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Outdated and fictional source data used! Why?

Doris' Blog
By: dorisjdickson

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Posted: Jun 5, 2009 16:45
  • Outdated and fictional source data used! Why?

    Someone recently pointed out that Wikipedia claims most diabetics have retinopathy >20 years since diagnosis. They quoted an ADA white paper from 2002. What almost no one noticed was that the study cited was from 1979-1984!

    The problem? This period of time was prior to most patients using home glucose testing methods. Obviously use of home glucose testing, A1C guidelines and rapid acting insulin would render the use of this data for a current (2002) consensus/recommendation statement useless and inaccurate.

    It would be reasonable to use this information as before and after markers? It would be reasonable if they had used the statistics for legacy guidelines and whitepapers. However, to the best of my knowledge (please correct if there is more recent information being used by the ADA) this is the information upon which their guidelines are formulated. Now to dispute the accuracy of the statement that nearly all diabetics >20 since diagnosis have retinopathy … apparently, I have far surprised the blindness deadline. I have never been diagnosed with or treated for retinopathy at 32 years and counting. I know several other >20 since diagnosis type 1/juvenile onset diabetics who can say the same.

    So where on earth did they get their statistics? Do they just guess? Do they make it up? Do all diabetics report to some agency that is counting the years since diagnosis and current retinopathy status? I think not.

    Why do they do this? Scare tactic? Justification for funding? I have not the foggiest idea why they use 1) outdated statistics that are 2) created from fiction.

    So the lessons learned to patients: 1) don’t believe every statistic you read 2) if you have the time, follow the technical reference back to the source and 3) buyer beware! Garbage is garbage; it doesn’t matter who the “trusted” source is.

    My message to the ADA – please knock it off. Patients put their lives in your hands, depending on you to be their advocate. They believe what you say – ya know, the gospel according to Matthew, Mark, Luke, and the ADA. They trust you. Insurance companies approve/deny claims based on your consensus statements. In fact, they often quote you verbatim in their medical policies. If you, as physicians, take oaths to do no harm, then, please do just that or please, keep your mouths shut. As they say, with friends like that, who needs enemies?

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  • By: FatCatAnna: Jun, 25, 2009 21:19 PM

    Who knows why ADA does this scare tactic? Like many long term diabetics (41 years for me) - I've taken everything I hear with a grain of salt from both my doctors / CDA / ADA.  For many newly diagnosed diabetics tho' - ADA/CDA is all that they can turn to for help.  If they have the initiative like some of us have to be their own advocates of their health - then more power to them!  Others maybe abit wary, but with folks like yourself Doris / diabetic educators that perhaps have diabetes themselves - hopefully they will change their attitude to how to handle their health to attain less complications down the road. Also, there is so much info/technology now compared to before like Gkelly says  - that things will hopefully only get better - along with one day a cure for diabetes!!

    BTW Doris, is this the link that you were basing your blog - scroll down to Reference 5 - http://en.wikipedia.org/wiki/Diabetes_mellitus ?

    By: gkelly: Jun, 23, 2009 12:54 PM
    Great point. Before glucose testing, monitoring was limited and not as good as today. Therefore, more complications were the likely result. And congrats to you for having such great success with treating your type I. There is often times careless reporting wherein the most important point "good control" is not even addressed. C'mon. With diabetes, one's health "outcome" is largely dependent on one "does" as opposed to what course the condition takes. In this case (good control) is the answer. Great response.


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