20screening%20programmes.pdf and http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.129.8698&rep=rep1&type=pdf where ants are used as a diagnostic tool.Sjö (talk) 19:20, 15 June 2010 (UTC)
The references are not sufficient for Madhumeha. Please find a better one. With regards to ants being used nowadays, these sources are similarly poor. The Oputa reference states, rather than using ants as a diagnostic test, diabetes should be tested for if someone's urine attracts ants. Similarly, in the last reference, it is simply noted as a sign. JFW | T@lk 23:00, 15 June 2010 (UTC)
"... aware of any body that recommends the urine ant test in.." Whether or not it is a recommended method is irrelevant? I think it is notable because it is so widely used. But, I assume you meant that it therefore does not belong in the diagnosis section. I am fine with it in the history section. It seems to fit well there, except for the fact that the method is still used today. Best, Anna Frodesiak (talk) 12:16, 16 June 2010 (UTC) Anna Frodesiak (talk) 12:22, 16 June 2010 (UTC)

It is not a "method" that is "used". It is a sign, and nothing more. Very few doctors would be prepared to make a diagnosis purely on the basis of this phenomenon and would want more confirmation. JFW | T@lk 09:55, 27 June 2010 (UTC)

See also section and brittle diabetes

I started Brittle diabetes sometime ago. I was going to put a

or add it to a see also section. I can't remember why I didn't, but I remember there was some reason. This is quite a big article to be without a see also section. Odd. Thoughts? Anna Frodesiak (talk) 12:28, 16 June 2010 (UTC)

Obsolete name

Hi, isn't there any obsolete name for 'diabetes' in English? 217.67.37.200 (talk) 12:37, 16 June 2010 (UTC)

gestational diabetes

Isn't gestational diabetes caused by an immune response, and thereby related more to type 1 DM than type 2 DM? —Preceding unsigned comment added by Pernillebirck (talkcontribs) 13:19, 30 June 2010 (UTC)

Diabetes as an unseen disability

Since diabetes mellitus is an unseen disability, readers of this page may be interested in the recently created WikiProject group on disability, which can be accessed on: http://en.wikipedia.org/wiki/Wikipedia:WikiProject_Disability

ACEOREVIVED (talk) 19:18, 18 July 2010 (UTC)

Gluctamic acid high reading

what does a high Gluctamic acid reading mean? Thank you —Preceding unsigned comment added by 69.14.208.73 (talk) 15:28, 3 August 2010 (UTC)

Edit request from Peterkinxl5, 13 September 2010

{{edit semi-protected}} There are severe symptoms and side effects of Diabetes not contained in the article. These include hearing loss and hair loss. These need to be added asap. I suffer from Type II Diabetes and only found out via a chance conversation with a work colleague.

Peterkinxl5 (talk) 21:13, 13 September 2010 (UTC)

Not done: please provide reliable sources that support the change you want to be made. Salvio Let's talk 'bout it! 21:23, 13 September 2010 (UTC)

Polyphagia in diabetes

The lead paragraph of this article seems to imply that there is a chain of cause and effect that leads from high plasma glucose to polyphagia. What is the hypothesized chain of physiological events for this association? —Preceding unsigned comment added by Rdphair (talkcontribs) 22:49, 31 October 2010 (UTC)

Gladys Dull

There is currently a discussion on whether the article on Gladys Dull should be deleted, which might interest some people here. ACEOREVIVED (talk) 00:09, 6 November 2010 (UTC)

The article has already been deleted. --Monterey Bay (talk) 04:13, 16 November 2010 (UTC)


Probably the right decision - I just have received an e-mail from Diabetes U.K. about a man who has lived for diabetes for 75 years. I am sure that there are quite a few diabetics who have lived to a good age. So, I agree with the move - and yet, I always saw myself as being more inclusionist than deletionist! ACEOREVIVED (talk) 19:55, 23 November 2010 (UTC)

Edit request from 24.130.84.60, 19 November 2010

{{edit semi-protected}}

Walking downhill is apparently very effective in keeping blood sugar controlled. Please add this info to the article. Thanks. http://www.medscape.com/viewarticle/493323

24.130.84.60 (talk) 21:08, 19 November 2010 (UTC)


24.130.84.60 (talk) 21:08, 19 November 2010 (UTC)

  • Thanks for the input. However, one small study, involving 45 non-diabetic participants, isn't enough evidence for such a claim to be included in this article. If there's really something there, additional studies will confirm this result. Gentgeen (talk) 21:32, 19 November 2010 (UTC)

Vitamin D3 deficiency and diabetes

I am under coaching on how to create a better article about the connections between vitamin D3 deficiency and Diabetes thanks to Doc James. I am a completely new Wikipedia user, and I have a lot to learn about creating a completely neutral article. My first few writings are being moved to my user page.

I will be working through an article he has sent me on specifically the role of D3 in the endocrine and metabolic systems, so that I can produce something much less personally-flavored.

The medical journal article he has pointed me to is: Takiishi T, Gysemans C, Bouillon R, Mathieu C (2010). "Vitamin D and diabetes". Endocrinol. Metab. Clin. North Am. 39 (2): 419–46, table of contents. doi:10.1016/j.ecl.2010.02.013. PMID 20511061.  Unknown parameter |month= ignored (help)

Thank you for your patience with me, --JHansen (talk) 12:39, 5 January 2011 (UTC)

Etymology

Is it worth adding the following to the heading? I think it is as it helped me to understand what I am suffering from.

Diabetes from a Greek word for siphon, referring to the urination. Mellitus is based on the latin word for honey as urine of people with diabetes mellitus is sweet smelling (and tasting - historic diagnostic technique) because of the excess glucose in it. Insipidus is the same as insipid (lacking flavor) because diabetes insipidus does not result in sweet urine.Ppeetteerr (talk) 17:42, 3 April 2011 (UTC)

It is already in the second paragraph. -- Ian Dalziel (talk) 18:00, 3 April 2011 (UTC)

Yes - I've just noticed that but only after wading through the diabetes 1 and 2 links, could it be moved from the second paragraph to the start of the heading to help others like me coming to it for the first time? — Preceding unsigned comment added by Ppeetteerr (talkcontribs) 18:11, 3 April 2011 (UTC) Oops, forgot to sign it - sorry.Ppeetteerr (talk) 18:24, 3 April 2011 (UTC)

Is it too much to ask that people actually read the article? It can't all be in the first sentence... -- Ian Dalziel (talk) 19:52, 3 April 2011 (UTC)

Your patronising sarcasm is noted. As I said, I did read the article, starting at the top and following the links in sequence, which is why I had read everything (and researched the etymology, and posted my comment) before I reached the inappropriately positioned and inappropriately titled "definition".Ppeetteerr (talk) 09:10, 4 April 2011 (UTC)

I don't think the etymology of the phrase belongs in the lead. I think it is entirely appropriately positioned. I do agree that the heading "Definition" is quite wrong, though. -- Ian Dalziel (talk) 11:30, 4 April 2011 (UTC)

I'm sorry that my experience of using the article counts for so littlePpeetteerr (talk) 16:26, 5 April 2011 (UTC)

cause

please see editing history of alloxan and help. Some say alloxan causes diabetes in humans, and others suggest otherwise. What does the current research suggest?--211.5.24.30 (talk) 02:40, 8 April 2011 (UTC)

Pubmed and google scholar could help you. Doc James (talk · contribs · email) 02:46, 8 April 2011 (UTC)

Affecting the body

I think it would be important to add the body systems that it affects and what it does to those certain body systems.

Cardiovascular When diabetes develops in the body it begins to spread coronary artery disease. The cardiovascular system becomes weak because the blood is not as rich due to the high level of glucose. As a result of a weak cardiovascular system the body is more susceptible to hypertension, strokes and also produces more body fat. The veins and arteries of a person with diabetes hardens which makes blood much harder to travel and may cause the patient to have heart attacks and strokes. The kidneys in a person with diabetes has to work twice as hard to keep the body balanced and needs to be supplied with plenty water because it is doing twice as much work as it usually does.

Nervous System Diabetes slows down the mobility of a person because it affects a number of nerves in the body. Once hit with diabetes main nerves that lead to the brain and other vital areas of the body. The brain may become suffocated because of the lack of oxygen and will not respond to basic commands such as walking or even just picking up a pencil. Coma’s may also occur in diabetes. “The nerves that become damaged are the ones that allow you to sense temperature, pressure, texture, or pain on your skin. In most people with diabetes, nerve disease (neuropathy) effects the feet and lower legs, causing numbness or tingling. The real problem arises when numbness allows injuries to the foot to go unnoticed." It is very important for diabetes patients to see a foot doctor at least once a year to check out if there is a lot of nerve damage. Alcohol and smoking can also do much damage to your nerve system adding to the stress that the nerve system has. Carpal nerve system commonly occurs with people suffering from diabetes. This disease causes numbness in your hands a feet and may cause it to become very weak. SN: sorry if this is done wrong this my first entry otwin011 (talk) —Preceding undated comment added 19:57, 17 May 2011 (UTC).

Brittle diabetes

Respectfully requesting support for the opinion rendered here. Thanks. Anna Frodesiak (talk) 10:56, 18 May 2011 (UTC)

Diagnosis section needs clarification

As I post this, the section in the article doesn't say what kind of test is used to diagnose diabetes. A blood, saliva, or urine test? Also, a mention of those urine strip tests I used to see sold in pharmacies would be nice, if they still make them. Are they used in any way? 5Q5 (talk) 17:12, 25 May 2011 (UTC)

Diabetes not only confined to humans

Presumably there are others - think these should probably be in the see also section - so I'm going to add them. Hope that's ok - you don't have a see also section - but seem to have that in the disambiguation page, so I've added the horses link there.

I presume diabetes is possible in all mammals - so perhaps there should be a subsection of this article covering that with {{main |Diabetes in dogs|Diabetes in cats| etc etc etc}} ?

Yes creating a section called "In other animals" per WP:MEDMOS would be a good idea. See also sections are discouraged. Doc James (talk · contribs · email) 08:02, 1 June 2011 (UTC)

Step-Up to Medicine

Mikael Häggström (talk · contribs) has added some content sourced to "Step-Up to Medicine". I suspect that this is a borderline non-MEDRS as it appears to be a tutorial/revision book rather than a textbook. Similar books are being used in other articles by this editor. Comments invited. JFW | T@lk 07:50, 10 June 2011 (UTC)

Yes does not look like the best source. Hopefully we can convince this regular editor to stick with the highest quality evidence ( ie. recent review articles ) Doc James (talk · contribs · email) 01:40, 11 June 2011 (UTC)


Prevalence

I have temporarily reverted the addition of a news story about rising prevalence of diabetes worldwide. This all relates to an "online first" article (link) in The Lancet. It seems to be an appropriate source (it is a systematic review of health surveys), but it might help to wait until it is in print. JFW | T@lk 07:06, 27 June 2011 (UTC)

DOI is not functional yet: doi:10.1016/S0140-6736(11)60789-7 JFW | T@lk 07:06, 27 June 2011 (UTC)

Somogyi effect

Somewhere in Wikipedia we could mention the Somogyi effect, which is mentioned http://www.diabetes.co.uk/blood-glucose/somogyi-phenomenon.html. This would be of interest, if not here then in one of the many other articles on diabetes in Wikipedia. ACEOREVIVED (talk) 09:30, 23 June 2011 (UTC)

All right - I have now seen that there is an article entitled Chronic Somogyi rebound, as well as an article on Michael Somogyi. ACEOREVIVED (talk) 20:43, 29 June 2011 (UTC)

There seems to be a cure

A recent study from Newcastle University, published in Diabetologia, suggests that type 2 diabetes is not chronic and can indeed be cured: Newcastle University article and study published in the journal. --Amazeroth (talk) 09:10, 26 June 2011 (UTC)

Per WP:MEDRS we use review articles. Press releases are often inaccurate thus this is an insufficient ref. --Doc James (talk · contribs · email) 15:35, 26 June 2011 (UTC)
What's all that nonsense talk about reliable sources? This is a peer-reviewed mecidal journal, and the leading medical journal on diabetes in Europe. --Amazeroth (talk) 19:04, 26 June 2011 (UTC)
The article does not once mention that a "cure" has been found. They looked at eleven people. Please use review articles. Cheers --Doc James (talk · contribs · email) 22:18, 26 June 2011 (UTC)

Amazeroth, you have also discussed this on WT:MED. Could I strongly suggest that you read (and actually read) the WP:MEDRS guideline? It will open your eyes to the importance of adequate sourcing of medical content. Newspapers and TV news hype stuff up because it increases readership/faces to televisions. As an encyclopedia we need to be more circumspect and selective. The understanding of diabetes treatment has not been materially altered by the paper you have mentioned, so there is really no need to emphasise it beyond what we can cite from high-quality reviews. JFW | T@lk 07:06, 27 June 2011 (UTC)

To date, the idea that type 2 diabetes can be cured is a scam that is being pushed by some quack doctors and "holistic" practitioners. Diabetes can be managed, but it cannot be cured.Arlesd (talk) 21:15, 29 July 2011 (UTC)

Edit request from 144.82.242.6, 15 September 2011

Please change HAVE to HAS in the following sentence (two occurrences): Gestational diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2 DM.

144.82.242.6 (talk) 17:42, 15 September 2011 (UTC)

Have is correct when it refers to women (plural).Sjö (talk) 18:38, 15 September 2011 (UTC)

Diabetes caused by corn syrup

"There has been a remarkable increase in consumption of high-fructose corn syrup," said Gerald Shulman of Yale University School of Medicine. "Fructose is much more readily metabolized to fat in the liver than glucose is and in the process can lead to nonalcoholic fatty liver disease," he continued. NAFLD in turn leads to hepatic insulin resistance and type II diabetes.

Not only is the corn syrup from GM crops in the USA, it is widely used instead of sugar. In Europe the use of corn syrup is limited. The occurrence of type 2 diabetes in the US is much higher than that in Europe. Also the increase of diabetes can be directly linked with the introduction of GM foods into the US food chain. — Preceding unsigned comment added by 188.76.232.51 (talk) 09:48, 17 September 2011 (UTC)

Khan Academy

The external link to Khan Academy was recently removed. It should be reinserted because it provides a good introduction to the concepts in pedagogical form. It complements the article by presenting with use of more media (sound) in a different way, thereby maing it easier for people to understand. --Ettrig (talk) 06:08, 25 September 2011 (UTC)

These are interesting. I am not sure if they should be used as external links. They are under a CC NC SA license which is good. But we are not a collection of external links. And they are not referenced.--Doc James (talk · contribs · email) 06:27, 25 September 2011 (UTC)
Wikipedia does not include any associated link. True. Wikipedia includes links to resources that contribute to the goal of informing and educating the user. This link does that. --Ettrig (talk) 09:07, 25 September 2011 (UTC)

new aspects in diabetes care

According to various inventions made , it was found that there were many missed opportunities that may help to reduce the risk of diabetes through improved measures introduced for control of blood glucose levels . The improved investigation methods and by use of proper interventions for control of arterial hypertension and hyper cholesterolaemia helped to reduce the risk for type two diabetes .<brMallinger,Leslie et. al.Bulletin of world health organization ; march 2011, vol. 89 issue 3, p172-183 />
It was found that there is a multi generational inheritance of diabetes and other characteristics that may arise with early onset of type two diabetes . The inheritance was accompanied by factors such as overweight , insulin resistance , low insulin secretion, dyslipidemia and mild intra abdominal obesity . It is also found that psychological and family based interventions play a significant role in outcomes related with poorly controlled type two diabetes . Moreover psychological well being, diet, exercise and family support can also play a significant role in improvement of (A1C) glycated hemoglobin levels and their outcome.<brMills,James L et. alRevista Panamericana de Salud publica; June 2010 , vol. 27 issue 6, p435-441, 7p />Intensity and selection of treatment for type two diabetes mellitus is based on strict glycemic targets for elderly patient is reasonable for more patient and the risk for hypoglycemic complication must be weighed against potential benefit of reducing microvascular and macrovascular disease . Metformin may be used as first line therapy, whereas chloropropamide and glyburide , which posses a great risk for hypoglycemia , should be avoided in elderly and also the use of rosiglitazone should be avoided to reduce increased cardiovascular risk .<Keogh,Karem. Et.al American journal of managed care ; Feb. 2011 , vol.17 issue 2, p105-113, 9p > — Preceding unsigned comment added by Doctor jaikal (talkcontribs) 19:15, 26 September 2011 (UTC)

TOC left

I am a huge fan of moving images and diagrams around so that the flow of articles are not jagged with photos and stuff. I know a lot of resolutions are mean to me in regard to that but what do you guys think about moving the TOC to the left? Template:TOC, cheers Je.rrt (talk) 04:04, 2 October 2011 (UTC)

I think it would look bad. Also, for example, WP:MOSIM says "Infoboxes, images, and related content in the lead must be right-aligned." Can you give me an example of a WP:FA that uses this template? If one doesn't exist then you should probably stop trying this with articles, as it appears to be against "formatting consensus". Jesanj (talk) 15:50, 3 October 2011 (UTC)
Yes if you are wanting to make this change to a bunch of medical articles it needs to be discussed at WT:MED first.--Doc James (talk · contribs · email) 16:27, 3 October 2011 (UTC)

Testosterone revisited

The recent edit about testosterone as a treatment reminded me of the discussion in Talk:Diabetes mellitus/Archive13 which I link here for convenience. The same arguments against inclusion are still valid IMO, among others that it's still in the experimental stage. A text about testosterone has been added to Anti-diabetic medication#Research where it might be relevant, but in this article, which is mostly an overview of the topic, I feel that it is WP:UNDUE.Sjö (talk) 16:26, 17 October 2011 (UTC)

Agree with Sjo. When this hits the guidelines than we can reconsider the issue. Doc James (talk · contribs · email) 16:30, 17 October 2011 (UTC)

What does it mean? That we can not talk about testosterone until it will be approved by FDA (the protector of pharmaceutical profit) we can not write about nresearch? — Preceding unsigned comment added by Moscone (talkcontribs) 17:41, 17 October 2011 (UTC)

Look that there is scientific consensus on the fact that testosterone is effective against diabetes mellitus. I do not understand why research articles can not be mentioned. Obviously you do not want to talk about it and to mention the scientific articles because you want to protect the profit of pharmaceutical industry. Obviously the articles say that testosterone deficiency play a important role in diabetes mellitus but you say that is undue weight. I remind you that removal of citations is vandalism.

You will never approve to say something that go beyond the profit of pharmaceutical industries and you will delete all the articles.

I saw the discussion the users testosterone vs diabetes and cyclopia had the consensus and you consored the articles, as I said...--Moscone (talk) 17:07, 17 October 2011 (UTC)

Forget FDA approval. Forget drug company profits. This article is about the way diabetes is treated. Currently, diabetes is not treated with androgens. The data is vaguely interesting, but much larger trials are needed, particularly about the safety of androgens with respect to liver tumours and behaviour.
Please have a good close look at WP:MEDRS, the guideline that we use to decide what kind of sources to use. On this particular page, we need very strong sources because the topic is so immense and because there is such a large literature on diabetes.
We cannot look into the future, so making predictions about the possibility that androgens may one day be used for diabetes is not really our remit. Minor "breakthroughs" from small studies, sadly, are also something for newspapers rather than an encyclopedia. JFW | T@lk 19:22, 17 October 2011 (UTC)
Agreed that this material is WP:UNDUE weight for this overview article. This has nothing to do with the pharmaceutical industry and everything to do with applying due weight as established in the medical literature. A few speculative articles does not establish that weight. Yobol (talk) 20:13, 17 October 2011 (UTC)

Yet another intro rewrite

It has become a bit of a sport to rewrite the introduction of this article, trying to include as much detail as possible (often with nesting brackets and other features). There's been a couple of fights over this also - a while ago there was a vocal disagreement over the need to specifically mention relatively rare types (such as MODY).

What this article needs, in my view, is more attention to the rest of the body. Several long-term editors, such as Doc James and myself, have been chipping away at this over the years, but I believe the article needs a push. The trouble is that it is an enormous subject field, and consensus decisions need to be reached about the level of detail to include here, as opposed to the numerous subarticles.

I believe the basic structure of the article is in keeping with WP:MEDMOS. I have just done another shuffle to ensure compliance, moving the "complications" section into "signs and symptoms". What still needs to be done is working on the content to the point that we manage to strike that elusive balance between brevity and comprehensiveness - we have subarticles for almost every single concept related to diabetes. JFW | T@lk 14:52, 23 October 2011 (UTC)

Are there sections that stand out to you as needing expansion or trimming? I'd like some ideas on what is most needed. Jesanj (talk) 08:08, 4 November 2011 (UTC)
All sections need unsourced items sourced properly. Many sections are currently based on sources that are not ideal and fall foul of WP:MEDRS.
Almost every section could have links to relevant subarticles added using the {{main}} template.
The "classification" and "causes" sections could be merged.
The "pathophysiology" section needs very close attention so it can be both concise and comprehensive, an almost impossible task.
The "diagnosis" section needs to be updated to the latest guidance.
The "management" section could be made a little meatier, particularly with regards to the fact that glycaemic control in type 2 diabetes has really quite modest benefits.
Just a beginning... JFW | T@lk 00:25, 6 November 2011 (UTC)

Source

This was the sole source under "Further reading":

Furdell, Elizabeth Lane. Fatal Thirst: Diabetes in Britain until Insulin (Leiden, Netherlands: Brill, 2009) 194 pp.

This work (ISBN 9004172505) seems a good source for the historical content. Does anyone have access to it?

 JFW | T@lk 15:11, 23 October 2011 (UTC)
Does Google Books' copy help? We hope (talk) 22:25, 2 November 2011 (UTC)

Diagnosis section

If you have sex with someone with aids your diabetes will go away and you will not have aids. determination of HbA1c levels has not been universally considered a specific diagnostic test for diabetes See http://emedicine.medscape.com/article/117739-workup under the section of "Measurement of Glycated Hemoglobin levels" — Preceding unsigned comment added by Trueleowdeo (talkcontribs) 14:22, 4 December 2011 (UTC)

Piece on "Today" programme

I thought that if this article included reference to the section on the Radio Four programme Today on December 14 2011, it would update the piece. The interview with Bob Young can be heard as a podcast on:

http://news.bbc.co.uk/today/hi/today/newsid_9661000/9661714.stm

There were other sections on "Today" however, that mentioned diabetes, stressing how better management of diabetes (such as improvements of diet on both Diabetes_mellitus_type_1 and Diabetes_mellitus_type_2, or better control of insulin therapy in Diabetes_mellitus_type_1, could prevent many deaths each year through diabetes. ACEOREVIVED (talk) 14:49, 14 December 2011 (UTC)ACEOREVIVED (talk) 14:52, 14 December 2011 (UTC)

Removal of my piece

I did put in a reference to the article on the "Today" programme, but some one has removed it on the grounds that Wikipedia is not news, citing http://en.wikipedia.org/wiki/Wikipedia:NOTNEWS to justify this removal. However, if Wikipedia is not news, how come it already has an article on the Liege shootings, which can be found at:

http://en.wikipedia.org/wiki/2011_Li%C3%A8ge_attack

ACEOREVIVED (talk) 20:48, 14 December 2011 (UTC)

We at WP:MED probably apply the NOTNEWS more than other parts of Wikipedia.Doc James (talk · contribs · email) 21:10, 14 December 2011 (UTC)

drinking extreme amounts ...

"drinking extreme amounts of sugar-containing drinks" come on... . What kind of happy horse shit is this? Extreme? Like 15 gallons a day? Delete this bullshit. — Preceding unsigned comment added by Random User 643873 (talkcontribs) 22:16, 14 December 2011 (UTC)

Done and feel free to begin editing yourself. We are so few and the content is so great... Doc James (talk · contribs · email) 23:14, 14 December 2011 (UTC)
15 gallons per day would definitely be a concern. :-) | pulmonological talkcontribs 06:35, 28 December 2011 (UTC)
15 gallons per day of anything would definitely be a concern. :-) (User:miketosh) 20:14 1 February 2012 (UTC)

Glucagon's the boss

Just when we thought we understood diabetes, doi:10.1172/JCI60016 provides a completely different paradigm that suggests that glucagon is the central player in the pathogenesis of diabetes. JFW | T@lk 20:13, 3 January 2012 (UTC)

ref error on note 27

There is a ref error on 27 --Halqh حَلَقَة הלכהሐላቃህ (talk) 10:03, 7 January 2012 (UTC)

Reader

Apologies for not adhereing the proper "talk page" protocol, but I am unfamiliar with the mandated methods for posting relevant criticism on this site. Having said that...


HOW THE HELL IS OBESITY MENTIONED ONLY THREE TIMES IN THIS ARTICLE? The vast majority of scientific literature on the subject indicates a strong correlation between the incidence of obesity and diabetes; furthermore, there exists a body of evidence detailing how obesity physiologically causes type II diabetes. If this article is to be relevant (don't give me that "neutrality" bullshit, everything must exist within a certain context as there are no privileged frames of reference), then it should elaborate how increases in the diagnosis of diabetes amongst developed nations is due to obesity, which itself is due to sedendtary lifestyles and excessive caloric intake. Geneitc propensity to acquire diabetes is substantial with type I diabetes, not type II. — Preceding unsigned comment added by 212.19.100.146 (talk) 18:06, 20 February 2012 (UTC)

New information

It has been reported on the Radio Four programme presented by Mark Porter called "Inside Health" that people aged 16-24 may be the least likely age group to get care for diabetes. If other sources confirm this, it could go in the article. ACEOREVIVED (talk) 21:10, 6 March 2012 (UTC)

Sure planning on taking on this article soon as I finish Type 2 diabetes mellitus --Doc James (talk · contribs · email) 06:29, 11 March 2012 (UTC)

Predicted increases

On the Radio Four Today programme on April 25 2012, it was reported that there have been predictions that rates of diabetes mellitus in the United Kingdom will increase from four million to six million in the next few years. If any one knows the source of these claims, it could go in the article. Diabetes will be discussed on You and Yours today (April 25), so I can listen and update accordingly. ACEOREVIVED (talk) 10:58, 25 April 2012 (UTC)

Yes, I have now heard it - it was Diabetes U.K. who have predicted the increases - and I have updated the article by adding a little about epidemiology in the United Kingdom. This will make the article more comprehensive, but sorry if I got the subtitling wrong - if any one knows how to clear that up, please do. ACEOREVIVED (talk) 15:13, 25 April 2012 (UTC)


The predictions were actually made in the journal "Diabetic Medicine". More on these predicted increases, and the increases in the percentage of spending that diabetes will take up of the N.H.S. budget, can be found on the website:

http://www.diabetes.org.uk/About_us/News_Landing_Page/NHS-spending-on-diabetes-to-reach-169-billion-by-2035/

I hope that other Wikipedians will now take that as an appropriate source. ACEOREVIVED (talk) 15:34, 25 April 2012 (UTC)

This website gives the figure of 3.8 million people in the United Kingdom who have currently have diabetes mellitus, and notes that article in "Diabetic Medicine" predicts that this figure is expected to rise to 6.25 million by 2035/6. ACEOREVIVED (talk) 15:37, 25 April 2012 (UTC)

Do not worry now about the subtitling problem - I went to Wikipedia: Help desk, where User: Ryan Vesey was ever so quick to respond to my query, and has now kindly fixed the problem! ACEOREVIVED (talk) 18:51, 25 April 2012 (UTC)

grammar

some grammatical errors in the Epidemiology section I cannot tell if the first line should read "...estimated that there are 285 million people [with] diabetes[. Type 2 makes] up about 90% of the cases" Or "estimated that there are 285 million people with type 2 [diabetes] making up about 90% of the cases" — Preceding unsigned comment added by 24.247.93.40 (talk) 20:40, 26 February 2012 (UTC)

Rather ironically, there were also some punctuation errors in those comments. ACEOREVIVED (talk) 10:47, 24 May 2012 (UTC)

Section: Type 1 diabetes

In the first sentence of the second paragraph:

  • "... often occurring for no apparent reason in insulin-dependent diabetes."

diabetes was originally a link to this article (it linked to itself). I have piped it so it links to the disambiguation page of diabetes instead, as it seems unnecessary to have a link in an article to the same article. Let me know if I should change it back, or if the link should be removed altogether. Comparison of sentences:

  • Old: "... often occurring for no apparent reason in [[insulin]]-dependent [[diabetes]]."
  • New: "... often occurring for no apparent reason in [[insulin]]-dependent [[Diabetes (disambiguation)|diabetes]]."

L1ght5h0w (talk) 17:22, 19 May 2012 (UTC)

After thinking about it more, and looking through the article, I almost want to say the right thing would be to change the aforementioned link to a link to the article on Insulin-dependent diabetes mellitus. However, this again wouldn't exactly be right, because the topic is discussed one section up in the Classification section in the following sentence:
  • "The term "type 1 diabetes" has replaced several former terms, including childhood-onset diabetes, juvenile diabetes, and insulin-dependent diabetes mellitus (IDDM)."
I think the sentence in the Classification section should include a link to the IDDM article, and the sentence in the Type 1 diabetes section have the link to diabetes/diabetes disambiguation removed, so that they would be as follows:
  • "The term "type 1 diabetes" has replaced several former terms, including childhood-onset diabetes, juvenile diabetes, and [[Insulin-dependent diabetes mellitus]|insulin-dependent diabetes mellitus]] (IDDM)."
  • "... often occurring for no apparent reason in [[insulin]]-dependent [[diabetes]]."
What do you think? Thoughts/comments appreciated.
L1ght5h0w (talk) 17:32, 19 May 2012 (UTC)

Should we remove this from the category "Medical conditions related to obesity"?

I am not really sure that this should be in the category "Medical conditions related to obesity". This is certainly true of Diabetes_mellitus_type_2, but it is hardly true of Diabetes_mellitus_type_1. Since this article is on diabetes mellitus in general, I rather think that we should remove the article from this category (the article on Diabetes_mellitus_type_2 is already in this category). ACEOREVIVED (talk) 10:43, 24 May 2012 (UTC)

Seems reasonable. JFW | T@lk 23:46, 24 May 2012 (UTC)

Overlap syndromes and "type 3" diabetes

I have removed a section that engaged in original research and misused the sources it cited. It tried to list the forms of diabetes sometimes referred to as "type 3". In truth no authoritative body has used the term. We are therefore talking about folklore. There are certainly some interesting diabetes syndromes that we should mention (LADA, MODY, ketosis-prone diabetes, DM2 with islet autoimmunity), but only supported by the right kind of sources. doi:10.1002/dmrr.877 is an interesting document that covers three of these syndromes, and doi:10.1136/bmj.d6044 covers MODY. But let's move away from attempts to invent nomenclature that doesn't exist (e.g. type 3 or type 1.5). JFW | T@lk 10:55, 29 May 2012 (UTC)

Recent stuff

doi:10.1001/archinternmed.2012.3130 combines a research study and meta-analysis of physical exercise in DM2, suggesting a very significant mortality benefit. Seeing that it's a hybrid, I'm unsure whether we should cite this.

doi:10.1001/archinternmed.2012.3147 shows that while tight blood pressure control reduces the relative risk of stroke by a third, the absolute risk reduction is very small, and there is no impact on the risk of MI or mortality. Sobering. JFW | T@lk 08:18, 7 August 2012 (UTC)

Vote to split and disambig

I think that we should split the article into a disambig page as to avoid confusion between t1d and t2d, i am passionate about this as i have t1d, and would like to help make aware the difference between the two 124.149.102.149 (talk) 06:49, 30 August 2012 (UTC)

Yes I have worked to bring the article on type 2 DM to GA. You should register an account and try to do the same with type 1 DM. A few good pages to read are WP:MEDRS and WP:MEDMOS. Once the two articles are GA than we can consider the best way to combine them as an overview. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:16, 30 August 2012 (UTC)

Differentiating signs and symptoms

Some of the symptoms listed were signs. Classical does not mean 'typical', 'definitive' or 'usual'. Richard Avery (talk) 07:42, 2 September 2012 (UTC)

A symptom is generally accepted as a problem reported by the patient (or their caregiver) to the doctor, as opposed to signs which are physically detectable abnormalities that are identified on physical examination. Unless the doctor witnesses the patient gulping down several cups of water or dashing to the toilet repeatedly during the consultation, the history provided by the patient provides symptoms. Hope you don't mind I've changed it to "classical symptoms". JFW | T@lk 14:20, 2 September 2012 (UTC)
Do you think loss of weight is a sign or symptom. I think it could be either, depending on its mode of discovery. I agree I have been a little hasty in this instance. However 'classical' does not mean 'classic'. Did you look them up to check? ;-)) Richard Avery (talk) 14:42, 2 September 2012 (UTC)

Requested move

The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section.

The result of the move request was: Not moved Mike Cline (talk) 14:22, 5 October 2012 (UTC)



Diabetes mellitusDiabetes – Per WP:COMMONNAME and Wikipedia:Article titles. "Diabetes" is much, much more common (287,000,000 vs. 27,700,000 results in Google) and should clearly not be the redirect. -- Wikipedical (talk) 08:21, 27 September 2012 (UTC)

  • Support Obvious WP:COMMONNAME case. --BDD (talk) 18:39, 27 September 2012 (UTC)
  • Comment: There exist naming conventions for medicine-related articles here that say the "article title should be the scientific or recognised medical name". It even mentions "Diabetes mellitus" as an example (though compared to "Diabetes Mellitus"). I'm inclined to believe that the current setup conforms with these guidelines. Erik (talk | contribs) 20:00, 1 October 2012 (UTC)
  • Oppose Fine where it is. Seperates it from Diabetes insipitus. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:18, 1 October 2012 (UTC)
  • Comment: I understand Erik and James' objections, but my concern is the lay-reader who enters "diabetes" and finds herself at an article titled with an unfamiliar technical term. Powers T 23:54, 1 October 2012 (UTC)
Likewise. I wasn't familiar with WP:MOSMED, but it seems to conflict pretty strongly with WP:COMMONNAME and, in this case, WP:ASTONISH. --BDD (talk) 00:04, 2 October 2012 (UTC)
  • Oppose. "Diabetes" is not the full name of the condition. COMMONNAME should not apply if the name is colloquially widely used but factually wrong. JFW | T@lk 08:14, 5 October 2012 (UTC)
The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.

Edit request on 27 September 2012

Commonly, there is a stigma attached to type 2 diabetes. It is unfairly and incorrectly seen as a completely preventable disease, caused by laziness and poor eating habits alone. This ignorance is common in society, despite the known fact that neither of these factors are the true cause of diabetes. The resulting bias is unfair to those afflicted by this disease. http://www.health.com/health/condition-article/0,,20189184,00.html. Diabetes S.P. (talk) 15:33, 27 September 2012 (UTC)

Not done: please be more specific about what needs to be changed. —KuyaBriBriTalk 19:35, 27 September 2012 (UTC)
How much stigma exactly? Lifestyle factors in those with a genetic predisposition cause the majority of type 2 diabetes, and currently I believe this article has the balance right. Please advise what particular changes you would wish to make. JFW | T@lk 08:17, 5 October 2012 (UTC)

Historical review

doi:10.1056/NEJMra1110560 is a NEJM historical review of diabetes that we could use to support the history content. It doesn't go into some of the finer details of novel treatment, such as the incretins. JFW | T@lk 08:16, 5 October 2012 (UTC)

Diabetes mellitus and protein glycation

I would like to add a section about the underlying pathophysiology of protein glycation to this article. The text was removed because it was poorly ref'ed and poorly written. The text that was removed was:

Lastly, high glucose concentration causes glucose molecules to react with proteins and form excessive amounts of glycoproteins. Red blood cells act as a glucose buffer and tend to increase their glucose intake when there is excessive serum glucose concentration. Hemoglobin is then transformed to glycated hemoglobin (HbA1c), which is permanent and irreversible. (http://books.google.rs/books?id=Tye_Y5gs2pIC&lpg=PA601&ots=zd34y8g3Ev&dq=Glycated%20hemoglobin%20pathophysiology&pg=PA601#v=onepage&q=Glycated%20hemoglobin%20pathophysiology&f=false)

The underlying part about protein glycation is explained at these articles: glycated hemoglobin, glycation and Advanced glycation endproduct. I believe it should be improved. Glycation is an important process which could explain partly the pathophysiology of peripheral neuropathy and angiopathy in diabetes. It's important for medical students to understand the underlying mechanism.

Here's an article to prove it: Hyperglycemia in diabetes causes non-enzymatic glycation of free amino groups of proteins (of lysine residues) and leads to their structural and functional changes, resulting in complications of the diabetes. Glycation of proteins starts with formation of Shiff’s base, followed by intermolecular rearrangement and conversion into Amadori products. When large amounts of Amadori products are formed, they undergo cross linkage to form a heterogeneous group of protein-bound moieties, termed as advanced glycated end products (AGEs). Rate of these reactions are quite slow and only proteins with large amounts of lysine residues undergo glycation with significant amounts of AGEs. The formation of AGEs is a irreversible process, causing structural and functional changes in protein leading to various complications in diabetes like nephropathy, retinopathy, neuropathy and angiopathy. (https://www.ncbi.nlm.nih.gov/pubmed/17285797)

The only part I wrote (and I don't understand) is how erythrocytes increase their glucose intake (https://www.ncbi.nlm.nih.gov/pubmed/2045061) to create HbA1c -- I'm open to suggestions. I suppose GLUT1 transporter on erythrocytes is not insuline-dependant. :) --Sav_vas (talk) 22:37, 16 October 2012 (UTC)

removing "hypoglycaemia" from acute complications

Hypoglycaemia only occurs because of the treatment of insulin. I don't think it should be put as one of the acute complications of diabetes mellitus itself. — Preceding unsigned comment added by Jackzh (talkcontribs) 07:48, 21 October 2012 (UTC)

Possible Type 3 Diabetes

Back in 2005, it was first proposed that Alzheimer's Disease was caused by a new type of diabetes, termed Type 3:

http://www.nationalreviewofmedicine.com/issue/2005/12_15/2_advances_medicine01_21.html

It seems like this hypothesis is gaining traction:

http://www.rhodeislandhospital.org/wtn/Page.asp?PageID=WTN000249

http://alzheimers.org.uk/site/scripts/documents_info.php?documentID=1741

http://www.newscientist.com/article/mg21528801.100-brain-diabetes-the-ultimate-food-scare.html

http://www.newscientist.com/article/mg21528805.800-food-for-thought-eat-your-way-to-dementia.html

First heard of this back in '05 and just saw a news article (with most of the links above), re. it at:

http://www.guardian.co.uk/commentisfree/2012/sep/10/alzheimers-junk-food-catastrophic-effect

Something about this should be added to the main article (and perhaps a separate Wiki entry for Diabetes Type 3), at a suitable time.

Phantom in ca (talk) 04:53, 9 December 2012 (UTC)

We need reliable sources. Please see WP:MEDRS for what those are. The popular press makes stuff up all the time. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:49, 9 December 2012 (UTC)

Not at all ready for prime time or an encyclopedia article. That term was ridiculous. Back in 2005 a pathologist reported finding a pathological finding (reduced insulin receptors) in brains of dead patients with Alzheimers disease (AD). She hypothesized that a common causal mechanism of alzheimer's disease might be loss of insulin sensitivity in brain neurons leading to death of neurons. She did not describe any abnormality of glucose in blood or brain. As our article says, the term diabetes is used for diseases in which the blood glucose level is persistently too high. (Besides, there are not two types of diabetes to doctors, there are dozens of types.) There has been almost no corroborative evidence for her hypothesis, and even if it turns out to be a major advance in understanding of AD, it wont be called type anything diabetes because it isnt diabetes. alteripse (talk) 16:09, 9 December 2012 (UTC)

Type 2 causes

The article says type 2 is caused by lifestyle factors and doesn't indicate what those are. Are they not known? Why are they not given? GeeBIGS (talk) 08:05, 9 February 2013 (UTC)

In short, eating too much, moving too little. Perhaps they need to be spelled out in more detail. alteripse (talk) 20:24, 10 February 2013 (UTC)

Management

I added a reference in this section (to http://www.kuleuven.be/english/news/a-permanent-cure-for-type-1-diabetes ). KVDP (talk) 06:35, 18 April 2013 (UTC)

Please see WP:MEDRS for what sort of refs are needed for medical content. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:28, 18 April 2013 (UTC)
Also, it's a huge step from promising results with rats to a working cure for humans. To say that diabetes is curable and point to early research is just wrong. There are so many obstacles from early research to approved treatment that most of the promising results never make it to an approved treatment. Sjö (talk) 08:15, 18 April 2013 (UTC)

Edit request

Could someone hyperlink "Blured Vision" (in Signs and symptoms) to Hyperphacosorbitomyopicosis. I can't edit as the article is protected. Ohghae4a (talk) 18:44, 6 April 2013 (UTC)

I have nominated that page for deletion, as I cannot find good WP:MEDRS compliant refs for either the term or the phenomenon. If you have references for it those would be helpful, it's possible or probable that i am not searching properly. -- [ UseTheCommandLine ~/talk ] # _ 02:41, 7 April 2013 (UTC)

Another cause of type 2 diabetes

The article says that type 2 diabetes is caused by insulin resistance. What about the other popular theory that the body simply does not recognize the presence of glucose and hence does not try and produce insulin even though it can? I think that I support this theory because as a diabetic, whenever I take a sulfonyurea my body does produce insulin and my blood glucose is lowered. So I cant see why the theory goes along the line of saying that my body resists the insulin if the BG is lowered. — Preceding unsigned comment added by 81.159.211.236 (talk) 23:42, 23 March 2013 (UTC)

MODY2 is literally a genetic failure of the beta cell sensor system (glucokinase) to "recognize" the glucose level. It is not usually treated with sulfonylureas, and is not considered ordinary type 2 diabetes, though it is often misdiagnosed as such. In ordinary type 2 diabetes, the defects can occur at many steps in secretion and response to insulin, but there does not seem to be a problem with "recognition" of glucose by beta cells. alteripse (talk) 16:11, 26 March 2013 (UTC)

Diabetes — Preceding unsigned comment added by 5.21.254.153 (talk) 19:41, 15 May 2013 (UTC)

natural cure for diabetes

hi i am from mumbai - india had expereinced a new wellness product by which the diabetic can be cured using biolight and water. — Preceding unsigned comment added by 49.248.83.163 (talk) 09:59, 9 May 2013 (UTC)

At present, there is no cure for diabetes. Only quacks and fraudsters claim there is.Arlesd (talk) 05:40, 23 May 2013 (UTC)

ATP/P2X7R link to diabetes

According to Boston Children's Hospital P2RX7 is the cause of Type 1 diabetes.

Can somebody add a link to the P2RX7 page? — Preceding unsigned comment added by HalSnowflake (talkcontribs) 17:08, 15 June 2013 (UTC)

Edit request on 18 August 2013

why don't i see any mention that diabetes can be improved and perhaps cured simply by eating properly... eating mostly RAW food. My case is no different than thousands of others... My medications were not working for me, my type 2 diabetes was not be properly controlled by medications for 5 months, then after 2 weeks of eating raw food my blood sugars are completely under control and i no longer required medications. To state that diabetes is not curable is a lie. 174.7.27.151 (talk) 06:39, 18 August 2013 (UTC)

The article says there is no cure (usually). The rest is covered in Diabetes_mellitus#Management and the article it links to. RudolfRed (talk) 07:35, 18 August 2013 (UTC)

Vitamin D at optimal levels of around 50 ng/mL may lead to 90% reduced rate for Americans

There are studies supporting vitamin D key role in avoiding many cancers and diseases (since needed for proper DNA decoding as mentioned in second link below at 13:30 and earlier) even if this following particular study on diabetes type II is not yet published http://grassrootshealth.net/index.php?option=com_content&view=article&id=193 . For example, see the graphs in this video http://www.youtube.com/watch?v=-Za2H5oTXJY at minute 28:00 for an earlier diabetes studies and vitamin D correlation.

This information is too important to ignore totally and should be included on this page even if it is under-developed science. — Preceding unsigned comment added by Hozelda (talkcontribs) 01:25, 3 September 2013 (UTC)

include section "Major breakthrough in diabetes cure" - permanent cure

Under medications section, please include this recent breakthrough in treatment of diabetes. This is kind of permanent cure for diabetes:

http://www.cleveland.com/healthfit/index.ssf/2013/06/diabetes_breakthrough_might_re.html

http://harvardmagazine.com/2013/04/potential-diabetes-treatment-discovered

http://news.harvard.edu/gazette/story/2013/04/potential-diabetes-breakthrough/

CLEVELAND, Ohio -- Diabetes is an enormous, and growing, public health problem. To cite the most recent statistics: 1.9 million new cases were diagnosed in people 20 years old and older in 2010, and last year the disease cost this country $245 billion in medical costs and reduced productivity.

Numbers this large can be hard to take in. Here are a few that, while much smaller, hit a lot closer to home for people living with the disease.

The average person with diabetes tests his blood sugar three or four times a day (but should do it about twice as often) with a needle stick. To keep blood sugar under control, diabetics may need to inject insulin more than five times a day. That's about 10 needle jabs a day, if things are going well.

A recent discovery from a lab at Harvard University's Stem Cell Institute could be a step toward drastically reducing those painful numbers. Researchers there, led by the institute's co-director Douglas Melton, found a hormone that caused an amazing increase in the ability of mice to produce their own natural insulin.

The hormone, called betatrophin, caused up to a 30-fold boost in the production of beta cells, the cells in the pancreas that make insulin. The lab's results were published last month in the journal Cell.

"Imagine instead of taking three insulin injections a day, if you took one injection of betatrophin a month, or every year," said Melton. Then "your body makes more beta cells and then those beta cells produce the insulin you need."

And unlike synthetic insulin injections and pumps, beta cells only produce insulin when it's needed, promising the potential for much greater natural control of blood sugar, and reduced complications associated with poor management of the disease.

Diabetes now affects 25.8 million children and adults in the United States, and almost one in 10 adults in Ohio, according to data from the American Diabetes Association and the Centers for Disease Control and Prevention. The disease results in high blood sugar and is caused either by an inadequate production of insulin or when the body does not respond to the insulin it makes.

"This discovery is very exciting," said Dr. Sangeeta Kashyap, an endocrinologist at the Cleveland Clinic. "It could have a great impact for people with both types of diabetes."

In Type 1 diabetes, formerly called juvenile-onset diabetes because it tends to strike at a younger age, a patient's immune system attacks its beta cells and kills them off so the body can no longer produce its own insulin.

Unlike red blood cells, which are continuously produced throughout life by stem cells in the bone marrow, beta cells reproduce through replication, or self-copying, meaning that once all existing cells are gone, there can be no more.

While Melton believes betatrophin may be able to help slow the progression of Type 1, he said it is more likely to help those with Type 2 diabetes. Type 2 patients account for about 90 percent of diabetes cases, and their disease is usually caused by excess weight, poor diet and a lack of exercise.

It's unclear in these patients if the beta cells are still producing adequate insulin but the body cannot use it; if the cells are overtaxed by the excess demand and stop working; or if there is a gene defect that prevents the body from making adequate beta cells to keep up with the demand, Melton said.

"It takes a diabetic person years to kill off their beta cells," he said. "I think therefore if we provide a new [dose] of them, it will again take years for them to wear out. It won't be a permanent cure, but if you can do this three times in your life and each time it lasts for 10 years, then that will probably be enough." “Imagine instead of taking three insulin injections a day, if you took one injection of betatrophin a month, or every year.”

Melton said his lab, which is "sort of obsessed" with beta cells, discovered betatrophin in the fat and liver of diabetic mice that had taken a medication to block their bodies from using insulin. In response, a gene that no one had studied before kicked into high gear and the mice ramped up their beta-cell production.

The team isolated the gene (which they initially dubbed, tongue in cheek, "mo'beta") and found that not only did it rev up beta-cell production in mice, but it also exists in people.

"This gene is expressed in people in the same way," Melton said. "Betatrophin is in the liver, and it's in the serum. Now what we have to do is prove that if you inject the protein into a human, it will do the same thing."

But first, and perhaps more importantly, they need to figure out if an injection of betatrophin actually cures diabetes in a more realistic model of the disease. The mice that Melton and his team used initially were genetically altered to mimic the disease, but are very different from the real thing.

"It's sort of like a circus trick," he said, referring to the technique researchers use to create diabetes symptoms in mice that aren't diabetic. To really see if betatrophin works, they have started a test on obese mice that have become diabetic after being raised on high-fat diets.

"If we can't improve the health of a rodent by giving it more beta cells, then it means that we really don't understand what's going on," Melton said.

Those results could be available in the fall.

In the meantime, Melton's lab will continue its basic science research on betatrophin, looking for the hormone's receptor in the body. Finding a receptor, while not necessary for clinical use of the hormone in patients, will help researchers better understand how the hormone works.

Their work, which has largely been funded by grants from the National Institutes of Health, has caught the attention of biotech companies looking to develop betatrophin into a diabetes treatment.

Melton's lab has partnered with German biotech firm Evotec and international giant Janssen Pharmaceuticals, a Johnson & Johnson company, to produce the hormone for potential clinical trials.

Both Melton and Kashyap caution that the results, while potentially life-changing for millions, are preliminary.

"It's still very early in the march of science, but it's a very important early finding," Kashyap said.

Melton said the scenario where a person with diabetes gets a betatrophin shot once every 10 years is the ideal one, but "I don't think in the history of science the ideal thing ever works out.

"Things are likely to become more complicated. But if the ideal goal isn't worthwhile then you shouldn't be working on it anyway."

And this goal is most definitely worthwhile.

— Preceding unsigned comment added by Alavoor (talkcontribs) 5 okt 2013 18:27‎

I don't want to be a killjoy, but there is as of now no major breakthrough. The substance has been shown to have an effect in mice, but it's an extremely long way from a treatment for humans. Very, very few substances make it from laboratory tests to being approved medications. I have seen several promising treatments for diabetes fail, sometimes even in the late, full-scale tests on humans. So unless it becomes an approved drug it is, at best, a promising development. Sjö (talk) 07:57, 6 October 2013 (UTC)

Trial to Assess Chelation Therapy (TACT). Its relevance here.

I'm surprised this article hasn't gotten a request for inclusion of this study as a source since it also relates to diabetes, so I'm going to drop some information here. We have discussed it at the Chelation therapy article and rejected using it. You can read the discussion and the reasons for rejection here:

Here is the abstract of the study:

The full article can be downloaded free as a PDF document:

In the "Methods and Results" section of the abstract you'll find this: "However, after adjusting for multiple subgroups, those results were no longer significant." There was no effect on the group of patients without diabetes nor a mechanism of action to explain why it would work on diabetes patients, but not other patients. The difference was about 11 patients out of 300+ patients or about 3%. So, it is probably just chance rearing its ugly head and giving misleading results. As the study authors say: "These findings support efforts to replicate these findings and define the mechanisms of benefit. However, they do not constitute sufficient evidence to indicate the routine use of chelation therapy for all post–myocardial infarction patients with diabetes mellitus."

It is definitely an interesting study and we'll be allowed to report this in the article when it clears our WP:MEDRS rules, which will be when reviews of multiple studies are finished. These are preliminary and uncertain results: "...more studies are needed before it’s known whether this promising finding leads to a treatment option."[22] We don't use primary studies like this as sources, IOW we don't present the latest findings. We are not a news agency when it comes to medical matters. If anyone disagrees, they can go to the MEDRS talk page and try to get the rules changed. We can't do anything until that is done. -- Brangifer (talk) 17:48, 1 December 2013 (UTC)

We need a secondary source. This one is primary. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:59, 1 December 2013 (UTC)
My point exactly. That's why we rejected it. It just happens to be of interest and I suspect that it may get proposed here, so editors need to be aware when that happens. -- Brangifer (talk) 02:08, 2 December 2013 (UTC)

"Type-2 diabetes linked to autoimmune reaction in study"

Stanford published an early report (Type-2 diabetes linked to autoimmune reaction in study) indicating "Type-2 diabetes is likely to have its roots in an autoimmune reaction deep within the body, according to researchers at the Stanford University School of Medicine and the University of Toronto. The finding, coupled with a similar study by the same group in 2009, vaults the disorder into an entirely new, unexpected category that opens the door to novel potential therapies."

The La Times printed "Type 2 diabetes, like Type 1, may be an autoimmune disease, researchers say" April 18, 2011 which said in part "Type 2 diabetes, like Type 1, may be an autoimmune disease, but the immune system's target cells are different, Stanford researchers said Sunday. The discovery sheds new light on how obesity contributes to the onset of Type 2 diabetes and could lead to new types of treatment for the disorder, the researchers reported in the journal Nature Medicine."

More over there was "Is type 2 diabetes a chronic inflammatory/autoimmune disease?" Diabetes Nutr Metab. 2002 Apr;15(2):68-83.

So some mention of the possibility that Type-2 diabetes like Type-1 may be an autoimmune disease should be made in the article.--216.31.124.176 (talk) 06:12, 23 January 2014 (UTC)

+2 External links

  • Handbook of Life and Stress, Cognition and Health. Editors: S. Fisher and J. Reason (1988). "Stress and Diabetes" (PDF). Clare Bradley. University of Sheffield. England.
  • Diabetes Myths. American Diabetes Association.

I think these 2 external links might be very useful. Alex discussion 15:48, 28 January 2014 (UTC)

Diabetes Type I definition

The definition here assumes that the the body has stopped producing insulin, while it doesn't not stop producing insulin, but the cells that make insulin themselves are destroyed. This needs to be clarified to stop misinformation from being spread. — Preceding unsigned comment added by 76.184.24.9 (talk) 17:50, 5 December 2013 (UTC)

Maybe I misunderstand you, but the body does stop producing insulin precisely because the cells that produce insulin are destroyed. There is no misinformation about that in the article, as far as I can see. If you think there is, please explain where and what kind of information you would like to have there instead. Sjö (talk) 21:15, 28 January 2014 (UTC)

Peer Review

Peer Review

So first of all, I would like to say that I compared your two articles beginning to end (from 4/4 and today). I like the edits you have made. I think they simplify the language and update the statistics and information well.

I think it would be helpful to think about the language a bit more for example "metabolic disorder" is a term many people may not understand. Is there a way to explain it better while still using the term? Other terms I might think about include: acute,glucose (can we say sugar?), end stage renal disease, level of consciousness, coronary artery disease, altered sensation, cognitive, impaired counterregulatory response to hypoglycemia,endocrinopathies, unequivocal hyperglycemia, glycated hemoglobin (HbA1c in parentheses maybe?), improve outcomes.

I like the edits you did to the section on genetics. I think it much simplified and clarified existing information.

In the section on pancreas transplants, you say they there has been limited success but the sentence is not complete! Just think that is a typo. The pathophysiology section could definitely use some citations!

I think those are my comments from looking at what is up so far! Good luck!Lmciszak (talk) 22:44, 18 April 2014 (UTC)

I just would like to comment on the "hard words" in the article because you have asked whether it would be possible to replace some of them with terms that would be easier to understand. I am a diabetes patient, and I think the medical terms should be kept in the text. They are all explained in brackets and linked to other articles which give a proper explanation of what they mean. I have activated the popup gadget in account preferences, so I can read the introduction of the article on such a technical term when hovering over the link with the mouse. This is the way it should be in a hypertext encyclopedia. Apart from that I like the article. I think it covers most of what a patient should know about the disease as an overview. I made only a minor edit you will find in the article history. Thanks for the good work.--Aschmidt (talk) 20:30, 19 April 2014 (UTC)

Thanks for these comments to both of you, I appreciate the feedback and input! UCSFrb1983 (talk) 23:37, 23 April 2014 (UTC)

Semi-protected edit request on 3 May 2014

Tiny change: The link is missing from the letter "D" in "Diabetic neuropathy" Yueli7 (talk) 00:31, 3 May 2014 (UTC)

Yes check.svg Done thanks for the eye Cannolis (talk) 01:01, 3 May 2014 (UTC)

Orphaned references in Diabetes mellitus

I check pages listed in Category:Pages with incorrect ref formatting to try to fix reference errors. One of the things I do is look for content for orphaned references in wikilinked articles. I have found content for some of Diabetes mellitus's orphans, the problem is that I found more than one version. I can't determine which (if any) is correct for this article, so I am asking for a sentient editor to look it over and copy the correct ref content into this article.

Reference named "nps01":

I apologize if any of the above are effectively identical; I am just a simple computer program, so I can't determine whether minor differences are significant or not. AnomieBOT 06:07, 13 June 2014 (UTC)

Rcats needed

A protected redirect, Diabetes, needs redirect category (rcat) templates added. Please modify it as follows:

  • from this...
#REDIRECT [[Diabetes mellitus]]

{{Redr|to technical name|unprintworthy}}
[[Category:Protected redirects]]
  • to this...
#REDIRECT [[Diabetes mellitus]]

{{Redr|mentioned in hatnote|to technical name|unprintworthy|fully protected}}
  • WHEN YOU COPY & PASTE, PLEASE LEAVE THE MIDDLE LINE BLANK FOR READABILITY.

Template Redr is an alias for the {{This is a redirect}} template, which is used to sort redirects into one or more categories. Thank you in advance! – Paine Ellsworth CLIMAX! 20:20, 23 July 2014 (UTC)

Done Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:56, 23 July 2014 (UTC)
Jmh649, you didn't remove the [[Category:Protected redirects]]. I've now done that. --Redrose64 (talk) 21:59, 23 July 2014 (UTC)

──────────────────────────────────────────────────────────────────────────────────────────────────── And thank you! to you both, Redrose64 and Doc James. – Paine  22:27, 23 July 2014 (UTC)

Semi-protected edit request on 28 July 2014

In the smart phone era, there are few apps available to Track & Monitor Diabetes, if you include some links, it will be useful http://appsnow.us/diabetes-apps-list/ 182.72.224.10 (talk) 07:35, 28 July 2014 (UTC)

Red information icon with gradient background.svg Not done: per WP:ELNO#EL5. --Redrose64 (talk) 11:11, 28 July 2014 (UTC)

Semi-protected edit request on 21 August 2014

Treating Diabetes With Sweet Purple Leather, Treating Diabetes With Sweet Purple Leather Enars01 (talk) 13:01, 21 August 2014 (UTC)

Red information icon with gradient background.svg Not done: please provide reliable sources that support the change you want to be made. This is not a WP:MEDRS Cannolis (talk) 17:56, 21 August 2014 (UTC)

Broad international perspective

I recommend the following book for a broad international perspective useful for this article:

Sher man 3312 (talk) 13:52, 23 August 2014 (UTC).

Portal bar

I recommend the following portal bar to be added below the navigation templates: {{Portal bar|Biology|Medicine|Health}}.

Sher man 3312 (talk) 13:52, 23 August 2014 (UTC).

Edit request

Could someone please change File:Glucose-insulin-release.png to its new svg equivalent, File:Glucose-insulin-release.svg? Many thanks. --207.207.22.183 (talk) 02:15, 6 November 2014 (UTC)

 Done. -- Ed (Edgar181) 13:09, 6 November 2014 (UTC)
Cheers.--207.207.22.215 (talk) 15:49, 6 November 2014 (UTC)

Prevention of Diabetes

All diabetes is preventable. In type 1 it needs to be caught in time of the early stage of the process in order to be reversed. It has only happened in a few cases. Type 2 is preventable by taking better care of your body through better eating habits and of course exercise. Gestational diabetes is preventable in a different way, control the diabetes during pregnancy and it will surpass by the time the pregnancy is over. If following these steps diabetes is 100% preventable in anyone.

[7]

References

  1. ^ Barnard, Neal (2007). "13". Dr. Neal Barnard's Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes Without Drugs. New York, NY: Rodale/Holtzbrinck Publishers. ISBN 13 978-1-59486-528-2 Check |isbn= value: length (help). 
  2. ^ Mozaffarian D, Kamineni A, Carnethon M, Djoussé L, Mukamal KJ, Siscovick D (2009). "Lifestyle risk factors and new-onset diabetes mellitus in older adults: the cardiovascular health study". Archives of Internal Medicine. pp. 798–807. doi:10.1001/archinternmed.2009.21. PMID 19398692.  Unknown parameter |month= ignored (help)
  3. ^ Centers for Disease Control and Prevention (CDC) (2004). "Prevalence of overweight and obesity among adults with diagnosed diabetes—United States, 1988–1994 and 1999–2002". MMWR. Morbidity and Mortality Weekly Report. 53 (45): 1066–8. PMID 15549021.  Unknown parameter |month= ignored (help)
  4. ^ Risérus U, Willett WC, Hu FB (2009). "Dietary fats and prevention of type 2 diabetes". Progress in Lipid Research. 48 (1): 44–51. doi:10.1016/j.plipres.2008.10.002. PMC 2654180Freely accessible. PMID 19032965.  Unknown parameter |month= ignored (help)
  5. ^ Arlan Rosenbloom, Janet H Silverstein (2003). Type 2 Diabetes in Children and Adolescents: A Clinician's Guide to Diagnosis, Epidemiology, Pathogenesis, Prevention, and Treatment. American Diabetes Association,U.S. p. 1. ISBN 978-1580401555. 
  6. ^ Lang IA, Galloway TS, Scarlett A; et al. (2008). "Association of urinary bisphenol A concentration with medical disorders and laboratory abnormalities in adults". JAMA. 300 (11): 1303–10. doi:10.1001/jama.300.11.1303. PMID 18799442.  Unknown parameter |month= ignored (help)
  7. ^ "The End to Diabetes" John Fuhrman, 2013 HarperCollins Publishers, New York. "No More Diabetes" Gary Null 2011 New Longevity Media USA.

Piperlover7 (talk) 19:09, 28 November 2014 (UTC)

That's a great pep talk (a great call to action for public health), but it's also hyperbolically inaccurate. What should happen is different from what does happen (see, for example, your statement that "It has only happened in a few cases"). To make accurate statements in an encyclopedia article, one would have to change "All diabetes" to "Most diabetes", "100%" to "most", and so on. Not everyone who develops type 2 can permanently reverse it with diet and exercise alone, which is why some people with type 2 require prescription drugs to avoid hyperglycemic complications such as peripheral gangrene, coma, and death. Now, to your point, it is true that more people could control it with diet and exercise alone than currently do, if their diet and exercise were truly improved enough—but for most of them, it isn't. They try (some try very hard), but many fail, and at that point, maintenance of health requires some other measure as second-line therapy. That's not overmedicating or medicalization—it's humanity (humaneness). In other words, health professionals should not withhold metformin or insulin because "it's your own fault; you should have eaten better and exercised more"—that would be cruel/inhumane/criminal. If an encyclopedia article is to say, "most diabetes is preventable", then it also has to say "but the prevention often does not happen, although public health efforts are underway to increase it". As for gestational diabetes, controlling (managing) a realized instance is logically not a way of preventing a potential instance from being realized. That's like saying "I can prevent snowfall by doing a good job of snowplowing." It's a "logically challenged" statement. And regarding the ideas that (1) gestational diabetes usually resolves postpartum and (2) controlling it well enough during pregnancy can reduce the risk of postgravid type 2: these ideas are not preventive revelations; they are truisms. Now, please understand, my comments here are not to disparage good-faith public health advocacy—obviously a book such as the one cited is pushing in the right direction—but all I'm saying is that one must not abandon logic in the quest for advocacy. Regards, Quercus solaris (talk) 20:22, 28 November 2014 (UTC)

Research

Given the vast amount of research attention diabetes currently receives (pubmed gives 35,458 articles for 2014 alone), why does this article provide a special mention for inhaled insulin? I suggest either expanding the research section to give an overview of current research efforts to understand and treat diabetes (this is a lot of work), or deleting the section entirely. GyroMagician (talk) 10:07, 14 January 2015 (UTC)

Yes needs expansion. Like all of Wikipedia it is a work in progress. We could have a subpage called Diabetes mellitus research Doc James (talk · contribs · email) 00:59, 15 January 2015 (UTC)
Or at least a decent section on this page. Unfortunately, I don't really feel qualified to start writing it. Until we have something that actually covers the topic, how do you feel about deleting the Research section? Currently it gives unfair weight to one product. GyroMagician (talk) 16:56, 15 January 2015 (UTC)
If I may add my 2 cents? I never heard about "inhaled insulin" until I read this article. So I find it rather odd that it should be deleted just because the section needs expansion. As much as I dislike those butt-ugly maintenance tags, I would rather see that used than be disappointed to see the information deleted. – Paine EllsworthCLIMAX! 17:09, 15 January 2015 (UTC)
Yes inhaled insulin was available for a time. People are working on better forms of it. Doc James (talk · contribs · email) 00:28, 16 January 2015 (UTC)

Poor quality source

To Doc James: – curious as to this edit. It appears that Diabetes Zone is not used in any article on diabetes. What is meant by "poor quality" as sources go, and if the quality is so poor, then why isn't the website on Wikipedia's blacklist (so that editors will know it's not to be used)? – Paine EllsworthCLIMAX! 11:08, 30 January 2015 (UTC)

It looks like a spam site. Pictures are clip art. There are 10,000 of spam sites being generated on a regular basis. Adding them all to the blacklist is time consuming. Doc James (talk · contribs · email) 11:14, 30 January 2015 (UTC)
Okay, got it, and thank you! – Paine EllsworthCLIMAX! 18:27, 30 January 2015 (UTC)

"Diabetes"

I am surprised at this article. It has the attachments (and "trappings") of science, but as a diabetes suffer (T2, some 12 years) the articles is not scientific.

One may well ask for "specific" citations, but the "tone" is incorrect. The phrase (3.rd paragraph) "Type 1 diabetes must be managed with insulin injections." "At the current state of research" ought precede such a statement. The "must" is what exactly ? Only clinical treatment available ? That is we assume the pancreas cannot recover, and that the root cause is unchangeable, and nothing else is discovered, THEN insulin is the only medical treatment, to lower blood glucose.

I say this because other treatments are possible, in Type 2 at least, "insulin" provision is not the only technique (set aside "tablets", etc.), to overcome "glucose excess", I myself use one of them, from experience, and have halved my need of injections, with several advantages. I find the article a verbal advocacy of an established technique (from the 1930's), it notes none of the side effects of this medication (this is a serious omission), nor anomalies of the theory, allergies (porcine short-term insulin, for example), and provides no prospects for the sufferer, and excludes all possibilities of other remedies. The diagnosis is defective (and denies certain symptoms). What is more, "hepatic insulin resistance", known since at least 1995, receives no mention -- the root cause of diabetes may well be a disorder of the liver, and the use of "force" (that is insulin) may in fact be as much a problem at higher levels as a solution. The broad term "body insulin resistance" is not good enough, since if the liver were involved (a major organ), then specific treatments can be considered. (But the convention blames "peripheral resistance", because of -- lack of knowledge !) We are "re-plastering" the walls, and ignoring the faulty foundations.

The patient suffers the ill-effects of either excess glucose or of the insulin treatment, or combined effects of both.

<See J.Clin.Invest.2005:115(5:1136-1139 (May 2, 2005) -- Google "hepatic insulin">

121.219.15.247 (talk) 12:17, 3 February 2015 (UTC) Peter LINAKER ASMB, BSc.

Yes currently insulin is the treatment for 99.9% of type 1 DM. Yes there are experimental treatments but they get less weight. Doc James (talk · contribs · email) 22:57, 3 February 2015 (UTC)

Change Req

Please change the last line (There are several advantages of inhaled insulin: they are convenient and easy to use and provide a useful alternative therapy for patients who cannot use intravenous insulin.) substitute subcutaneous for intravenous. IV insulin is generally only used in a hospital setting, whereas sub cue insulin is what inhaled aims to replace.

Also, why is this page protected? — Preceding unsigned comment added by 65.201.156.174 (talk) 18:19, 27 February 2015 (UTC)

Adjusted wording. Doc James (talk · contribs · email) 21:50, 5 March 2015 (UTC)

Heading

The second bullet in this article reads:

Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly.[3] As the disease progresses a lack of insulin may also develop.[6] This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes". The primary cause is excessive body weight and not enough exercise.[3]

This draws much too strong a link between obesity and inactivity as a cause for type 2 diabetes. The citation for this statement is apparently a WHO Fact Sheet. Problem is that the citation in question is to a publication titled:

"Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus. Geneva, World Health Organization, 1999 (WHO/NCD/NCS/99.2)."

Note that the citation is to a publication focusing on "Diagnosis" and "Classification" not CAUSALITY.


In contrast, see how the Mayo clinic discusses this same issue online:

Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas stops producing enough insulin. Exactly why this happens is unknown, although genetics and environmental factors, such as excess weight and inactivity, seem to be contributing factors.

http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/basics/causes/con-20031902

Carlos

Cebonilla (talk) 21:33, 5 March 2015 (UTC)

If you click on ref three it takes you to the WHO site http://www.who.int/mediacentre/factsheets/fs312/en/ which says "is largely the result of excess body weight and physical inactivity" so our content looks good. What Mayo is talking about is mechanisms rather than etiology. Doc James (talk · contribs · email) 21:53, 5 March 2015 (UTC)

Medications

User jytdog, Why do you think it is edit war on medications? I am adding useful information to the section with reliable references. Why do you want the section to talk about anti-inflammatory drug Aspirin but not an oral anti-hyperglycemic, Sulphonyl urea ? I am , to say the least, intrigued. Although there is a long separate article on antidiabetic medications , I believe, we have to make some mention of different classes of medication on this page too. Please tell me what your specific objections are ? You removed, uncited text, fine but now I have included information from peer reviewed journals with citations? Is there anything that I have missed ? Thanks.Jonathansammy (talk) 15:30, 7 April 2015 (UTC)

thanks for your note. you have put the same content in about three times now, and both Doc James and I have removed it. rather than putting it back you should have opened a discussion after the first time, and asked about what is going on - that is what the Talk page is for.
i think your desire to WP:SYNC the two articles is quite good. but yes, everything needs to be sourced, and sourced per WP:MEDRS. (please read that if you have not)
i don't know where you got the sourcing you used, but there is a source from 1999 (16 years old!) a source from 2005, another from 2006. these are all way too old.
here is how this should work, when we are doing great work. per WP:SUMMARY, this section should be the relevant parts of the lead of Anti-diabetic medication, with sources added, taken from the body of that article. I think the lead of the Anti-diabetic medication article is pretty poor, and should be fixed, and then brought over here, with sourcing from that article. I don't know where you got your sourcing from in the content that you added but it is not good. : does that make sense? Jytdog (talk) 16:39, 7 April 2015 (UTC)

No problem. Thanks for the comments. With in next day or two, I will add updated references that are from 2010 and later. In the meanwhile, please do not revert the changes. Jonathansammy (talk) 17:15, 7 April 2015 (UTC)

no no you are missing the point! the article that needs to be updated the most is Anti-diabetic medication! When that is updated, and the lead is updated, the lead should then be copied over here, with sources from that article. That is how you keep related articles in sync. does that make sense? 17:55, 7 April 2015 (UTC)

User jytdog, At present I do not have much time to work on the Anti-diabetic medication. If I change anything in the lead on that article, I will have to make changes, add references etc. to the main body too. That is why I just want to concentrate on the DM article and provide more recent references as promosed and please feel free to revert my edit on DM if that is not done. Thanks.Jonathansammy (talk) 19:40, 7 April 2015 (UTC)

I summarized your additions. Many of the specific details belong on the subarticle IMO. Doc James (talk · contribs · email) 20:30, 7 April 2015 (UTC)

USER:Doc James, Thank you for summarizing my additions. You could further help by clarifying what is "outcomes" when talking about ACE and ARB inhibitors. Same goes for Aspirin. The references make it clear the outcomes refer to cardiovascular events but perhaps you can say it in pithy concise sentences. Also under earlier paragraph on oral medicines, we start with saying "Metformin is generally recommended as a first line treatment for type 2 diabetes..." However, later we say " These include agents that increase insulin release, agents that decrease absorption of sugar from the intestines, and agents that make the body more sensitive to insulin.. Since Metformin falls under the bolded third category, do you think this paragraph should be reworded ? Let me know. ThanksJonathansammy (talk) 21:55, 8 April 2015 (UTC)

Ref says metformin works by by decreasing production of glucose by the liver? Doc James (talk · contribs · email) 19:48, 9 April 2015 (UTC)

Yes you are right but Drugs.com[23] says Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. This book[24] also list Metformin as insulin sensitizer. Well, I hope you get my point. Please also let me know what reference you are refering to ? Thanks.Jonathansammy (talk) 23:22, 9 April 2015 (UTC)

Jon, decreasing hepatic glucose production means exactly what Doc said (it means decreased glucose production by the liver). Also, drugs.com is not exactly the best reference for claims like that. The medical literature itself is strongly preferred over a source like that and I guarantee you there's no shortage of review articles discussing metformin's mechanisms of action. TylerDurden8823 (talk) 01:35, 10 April 2015 (UTC)
This is the ref in the article. I guess this article might not be the best place to discuss the individual mechanisms of the meds. That might be better in the sub articles. Doc James (talk · contribs · email) 20:13, 10 April 2015 (UTC)

Cure

I still don't understand it. I've read about a cure yet there isn't anything about it anywhere. — Preceding unsigned comment added by Skele (talkcontribs) 23:13, 17 June 2014 (UTC)

Probably because no viable cure exists.--Coro (talk) 22:27, 18 June 2014 (UTC)
If you have reliable sources we can consider. But yes no cure really except if you count bariatric surgery. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:21, 18 June 2014 (UTC)
The magazine article was in my country's (Finland) science magazine called Tieteen Kuvalehti. It was published in the 80's. It read about a Russian scientist/doctor who started giving electric treatment to the pancreas of the patients who had been diagnosed with diabetes under a year of the treatment. The treatment was given once a week for a few months if I remember correctly and after that the patients were completely cured of diabetes (It didn't specify which type but probably type 1).
I think the scientist was trying to kill the bacteria or virus that was blocking the passage to the pancreas and, according to the article, succeeded. Yet there is a possibility that the electrical treatment had some side effects and because of that wasn't marked as a cure. Nevertheless if the article was true it would be a viable cure, but I just can't find any source of the experiment taking place which makes it less possible that the article is true even though the magazine is a very reliable source. Skele (talk) 00:20, 19 June 2014 (UTC)
We would need a high quality source. The popular press often get a little ahead of themselves. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:49, 19 June 2014 (UTC)
Well, just need to keep looking.Skele (talk) 12:25, 19 June 2014 (UTC)
No viable cure? What do you call people going off medication while eliminating insulin resistance and all symptoms then? The cure is to lose weight and reduce fat consumption. Insulin resistance goes away when intramyocellular lipid is reduced sufficiently, and diet is low fat. Type 2 diabetes is completely curable. Not by drugs or surgery, but by dropping weight, eating right, and exercising. It takes time to drop the weight, but once it's down, A1c becomes good again and insulin resistance disappears. See the peer-reviewed references at the very bottom of the following page: https://www.drmcdougall.com/misc/2009nl/dec/diabetes.htm 2605:A601:5AF:2B01:E893:BF87:1931:8015 (talk) 17:23, 22 April 2015 (UTC)

Sugar diabetes

Fuse809 (talk · contribs) added "sugar diabetes" as a synonym to the lead. This is imprecise slang, and actually searching Google with the term doesn't lead to any key pages that primary discuss this subject. A redirect would be reasonable, but I don't think we should be promulgating the view that excessive sugar intake is the cause of diabetes. It might be, to some extent, but not enough to introduce this concept widely. JFW | T@lk 21:41, 6 October 2014 (UTC)

Sugar can refer to glucose, which is blood sugar. People with diabetes often have to monitor their blood sugar, hence sugar diabetes is an acceptable synonym. Brenton (contribs · email · talk · uploads) 04:05, 7 October 2014 (UTC)
Google books pulls up a fair number of cases [25]. It is a relatively common term among the lay public. Should be mentioned somewhere. Maybe not in the lead though. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:59, 7 October 2014 (UTC)
Note that it is also, roughly, a partial transliteration of "mellitus"; and that "sugar diabetes" showed up in medical writing until roughly 100 years ago. Anmccaff (talk) 19:37, 21 May 2015 (UTC)
User:Anmccaff I have added it under naming in the body of the article. Doc James (talk · contribs · email) 12:49, 22 June 2015 (UTC)

Diet & exercise

Works:

Worth including in the "Prevention" section in some form or another. JFW | T@lk 11:03, 14 July 2015 (UTC)


Smoking

We cannot say definitively, based on the existing evidence, that smoking directly increases diabetes risk. [1] — Preceding unsigned comment added by Svedingo (talkcontribs) 11:39, 19 September 2015 (UTC)

References

Screening

doi:10.7326/M14-2221 systematic review for USPSTF. JFW | T@lk 11:19, 14 April 2015 (UTC)

And now followed by recommendations doi:10.7326/M15-2345 JFW | T@lk 09:40, 27 October 2015 (UTC)

Cures: Bypass surgery and Roy Taylor's fat and starvation theories

Summary: After remarks (see below) by users jytdog and Doc James (the links are to their talk pages), this entry and the bypass entry have been edited to the affect that the sources I brought, most of them copied from an existing entry on gastric bypass surgery, were not acceptable by WP standards. Following that, and my discovery of further evidence about this, my edit was corrected and mostly reverted. Thank you Doc James and Jytdog. פשוט pashute ♫ (talk) 09:50, 27 October 2015 (UTC)


I was careful to double and triple check claims by Prof. Roy Taylor with reliable sources, while noting that his theories of both the source (and not merely symptom) of diabetes, and about a possible cure through starvation are NOT ACCEPTED by the mainstream medical community. I added this at the beginning and at the end of the new section, with sources - all secondary, none of the original research, all valid and solid scientific sources, substantiating the report about Prof. Taylor's theories and their possible scientific merit.

Albeit, I was not able to find anyone who directly confronted Prof. Taylor's theories, so I noted the controversial history of starvation therapy which was used prior to the discovery of insulin. This too is substantiated in a thorough report by Allan Mazur found at the National Center for Biotechnology Information, and itself well documented and sourced, and with no controversy.

While researching and following material about Taylor's theory and in particular his explanation of gastric bypass surgery's success, (of which I wasn't sure was factual) I came across the research about the small intestine's behavioral change in rats, confirming that the bypass surgery in fact does work, and that it was only being researched as to the reason this was true.

Only then did I read the wp article on gastric bypass surgery in the wp. Saw what looked like accepted information (especially after the article about the rats) and therefore adapted it to this article with the sources unchanged.

Is there anything wrong with that information. Is the 90% success contested? Is that the promotional material based on primary sources? I confess, I didn't go deeply into it, although I gladly will, if you tell me its needed.

Yours, in good faith, Moshe, aka פשוט pashute ♫ (talk) 23:10, 20 May 2015 (UTC)

Pories content

The following content was added by Pashute first [ https://en.wikipedia.org/w/index.php?title=Diabetes_mellitus&type=revision&diff=663283524&oldid=662666428 here] and again here after i reverted it.

Discovered and reported by Walter Pories and Jose F. Caro in 1994, type 2 diabetes is reversed in up to 90% of obese patients going through gastric bypass surgery usually leading to a normal blood-sugar level without medication, sometimes within days of surgery.[1][2][3][4] The surgery has also been shown to assist in the prevention of Type 2 diabetes by more than 30-fold in patients with pre-diabetes.[1]

According to research by Professor Roy Taylor from Newcastle University, diabetes is mostly caused by abnormal fat storage, which can be reversed through fasting and an extreme diet followed by exercising.[5][6] Taylor also theorized that the drastic change of diet is the cause for the apparent reversal of diabetes symptoms in obese patients that had went through gastric bypass surgery, but recent research has shown that a change in behavior of the small intestine, consuming excess glucose out of the blood, is the source for the perceived withdrawal of diabetic symptoms after the surgery.[7] Starvation therapy had been promoted prior to the discovery of insulin with disputed results.[8]

Taylor's theories about the source of diabetes or its cure through an extreme diet have not been accepted by the mainstream medical authorities.[9][10]

References

  1. ^ a b Long, SD; O'Brien, K; MacDonald KG, Jr; Leggett-Frazier, N; Swanson, MS; Pories, WJ; Caro, JF (May 1994). "Weight loss in severely obese subjects prevents the progression of impaired glucose tolerance to type II diabetes. A longitudinal interventional study". Diabetes Care. 17 (5): 372–5. doi:10.2337/diacare.17.5.372. PMID 8062602. 
  2. ^ "Magee pilot study probes further into weight-loss methods". March 3, 2010. Retrieved 6 January 2014. 
  3. ^ Pories, WJ; Caro, JF; Flickinger, EG; Meelheim, HD; Swanson, MS (September 1987). "The control of diabetes mellitus (NIDDM) in the morbidly obese with the Greenville Gastric Bypass". Annals of surgery. 206 (3): 316–23. doi:10.1097/00000658-198709000-00009. PMC 1493167Freely accessible. PMID 3632094. 
  4. ^ Pories WJ, Swanson MS, MacDonald KG; et al. (September 1995), "Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus", Ann. Surg., 222 (3): 339–50; discussion 350–2, doi:10.1097/00000658-199509000-00011, PMC 1234815Freely accessible, PMID 7677463. 
  5. ^ Roy Taylor's research on diabetes and its reversal (Newcastle University website)
  6. ^ Slim no defence against diabetes (December 16, 2014, Daily Mail)
  7. ^ Small intestine explains diabetes 'cure' after gastric bypass, in reference to research published in Science magazine (July 26, 2013, Medscape website)
  8. ^ Why were "starvation diets" promoted for diabetes in the pre-insulin period?, Allan Mazur (Retrieved from the NCBI website, May 2015)
  9. ^ Cite error: The named reference webmd was invoked but never defined (see the help page).
  10. ^ Prof. Roy Taylor testimony about his diabetes research at the United Kingdom parliamentary Committee of Public Accounts.

So this is not how we write about health in Wikipedia. Please see WP:MEDMOS for style and WP:MEDRS for sourcing. Almost none of the sources above are OK. Happy to discuss. Jytdog (talk) 23:32, 20 May 2015 (UTC)

So you obviously did not read my comments above.
Please do read my remarks in the section before yours and respond with details.
Please see Gastric Bypass Surgery #Results and health benefits of gastric bypass. All sources and most of the wording about bypass surgery ]are from that section...
Thank you, Moshe aka פשוט pashute ♫ (talk) 01:03, 21 May 2015 (UTC)
sorry i missed your note! Please do read WP:MEDRS and WP:MEDMOS, and let me know when you are done so we can talk more. Thanks. Jytdog (talk) 01:16, 21 May 2015 (UTC)
1. I edited my original note for clarity. Please read my remarks about my experience and legacy, and understand that I have read MEDRS and MEDMOS. Please stop patronizing.
Please also understand that now that you noticed my note on the talk page, you may realize that you are the one who has engaged in a possible edit war, which is not good for anyone. I accept your apology for not noticing it, but expect, at least at the end of this discussion that you say something about future quick actions such as yours prior to notifying the editor and also about your bulk reverts of edits.
2. So: Which is the problem at? any or part of or all of:
2a. Bringing up Taylors method which has not been formally accepted by the medical establishment? As I showed, Taylor is NOT a Benveniste type of Homeopath medicine advancement guy. It seems more like an early stage of change of view. He has been a distinguished presenter at the governmental committee discussing diabetes. His research is solid. His theories MAY be contested, but, as I wrote above, I found no one contesting them. It is simply stated currently as the prevailing belief that there is no cure to diabetes. Putting all that together with the extra evidence as I listed in my first entry above it is obvious that his theory MUST be mentioned, but with due warnings, exactly as I did.
2b. In any case his theory has become extremely notable following various promotional writings in the Guardian (where a reporter had "tried" it on himself) and other non-scientific media outlets including the web. All those I skipped and eliminated precisely because of RS and MOS.
2c. Or maybe it is the Gastric Bypass? Did you take a look at that section of the wp article I pointed to?
2d. Are you saying that the facts stated about the Gastric Bypass surgery in healing diabetes are not true? Or that they are based on primary sources? (I did not look into it only gave the sources a glance). If so you should have an issue with THAT article...
2e. Could you point me to some information contesting the method and its affect on diabetes. I really did NOT look into it, other than, as stated above, seeing an article that contests Taylor's explanation of the success of Gastric Bypass surgery. Which surprised me with the claim that it works. I then saw the WP article, saw that it was sourced, not contested, and written concisely and clearly, and with complementing information important to the topic at hand, took its wording and fit it in the article with the original sources, while glancing at them briefly seeing what seemed to be reliable and non primary sources. פשוט pashute ♫ (talk) 01:52, 21 May 2015 (UTC)
so if you have read and understand MEDRS then you know that not a single source there is OK. (i really was trying to give you a chance; sorry that you saw that as patronizing) Jytdog (talk) 01:59, 21 May 2015 (UTC)
So if you read my remarks, you understand that your issue is mainly with the gastric bypass surgery article. Did you give it a glance?
I'll leave that to the end and lets look at the sources that I brought (and did not copy):
NCL website: Roy Taylor's research on diabetes and its reversal (Newcastle University website)
Is that a primary resource? No it is not. It is quoting and showing a list of research papers by various members of the Newcastle University Magnetic Resonance Center, and summarizing what their work is about. It points to primary resources, but itself it is the university showcase, a secondary resource, perhaps not a medical publication, but definitely a reliable resource for THE FACT THAT TAYLOR HOLDS THIS THEORY. About the truth and correctness of his methods and findings - EXACTLY BECAUSE of the lack of secondary sources confirming his findings, at least, to the best of my knowledge, I carefully noted that his findings a. Have not been accepted (wrote it twice at the beginning and end) and b. specifically noted that similar methods where used historically 100 years ago, with disputed results. (later, we'll get to the source for that, which is more historical than medical information.)
Is it not a reliable source? Is Prof Taylor not using acceptable methods, or have his research or credentials been contested?
Daily Mail: Slim no defence against diabetes (December 16, 2014, Daily Mail)
This secondary source is based on Taylors research published in the Clinical Science journal, and summarizing it in layman terms.
Clinical science is of course a peer reviewed journal. The Daily Mail of course is NOT pubmed, but it is not brought to prove the validity of the theory, but only its content (and in this case, only the foundation to his theory that diabetes pertains to a fat disorder, told as an aside to the main theme of the article that thin people can get diabetes).
Checklist:
Controversies or areas of uncertainty in medicine should be illustrated with reliable secondary sources describing the varying viewpoints.
- [Done: Varying viewpoints described]
Primary sources favoring a minority opinion should not be aggregated or presented devoid of context in such a way as to undermine proportionate representation of expert opinion in a field as presented in secondary sources.
-[Done: Given context]
If the same material could be supported by either a primary source or a secondary source, the secondary source should be cited.
- [Missing full secondary refs. Gave closest as possible]
A primary source may be presented adjunctIvely to a secondary source.
- [So even if the first one is primary, the second is (not the best but an available) secondary]

for nowפשוט pashute ♫ (talk) 02:59, 21 May 2015 (UTC)

Per WP:MEDRS
We should use high quality secondary sources. Neither the Mail nor the NewCastle website is one
These sources should be relatively recent last 3 to 5 and maybe 10 years.
Best Doc James (talk · contribs · email) 07:50, 21 May 2015 (UTC)
Very nice. So we don't have those. -
a. I'm talking only about Taylor now, how would you write about his research? Can it be totally ignored?
b. I just found this diabetes.org article. So now I understand the lacking. It is evolving research, seemingly a promising venue, with 2.4 million pounds invested, and should end only in 2018. But on the other hand I now found some disturbing articles which I missed before:
c. I found this response by a doctor:
Re: Dangerous advice on diabetes?
No one would recommend someone with a BMI of 21 to lose weight. This sounds like the Allen starvation diet used to keep type 1 patients alive in the pre-insulin era. Starvation certainly "cures" diabetes; see for example, what happened in occupied countries during World War II. But, it is not a treatment. Even in people for whom such a diet might be indicated, the concern is the loss of protein with its associated muscle wasting and immune suppression. Of course not eating will lower blood sugar, but at some point a person either eats or starves to death. Actually you do not "starve to death", your immune suppression eventually results in a fatal infection. The article is misleading at best and could result it risky behavior at worst.
d. Later in the same discussion group:
I am most grateful to Prof.Roy Taylor, who has responded to my email asking for his comments on the Guardian article, which referred to one of his recent papers. He has replied as follows, in which he refers to his Banting Memorial Lecture to the Glasgow Conference on Diabetes, 2012, which was published in Diabetes Medicine (March 2013, pp.267-275) http://onlinelibrary.wiley.com/doi/10.1111/dme.12039/full
_____________________________________________________
Dear John, Thank you for inviting my comment.The main point of interest in the report of Richard Doughty is that he was no overweight yet had type 2 diabetes. This causes enormous confusion as it is commonly thought that only fat people get type 2 diabetes, and some researchers even suggest that non-obese type 2 is a different disease. The latter point is clearly not correct in view of how type 2 incidence changes with food supply in populations. By the Twin Cycle Hypothesis (see appended lecture write up – Just read the Intro, Legend to Fig 9 and Summary!) a person developing type 2 merely has more fat on board than their body can cope with. So lose the diabetes by going from BMI of 23 to 20. The archetypal such person is Asian. The recent BMJ paper on change in BMI distribution in Cuba during the food shortage 1991-96 make the point nicely. The left shift in the frequency distribution curve of BMI does not look huge – but the whole population lost 5.5kg each and incidence of type 2 diabetes halved. The bottom line is that type 2 diabetes is reversible, even if the person has a “normal” BMI.Do come back to me with Q if anything is obscure.Best,
Roy
e. Another primary source is Pathogenesis of type 2 diabetes: tracing the reverse route from cure to cause Taylor's article from 2008 (!) on pubmed. So he's been promoting this for a long time, and referring to his theories as fact. The article ends with the following two lines: These defects are capable of dramatic reversal under hypoenergetic feeding conditions, completely in early diabetes and to a worthwhile extent in more established disease.
f. It seems that Taylor had been publishing in 2008 on an Open Access (online only) magazine, a practice usually tied with pseudo-science or problematic promoted practices, and problematic and sometimes unrecognized institutes.
g. And I finally DID find someone who contested Taylor's results directly: Here it is Why very low calorie diets VLCD won't solve the diabetes crisis. But the criticizer is problematic, owning a business that consults on a different diet (inducing ketosis) itself also claimed to cure diabetes, in accordance with claimed: "many peer reviewed studies over the past 10 years that delivered the same results using a low carb high protein diet."
h. Still, not one established scientific source has contested the idea head-long, but the silence is well heard.
Summary:
1. It has all the elements of a fad, and should probably be reported as such in a section of its own.
2. It is a borderline case, coming from an actual university, with both authentic research, and a seemingly plausible theory.
3. It has been widely promoted in the media.
3. Ignoring it is NOT the way to go IMHO. So how would you report this, and under which section?
Coming soon: The Gastric Bypass surgery. פשוט pashute ♫ (talk) 10:44, 21 May 2015 (UTC)
Sure bariatric surgery is sometimes an effective measure in those with type 2 DM. We previously said that in the lead. I have also added it to the body.
We mention weight control a number of times. What content do you feel needs adding?
Diets do not work on a population level as most people are unable to loss weight as they are unable to decrease the amount the eat. So well they may theoretically work they do not work in reality.
PLOS Medicine is not a magazine but a well respected journal by the way :-) Doc James (talk · contribs · email) 10:58, 21 May 2015 (UTC)
By the way the starvation diets were used with some success for type 1 DM not type 2 DM before the discovery of insulin. The two diseases at least initially are very different. A discussion of Ray Taylor's theories do not belong on this article IMO. A discussion of bariatric surgery does. Doc James (talk · contribs · email) 11:08, 21 May 2015 (UTC)
the gastric bypass surgery article is based on old sources - i plan to update that over the weekend and bring the updated content back over here. Jytdog (talk) 11:26, 21 May 2015 (UTC)
I added some. Doc James (talk · contribs · email) 11:39, 21 May 2015 (UTC)
The two diseases... sadly I know, and not from listening to my professors at university... פשוט pashute ♫ (talk) 11:50, 21 May 2015 (UTC)

────────────────────────────────────────────────────────────────────────────────────────────────────This looks like a time where one of Unca Mac's Incredible Citeless Rants is required; some of the discussion above looks, frankly, martian.

Outside of the Daily Mail, and things of that ilk, Dr. Taylor is not a plucky David taking on the EEvULL!!! Medicall EsTABlisment!!, nor is he a proponent of any non-standard therapy on wide scale, nor is he a crank. He's a -some might say -the- pillar- of one wing of diabetes research, his findings are not particularly controversial, and, with the exception of a small number of "highly motivated patients," and a possibly slightly larger number of non-obese victims of type II, he does not see the diet touted in yellow journalism like the Mail as clinically useful in itself any more than any other physicians do. For most patients, the circumstances that got them in trouble in the first place mean they will be unlikely to even finish the eight weeks, never mind maintain an appropriate calorie intake afterwards, and putting someone on a diet that suggests "arbeit macht frei" more than "first, do no harm" can only be justified if you are fairly certain it is going to work.

IOW, there isn't a controversy here. There is no actual "fad." (Ever try eating only 800 calories a day, give or take, and only 600 of those "easy" calories, for two months straight? Yeah, people are lining up to do that, I'll bet.) There is no widespread change in therapy; Dr. Taylor has suggested it might be useful for a small number of patients, under carefully controlled circumstances, but this was a (successful) test of a hypothesis about the proximate cause of type II; it was basic research, not something intended for short term clinical use.

Finally, there is absolutely no meaningful connection between low-calorie diets of pre-insulin days, and this diet; one's acute, the other chronic.

Thus endeth the Rant Anmccaff (talk) 20:48, 23 May 2015 (UTC)

Yup. We simply use review articles to discuss the content in question. Taylor is just one of many researchers. Loosing weight as a way to improve DM type 2 is not controversial. We state it many times already. Doc James (talk · contribs · email) 23:59, 23 May 2015 (UTC)

Semi-protected edit request on 16 November 2015

Fought a diabetes who offer online view
some one help adding into the article?

Pathophysiologic Approach to Therapy in Patients With Newly Diagnosed Type 2 Diabetes

http://care.diabetesjournals.org/content/36/Supplement_2/S127.full


http://care.diabetesjournals.org/content/36/Supplement_2/S127.extract?sid=26724552-84e7-4f19-a334-346c26f1b8b8


36.225.100.123 (talk) 14:31, 16 November 2015 (UTC)

What do you want to add and to which section? Doc James (talk · contribs · email) 13:58, 17 November 2015 (UTC)
Since the OP has not responded and the request was not clear anyways I have changed the answered parameter of this request to yes. The IP is more than welcome to reactivate if they want to. If they do please format your request in a "Please change X to Y" format. Thank you. --Stabila711 (talk) 01:27, 19 November 2015 (UTC)

ADA 2016

The ADA has issued Standards of Care for diabetes again. Here it is: http://care.diabetesjournals.org/content/39/Supplement_1 - likely to be important for this article and its subarticles. JFW | T@lk 09:13, 1 March 2016 (UTC)

Seeming contradiction in the Diabetes page

Currently Reads

The primary cause is excessive body weight and not enough exercise....

Type 2 DM is due primarily to lifestyle factors and genetics.


Suggested Rewrite for both of these statements:

Type 2 DM is due primarily to lifestyle factors (including excess weight and lack of exercise) and genetics.

Ceb20816 (talk) 18:46, 21 March 2016 (UTC)

Not really contradictory. The two lifestyle factors that are most important are excess weight and not enough exercise. Doc James (talk · contribs · email) 04:41, 22 March 2016 (UTC)
It would help to clarify that genetics predisposes to diabetes, but that the lifestyle factors generally provoke its development. JFW | T@lk 14:11, 3 April 2016 (UTC)

Monogenic diabetes

Endocrine Rev doi:10.1210/er.2015-1116. Posted here because it discusses the broadened understanding of diabetes in general through the studying of the monogenic types. JFW | T@lk 14:11, 3 April 2016 (UTC)

Cause of type 2 DM

WHO says "is largely the result of excess body weight and physical inactivity."[26] Doc James (talk · contribs · email) 07:53, 16 January 2016 (UTC)


Obesity seems to be a result of than a cause of. Even a fetus gets obese if the blood sugar level is messed up. It is doubtful that the fetus is raiding the frig. Losing weight may take some pressure off the body but it is unlikely ,except in very marginal cases, that weight loss tips the balance. Insulin allows diabetic to live long enough to have children. The maps seem to show that poorer countries have less diabetes but a higher death rate(years shorter lives) among those who have it. Seems to suggest heredity is the problem - obesity is a symptom. 2601:181:8000:D6D0:5D:1451:B2BE:D159 (talk) 23:00, 6 April 2016 (UTC)

Cause of Type One Diabetes

I heard on the news on the Today programme on Radio Four this morning (April 20) that a new research project is currently being conducted, suggesting that, contrary to received wisdom, Type One diabetes may not be an auto-immune disease but may have more to do with the beta cells. I do not wish to edit this article as I am not a medical doctor, but if any one reading this is and knows of this current research, s/he could do some welcome edits. Vorbee (talk) 20:24, 20 April 2016 (UTC)

If this is based on Prof Wilkin's research (Yes? No?), it isn't so much that he's ignoring immune response, but rather working on what triggers it, and whether the interventions used in early fullblown type one and two will nip the problem in the bud. This is a lot like the move in type II to go with metformin first -in fact, it's exactly parallel. Anmccaff (talk) 21:32, 20 April 2016 (UTC)

Semi-protected edit request on 27 April 2016

Reference 83 Dallas, John (2011). "Royal College of Physicians of Edinburgh. Diabetes, Doctors and Dogs: An exhibition on Diabetes and Endocrinology by the College Library for the 43rd St. Andrew's Day Festival Symposium".

Links to a webpage on a site I manage that no longer exists.

I can't delete it because the page is semi protected.

It would be helpful if someone could delete this incorrect reference.

Thanks. RCPE-99 (talk) 12:20, 27 April 2016 (UTC)

 Done  Stick to sources! Paine  02:25, 28 April 2016 (UTC)

Risk of death

"Diabetes at least doubles a person's risk of death".

What does this mean? Death is a certainty for everyone, whether you have diabetes or not. 85.255.233.202 (talk) 13:00, 22 May 2016 (UTC)

That is the wording sources us. It means early death. Doc James (talk · contribs · email) 17:06, 22 May 2016 (UTC)
I can't find anything resembling the wording in ref. 3, which is cited as the source. Can you point me to an alternative? 85.255.232.123 (talk) 19:37, 22 May 2016 (UTC)
Yes looks like that ref changed. This one says that wording http://www.clinicalendocrinologynews.com/specialty-focus/diabetes/single-article-page/easd-diabetes-doubles-death-risk-from-many-causes/5800533044840677c5b1dc8025915e95.html Doc James (talk · contribs · email) 23:48, 22 May 2016 (UTC)

Here is the other https://web.archive.org/web/20130826174444/http://www.who.int/mediacentre/factsheets/fs312/en/

"The overall risk of dying among people with diabetes is at least double the risk of their peers without diabetes" Doc James (talk · contribs · email) 23:51, 22 May 2016 (UTC)

Thanks for the clarification. It seems that the wording was included in the 2013 version of WHO Factsheet No. 312, and no longer features in the current (March 2016) version. I'm sure it was deleted for a reason! Rather than change the article's ref. 3 to point to the outdated 2013 version (as you've done), wouldn't it be better to retain the link to the live WHO webpage and instead support the "double risk" statement with the other link you provide? That article you cite (at www.clinicalendocrinologynews.com) at least makes it clear that it is the risk of death "from many causes" that is doubled, which makes far more logical sense to me than the concept of an "overall risk of dying". 185.69.145.78 (talk) 07:02, 23 May 2016 (UTC)
There is both an increased risk of death from many causes and of death overall. Doc James (talk · contribs · email) 20:54, 23 May 2016 (UTC)
It makes sense to me to talk about an increased risk of dying from one or more specific causes (e.g., "you are twice as likely to die from a stroke, if..."). It also makes sense to talk about an increased risk of premature death (e.g., "you are twice as likely to die early, if..."). But it doesn't make sense to say "you are twice as likely to die, if...", because you are already 100% certain to die, and nothing can increase or decrease that risk. Why should the Wikipedia article continue to speak of a doubled "overall risk of dying" when the original source (the WHO Factsheet) has seen fit to drop that phraseology? (P.S. Sorry for all the different IP addresses, I'm using mobile broadband) 212.183.128.143 (talk) 08:55, 24 May 2016 (UTC)
Changed it to "Diabetes at least doubles a person's risk of early death." Doc James (talk · contribs · email) 09:46, 24 May 2016 (UTC)

Eurostemcell editathon at the University of Edinburgh MRC Centre for Regenerative Medicine

Hi, looking to run a Eurostemcell editathon at the University of Edinburgh's MRC Centre for Regenerative Medicine on 20th July. Can the edit protection be lifted/reduced for this page for our editors for the purpose of this event? The event page is here. Or is it a case of submitting the proposed change after our editors have drafted new text during the event? Many thanks, Stinglehammer (talk) 22:46, 11 July 2016 (UTC)

Have you reviewed WP:MEDRS and WP:MEDMOS?
We have had issues with overly optimistic content about stem cells over the years. Doc James (talk · contribs · email) 08:51, 12 July 2016 (UTC)
Hi, have reviewed the pages indicated and disseminated to our editors. Would we therefore be ok to submit new material to the page following our editing session on Wednesday next week? Stinglehammer (talk) 11:06, 15 July 2016 (UTC)
Sure on the talk page if they are not confirmed editors. Doc James (talk · contribs · email) 19:29, 15 July 2016 (UTC)

Fully protected edit request on 2 August 2016

A protected redirect, Diabetes, needs redirect category (rcat) templates adjusted. Please modify it as follows:

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#REDIRECT [[Diabetes mellitus]]

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#REDIRECT [[Diabetes mellitus]]

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The {{This is a redirect}} template is used to sort redirects into one or more categories. When {{pp-protected}} and/or {{pp-move}} suffice, the This is a redirect template will detect the protection level(s) and categorize the redirect automatically. (Also, the protection categories will be automatically removed or changed when and if protection is lifted, raised or lowered.) There is a page move in this redirect's history, and there is no more need for the "fully protected" rcat, since it is now automatically added. Thank you in advance!  Temporal Sunshine Paine  02:54, 2 August 2016 (UTC)

Done Doc James (talk · contribs · email) 08:18, 2 August 2016 (UTC)
Thank you very much, Doc James!  Temporal Sunshine Paine  12:53, 2 August 2016 (UTC)

"High levels of physical activity reduce the risk of diabetes by 28%"

This seems to be a less important fact, clinically, than that moderate levels of exercise gain almost as much benefit. It's also, I think, vague about what "high" means. Anmccaff (talk) 16:56, 10 August 2016 (UTC) PS:I'd also add that maybe "Type II" needs to be in there. Yes, again. Yes, it's redundant...hell, it's tautologically redundant. Yet it still needs to be said, since so many readers seem to take away the idea that useful measures for Type II somehow ameliorate Type I. Anmccaff (talk) 16:56, 10 August 2016 (UTC)

We say there is no prevention for type 1 and then for two two we mention exercise. I think that is fairly clear. Doc James (talk · contribs · email) 20:52, 10 August 2016 (UTC)
I agree that that should be clear enough, but between wishful thinking, skimming, selective quoting, &cet, it ain't.
More importantly, though, the source strongly emphasizes the that the benefits of moderate exercise are nearly as great as those of extreme; I think the article should reflect that. Anmccaff (talk) 21:08, 10 August 2016 (UTC)
High levels of exercise is moderate exercise :-)
Ref says "Although higher levels of total physical activity were significantly associated with lower risk for all outcomes, major gains occurred at lower levels of activity (up to 3000-4000 metabolic equivalent (MET) minutes/week). For example, individuals with a total activity level of 600 MET minutes/week (the minimum recommended level) had a 2% lower risk of diabetes compared with those reporting no physical activity. An increase from 600 to 3600 MET minutes/week reduced the risk by an additional 19%."
Basically the typically recommended level is 600 MED min/week. Larger benefits require "higher" levels in the 3000 to 4000 ranges (that is 25 min of walking a day for 7 days a week). Over 9000 mets or an hour and a half of walking a day would be extreme exercise IMO.
Have changed to "higher" from "high" Doc James (talk · contribs · email) 21:28, 10 August 2016 (UTC)
High levels of exercise is moderate exercise :-) "Moderation in the pursuit of health is no virtue..."?
I think it still could use a tweak to show that the best return for time invested is a little lower; the source is aimed at encouraging any activity, not optimum. Anmccaff (talk) 19:03, 16 August 2016 (UTC)

Projections for the year 2035

Right now, there's a passage in the lead that says: The number of people with diabetes is expected to rise to 592 million by 2035,[27] and I was wondering if anyone else agreed that we should either remove it completely per WP:SPECULATION or at least remove the specific number and just say something like, "As of 2014, trends suggested the rate would continue to rise"? PermStrump(talk) 23:27, 13 July 2016 (UTC)

Yes not a big fan of future projects as they are typically not great. I would be happy with your final suggestion. Doc James (talk · contribs · email) 14:07, 14 July 2016 (UTC)
In total agreement with Doc James DocOfSocTalk 03:34, 5 October 2016 (UTC)

Reversal of type-2 diabetes by dietary means

There is on-going research into the reversal of type-2 diabetes by dietary means. Considerable success has been reported. In the words of Professor Roy Taylor, who runs a team at Newcastle University, "Our work has shown that type 2 diabetes is not inevitably progressive and life-long. We have demonstrated that in many people who have had type 2 diabetes for up to 10 years, major weight loss returns insulin secretion to normal". I'm wondering why this does not appear to be identified on the main page, since it has massive implications. Am I missing something? Should I make the changes myself? (I would prefer someone better qualified to tackle such an important addition). Here is the "top-level" summary (with many references) of all aspects of that research: "Reversing Type 2 Diabetes". Here is a summary of the most recent trial being run by Taylor's team: "Diabetes Remission Clinical Trial". Here is the registration of the trial at the World Health Organization. Here is a book based on Taylor's work, and introduced by Taylor, in effect enabling people to "do it themselves". Here is a website, based on the book, including a forum for people who are in the process of reversing their type-2 diabetes. Here is a paper at PubMed: "Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol". (I am also aware of medical practitioners elsewhere who help their patients "reverse", rather than simply "manage", their type-2 diabetes). Barry Pearson 06:56, 21 October 2016 (UTC)

Here is my understanding of the difference between "managing diabetes" and "reversing diabetes". (I'm talking about type-2). If you are managing diabetes, you still have the metabolic disorders of diabetes, including insulin resistance and elevated glucose levels, and you run the risks associated with these, including blindness, amputations, etc. If you have reversed your diabetes, you no longer have those disorders and risks. You may still be overweight, even obese, but you are roughly equivalent to an overweight or obese person who is at risk of getting diabetes, which is vastly less of a problem than someone who is both overweight/obese and actually has diabetes. You are likely to have to manage your weight, (for various reasons, including avoiding getting diabetes again), but you don't have to manage diabetes. Here is a 1-hour talk that Taylor gave to Diabetes UK earlier this year. Barry Pearson 10:13, 21 October 2016 (UTC)

I said above "I am also aware of medical practitioners elsewhere who help their patients "reverse", rather than simply "manage", their type-2 diabetes". Here are some links to such people. I suspect most of these source don't belong on the main page, because they are video presentations that don't have the required rigour, but I'm citing them here because they demonstrate that "reversing diabetes by dietary means" isn't confined to one team in England and Scotland. Dr Jason Fung "How to Reverse Type 2 Diabetes Naturally" and "Insulin Toxicity and How to Cure Type 2 Diabetes". Dr Sarah Hallberg "Reversing Type 2 diabetes starts with ignoring the guidelines". Dr Michael Mosley "How to stay healthy ... All About Women 2016". Plus an article from Diabetes Ireland "'Reversal' or Remission of Type 2 Diabetes". And another paper: "Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol". Barry Pearson 13:17, 21 October 2016 (UTC)

Content about health in Wikipedia must be sourced per WP:MEDRS - namely, literature reviews published in good journals or statements by major medical/scientific bodies. None of those sources are OK per MEDRS. Do any such sources discuss this work? Thanks. Jytdog (talk) 15:03, 21 October 2016 (UTC)
(edit conflict) No doubt interesting, but the science isn't clear enough on whether or not it works or whether it is safe. We use only quality secondary sources for these claims, and I'm not aware of anything but drastic weight loss having any high quality documentation of "reversing" diabetes. If you are looking for acceptable source Barry Pearson: you can use this pubmed search [28] and take a look at WP:MEDRS. PMID 26627223 seems like a decent enough article (only had a quick glance). Carl Fredrik 💌 📧 15:06, 21 October 2016 (UTC)

Thanks Jytdog and Carl Fredrik. I am still out of my depth, so here are a couple of follow-up questions. (1) What is the problem with "Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol"? (2) I can understand the need not to claim results if they are not supported by a high quality source. But is it valid to identify that a trial has been funded, and registered with the WHO? (In other words, instead of saying "this works", to say "a trial has been funded and registered to see if this works"). The registration of a trial at the World Health Organization. NHS: "Diabetes Remission Clinical Trial". "The Diabetes Remission Clinical Trial (DiRECT): protocol for a cluster randomised trial". — Preceding unsigned comment added by Barry Pearson (talkcontribs) 08:36, 25 October 2016 (UTC)

The rest of this paragraph has no place on the main page, but I believe it is useful background information here. In effect, the ability to reverse type-2 diabetes by dietary means is apparently becoming known and available to the public (at least in the UK) faster than the basis of this ability can be published per WP:MEDRS. On 27 October 2016, one of the UK's main TV channels broadcast a program "Can Your Diet Defeat Diabetes?" at 7:30 in the evening. It included a useful segment involving Professor Roy Taylor, who I described in my first paragraph above in this section. So what we have is: a cheap book (currently number 3 in the Amazon.co.uk best-seller list), explicitly based on Taylor's work, authored by a well-known and respected UK presenter of health-and-medical TV programs, based on a diet-framework which can be sourced in a typical supermarket, supported by a free-to-join website with forums in which people discuss their experiences. Obviously the usual caveats apply: the long term effects are not known (which is presumably the case with all new treatments), it doesn't work in all cases (especially in those who have had type-2 diabetes for more than 4 years), some people can't tolerate the restrictions of the diet-content and/or the degree of calorie-reduction in the first 8 weeks, and it should not be attempted by people with certain medical conditions. But given that the diet-framework is hardly novel, and neither is the concept of significant calorie-reduction (this is not fasting) for a matter of weeks, for many people this will be preferable to living with type-2 diabetes. I suspect that the critical factor will be how fast people become aware of it, and not how fast research results are published per WP:MEDRS. Barry Pearson 08:44, 28 October 2016 (UTC)

We try hard to keep the quality of content about health high, and that in turn depends on keeping source quality high. Again per MEDRS we generally use recent literature reviews published in good journals, or statements by major medical/scientific bodies, like NHS or NICE. A book by a TV presenter is not what we look for. We very much avoid sourcing content about health to popular media. There is loads of hype in popular media about diets and the like. We are nothing like popular media, in fact we end up spending too much keeping hype out of WP. (the advice about healthy eating in the "blood sugar diet" looks fairly reasonable btw but it has ~a bunch~ of the hallmarks of a fad diet too.) If you don't understand why we keep source quality high please see at least the lead of the essay WP:Why MEDRS?. Thanks. Jytdog (talk) 17:14, 28 October 2016 (UTC)
Thanks, Jytdog. Note that I said "The rest of this paragraph improvements to an article". That was for the reasons you stated. I understand that it is vitally important that information about the working of the human body is as accurate, and obtained from the highest quality sources, as possible. But I'm not talking about the working of the human body. I'm talking about how to manage the working of the human body. The statement under the "Management" heading that "Diabetes mellitus is a chronic disease, for which there is no known cure except in very specific situations" contains the word "known". In other words, it is a statement about someone's knowledge at a particular point in time, (May 22, 2016), not a claim of an everlasting truth. I'm confident that there is no robust evidence that there will never be a cure for type-2 diabetes. For example, see: "Pathogenesis of type 2 diabetes: tracing the reverse route from cure to cause". As far back as 2008, it appears to have been possible to claim "The metabolic abnormalities of type 2 diabetes can be reversed reproducibly by bariatric surgery". That is plausibly "reversal of type-2 diabetes by surgery". (This topic is also covered under the "Surgery" sub-heading). I believe Professor Roy Taylor has spent the last several years pursuing the reasons that bariatric surgery works in this way, and working out how to use dietary means instead of surgery to achieve the same results. The reason I wrote the above paragraph wasn't to change the main page. It was to make the point that, if Taylor is right, the way is now open for perhaps 100s of millions of people in the world with type-2 diabetes to cure themselves of a condition they would like to be cured of, as a do-it-yourself exercise. (Using a cheap book, currently the 3rd best seller in "Books" at Amazon UK, the contents of a typical supermarket, and plenty of will-power for 8 weeks on the low-calorie diet). If he is right, the only thing stopping them is that they don't know it is possible. (Just as the vast majority of medical practitioners don't know it's possible). As they say "the proof of the pudding is in the eating". And I've become aware (on forums, etc) of lots of people who are following this path, with various degrees of success. Those people didn't need WP:MEDRS. They had little or nothing to lose by trying it, and everything to gain if it worked. Barry Pearson 19:20, 28 October 2016 (UTC)
We need MEDRS sources to discuss this diet in a WP article. Please do not write further about this, unless you are bringing MEDRS sources. This page is not for general discussion of the topic. Thanks. Jytdog (talk) 19:24, 28 October 2016 (UTC)
Thanks, Jytdog. I've re-read Help:Using talk pages and Wikipedia:Talk page guidelines, and I can see that where I was talking about something that "has no place on the main page", that was not appropriate, because it was not a discussion of "changes to its associated article or project page" or "improvements to an article". But other material above was specifically intended to identify changes that might be valid. This was especially the case where I asked above whether a funded and registered trial could be mentioned on the main page. WP:MEDRS identifies sound rules "for medical content", typically excluding primary sources. But the sources I identified as associated with that trial are the NHS, Diabetes UK, and the World Health Organisation. They are not sources where "the authors directly participated in the research or documented their personal experiences". As far as I can tell, the facts of this trial are not subject to the uncertainty of primary sources. (And I would still like an answer, because I do want to contribute to the main page within WP:MEDRS). Barry Pearson 08:46, 29 October 2016 (UTC)
thanks for engaging with the policies and guidelines.  :) if you are talking about the links in your OP, those describe clinical trials, not results. Jytdog (talk) 17:16, 29 October 2016 (UTC)

Please provide

…the authority and citation behind the teaching video. The video has content, and should not appear, only appealing to WP/Wikimedia authority. This sets a very bad precedent for science and medical articles. Cite Osmosis.org, and the reviewing expert, Rishi Desai. Please. People should not have to dig for (leave the page for) information, to decide whether content appearing is trustworthy. This is an absolute for the text. And videos are just as much textual content as the text itself. Le Prof 73.211.138.148 (talk) 17:56, 25 November 2016 (UTC)

Videos have references. People already need to leave our pages to check our sources to make sure we are accurate. Doc James (talk · contribs · email) 23:13, 25 November 2016 (UTC)

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Type 3c (Pancreatogenic) Diabetes

I've been thinking about the above article for some time. It appears to me that it should not exist, but rather should be redirected to, and discussed in Diabetes mellitus type 1 and mentioned briefly in chronic pancreatitis.

I'm not formally proposing a merge but wanted to get thoughts.. Jytdog (talk) 21:45, 20 January 2017 (UTC)

while it seems like a good idea and I might support a merge,though more opinions/POV would be needed...IMO--Ozzie10aaaa (talk) 12:52, 21 January 2017 (UTC)
Yah not sure what is best. This is basically type one DM plus exocrine pancreatic dysfunction.
Like hepatorenal syndrome. Not just a kidney or a liver problem but both. Doc James (talk · contribs · email) 16:26, 21 January 2017 (UTC)
as near as i can see, the diabetes is caused by the panreatitis and then you have to start treating that, on top of the other stuff. which article should get the primary discussion in your view? Jytdog (talk) 02:53, 22 January 2017 (UTC)
This is a fairly decent source[29] as is [30] They do share one author though Doc James (talk · contribs · email) 06:41, 22 January 2017 (UTC)

RE: Content under title

I'm on my phone right now and I just noticed that it says "bug Papa" underneath the title of the article. Maybe I'm missing something but this seems rather amiss. Olision889 (talk) 01:37, 23 January 2017 (UTC)

I just checked the page and code on my computer and nothing comes up. --LibraryGurl (talk) 02:06, 23 January 2017 (UTC)
This is Wikidata vandalism. Thanks for pointing it out. Will fix User:Olision889 and User:Librarygurl.Doc James (talk · contribs · email) 02:55, 23 January 2017 (UTC)

Semi-protected edit request on 27 January 2017

Talk about how diabetes can cause AIDS and Cancer and Heart Failure. 2001:56A:70A4:5F00:602D:3F9C:C13F:6A89 (talk) 03:01, 27 January 2017 (UTC)

Not done: please provide reliable sources that support the change you want to be made. I doubt that diabetes can cause AIDS. Gulumeemee (talk) 04:16, 27 January 2017 (UTC)

Semi-protected edit request on 13 March 2017

Brycealley (talk) 16:32, 13 March 2017 (UTC)
Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. Cannolis (talk) 16:41, 13 March 2017 (UTC)

Genetics Causation

Linked reports do not show. Unverified. Just because they say it in the report, there is no proof. They do not do genetic testing on diabetic patients.207.119.192.39 (talk) 14:44, 15 March 2017 (UTC)

The logo image at the start of the article was rather preposterously large, was resized, and the resizing reverted. I believe it was adequately visible at the smaller size.--Quisqualis (talk) 08:20, 21 March 2017 (UTC)

@Quisqualis: The resizing wasn't fully reverted. The logo is smaller than it was before I reduced its size. To me, the current size seems ok. Holy Goo (talk) 17:24, 21 March 2017 (UTC)
Good to know.--Quisqualis (talk) 19:08, 21 March 2017 (UTC)

Fully protected edit request on 18 May 2017

A protected redirect, Diabetes, needs redirect category (rcat) templates added, and to be converted from a deprecated template to its replacement. Please modify it as follows:

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 Donexaosflux Talk 18:35, 20 May 2017 (UTC)
Thank you very much, xaosflux!  Paine Ellsworth  put'r there  20:39, 20 May 2017 (UTC)

"no known cure except in very specific situations"

We had this discussion in archive 14.

It is clear that there IS a cure. It just cannot be given as a "treatment" (yet). From the Prof.'s reply, there is all the scientific evidence that you can Lose diabetes (and not just type II) with starvation and the lowering of the BMI. So:

a. The source says there is NO cure. So the source is not backing what the article is claiming. The truth and nothing but the truth, is not the whole truth.
b. What are these "specific" situations and why not state the facts as they are.
c. Please bring one of the sources listed in the archive from those that had been agreed to be good ones. פשוט pashute ♫ (talk) 17:45, 4 June 2017 (UTC)

There is not a generally available cure that works in the majority of people. Doc James (talk · contribs · email) 03:45, 5 June 2017 (UTC)
It's worth explicitly noting that part of @Pashute:'s contention is simply wrong. You can not "cure" complete loss of working beta cells by diet, nor can you predictably "cure" violent immune system reactions that way. Some number of people diagnosed as type one, who still have some functioning insulin production may, of course, be helped by this, but that can't be generalized across all, or even many type I diabetics. Anmccaff (talk) 04:25, 5 June 2017 (UTC)

It was not MY claim but rather claims I gave with - so at least I thought - good sources. A medical physician wrote that starvation had been proven to reverse diabetes prior to the discovery of insulin, during famine, in WWI and with Allen's starvation diet.

I now found that User talk:Doc James and User:Anmccaff are both sadly (I have diabetes myself) correct. See here about the wrong depiction of the Allen Diet as reversing diabetes or being done following studies on animals. פשוט pashute ♫ (talk) 23:56, 10 June 2017 (UTC)

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Loss of weight

  I think this article would be improved if loss of weight were given as one of the symptoms of diabetes, or perhaps listed under the list of serious chronic complications. Vorbee (talk) 17:31, 10 September 2017 (UTC)