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Things that annoy me...
Sep. 7th, 2007 10:30 amJust been reading an article on the BBC website about 'fat genes'. No problem with the research itself (though my experience of gene research suggests things may not be as simple as they imply) but I am annoyed by the mention of Diabetes.
Here is a quick hint for all media types out there and anyone else who is not in the know:
There are TWO types of Diabetes. Type I and Type II. They have different pathologies but similar symptoms. It helps in media reporting to be precise about which type of Diabetes you are talking about. You see, Type I is linked to an inability of the Pancreas to produce insulin, the hormone which acts as a key to the lock that is the glucose receptor allowing glucose to pass from the blood to the body tissue where it can be used in metabolism. If these patients inject insulin, the glucose that has been building up in thier blood leaves the circulation and goes off to do useful things rather than hanging around in the blood causing problems (such as damaging circulation, kidneys, liver, etc and also causing you to want to pee lots and drink lots). Type I is an acute and very serious condition if not treated urgently. Untreated Type Is can die very quickly.
Type II, on the other hand, is a situation where the patient may have normal insulin production. Their problem is something called 'insulin resistance' - the receptors do not recognise insulin as a key and so do not open to let glucose into the body tissue. The dodgy receptor is possibly the thing that these patients inherit - making this more of a genetic condition than type I.
Now, what annoys me is that the media claim that 'incidence of Diabetes increase because of obesity'. This is bollocks for several reasons. First of all, obesity has no influence at all on Type I. The aeitiology of this condition is independent of weight and, in fact, many untreated Type Is can easily lose weight very quickly and die of malnutrition while eating their own bodyweight in lard because they cannot easily absorb nutrition until the lost insulin is replaced. This used to happen a lot before insulin was discovered and isolated for medical use in the 1920s - 1930s. Ok, a healthy diet is recommended for type Is in order to minimise secondary complicatons (we are more likely to get heart disease due to vascular damage, for example, and smoking and eating lard don't help this) but being fat does not make you automatically become a type I diabetic.
So, the 'obesity' link is actually referring to a link with type II and here we have the other piece of incorrectly interpretated 'facts'. Type II is linked to a genetic problem with insulin absorption. While some type IIs may have limited insulin production as well as this, the main cause of problems is the 'insulin resistance'. This is why you cannot treat a type II with insulin injections - they don't work because the insulin does not interact with the receptor normally. Instead they are treated with 'oral hypoglyceamics' which are drugs that create a passage for glucose to enter the body cells.
The link with bodyweight is down to the sheer mass of the person involved. If a type II diabetic is at a normal weight, in many cases they have enough insulin and enough working versions of the glucose receptor to have normal glucose absorption and so they may not even know that they are type II. However, at some point, usually when they start to develop middle age spread, their weight may get over the point where the amount of insulin they produce combined with the proportion of healthy to mutant receptors is not sufficient to continue to maintain a normal blood glucose. So, these patients start to develop 'diabetic symptoms'. The media seems to interpret this phenomena as the patient 'becoming diabetic' when really they were diabetic all the time, they just did not know it. The increase in obesity does not increase the incidence of diabetes at all. More precisely, what it does is bring more of those with Type II diabetes to the attention of the medical profession where they can be treated. A similar effect would be noted if you instigated a scheme to test all school children for the genes linked with diabetes. It increases the number of cases of type II that we are aware of, it does not increase the number of diabetics overall (because it has no effect on type I) nor does it increase the total number of type IIs as that is a function of genetic variability which generally follow fairly predictable laws of inheritance. A person without the genes to code for the faulty glucose receptors may never develop diabetes no matter how fat they get - something which the media's interpreation seems to suggest is likely. They are confusing nature with nurture in a big way.
Its sort of like saying that putting more police on the streets increases the crime rate when really all it does is allow the police to detect and report more crime that was previously hidden. That crime was still going on, we just didn't know about it.
Anyway, rant over now... Good morning everyone! :)
Here is a quick hint for all media types out there and anyone else who is not in the know:
There are TWO types of Diabetes. Type I and Type II. They have different pathologies but similar symptoms. It helps in media reporting to be precise about which type of Diabetes you are talking about. You see, Type I is linked to an inability of the Pancreas to produce insulin, the hormone which acts as a key to the lock that is the glucose receptor allowing glucose to pass from the blood to the body tissue where it can be used in metabolism. If these patients inject insulin, the glucose that has been building up in thier blood leaves the circulation and goes off to do useful things rather than hanging around in the blood causing problems (such as damaging circulation, kidneys, liver, etc and also causing you to want to pee lots and drink lots). Type I is an acute and very serious condition if not treated urgently. Untreated Type Is can die very quickly.
Type II, on the other hand, is a situation where the patient may have normal insulin production. Their problem is something called 'insulin resistance' - the receptors do not recognise insulin as a key and so do not open to let glucose into the body tissue. The dodgy receptor is possibly the thing that these patients inherit - making this more of a genetic condition than type I.
Now, what annoys me is that the media claim that 'incidence of Diabetes increase because of obesity'. This is bollocks for several reasons. First of all, obesity has no influence at all on Type I. The aeitiology of this condition is independent of weight and, in fact, many untreated Type Is can easily lose weight very quickly and die of malnutrition while eating their own bodyweight in lard because they cannot easily absorb nutrition until the lost insulin is replaced. This used to happen a lot before insulin was discovered and isolated for medical use in the 1920s - 1930s. Ok, a healthy diet is recommended for type Is in order to minimise secondary complicatons (we are more likely to get heart disease due to vascular damage, for example, and smoking and eating lard don't help this) but being fat does not make you automatically become a type I diabetic.
So, the 'obesity' link is actually referring to a link with type II and here we have the other piece of incorrectly interpretated 'facts'. Type II is linked to a genetic problem with insulin absorption. While some type IIs may have limited insulin production as well as this, the main cause of problems is the 'insulin resistance'. This is why you cannot treat a type II with insulin injections - they don't work because the insulin does not interact with the receptor normally. Instead they are treated with 'oral hypoglyceamics' which are drugs that create a passage for glucose to enter the body cells.
The link with bodyweight is down to the sheer mass of the person involved. If a type II diabetic is at a normal weight, in many cases they have enough insulin and enough working versions of the glucose receptor to have normal glucose absorption and so they may not even know that they are type II. However, at some point, usually when they start to develop middle age spread, their weight may get over the point where the amount of insulin they produce combined with the proportion of healthy to mutant receptors is not sufficient to continue to maintain a normal blood glucose. So, these patients start to develop 'diabetic symptoms'. The media seems to interpret this phenomena as the patient 'becoming diabetic' when really they were diabetic all the time, they just did not know it. The increase in obesity does not increase the incidence of diabetes at all. More precisely, what it does is bring more of those with Type II diabetes to the attention of the medical profession where they can be treated. A similar effect would be noted if you instigated a scheme to test all school children for the genes linked with diabetes. It increases the number of cases of type II that we are aware of, it does not increase the number of diabetics overall (because it has no effect on type I) nor does it increase the total number of type IIs as that is a function of genetic variability which generally follow fairly predictable laws of inheritance. A person without the genes to code for the faulty glucose receptors may never develop diabetes no matter how fat they get - something which the media's interpreation seems to suggest is likely. They are confusing nature with nurture in a big way.
Its sort of like saying that putting more police on the streets increases the crime rate when really all it does is allow the police to detect and report more crime that was previously hidden. That crime was still going on, we just didn't know about it.
Anyway, rant over now... Good morning everyone! :)
