Wednesday, December 13, 2006

VOTE for 2006 Dumbest Diabetes Research Study


Although voting for the 2nd Annual Diabetes O.C. Blog Awards is probably more noteworthy, in what has become something of a tradition, this year, I am again polling people to evaluate the "Dumbest Diabetes Research Study" award for 2006, and this is my second annual poll. Note that polling closes around 4:00 pm EST on New Years Eve. Last year, I did the same the same poll (see here for details), and the winner was a study that concluded "High Fasting Blood Glucose May Be a Risk Factor for Type 2 Diabetes" which was published in The New England Journal of Medicine. Not surprisingly, the winners never claimed their prize, a packet of Sweet & Low. Of course, I ask everyone to help me by calling attention to a sampling of truly "dumb diabetes research" (defined as having done little, if anything to improve the lives of people now suffering from diabetes) which is published in a scientific or medical journal if and when you learn about it. Please e-mail it to "DiabetesPortal-owner@yahoogroups.com".

Millions of dollars are wasted on foolish and unnecessary diabetes research each year, instead of spending money on research towards curing patients with diabetes. Most of these studies have only only served to keep researchers working, but have done little, if anything to improve the lives of people actually suffering from diabetes. The researchers and the medical establishment should really be ashamed of studies like these, as should the organization(s) who funded this research. Ask yourselves: were these studies really necessary? To vote, click on the title link (above) and you will be forwarded to DiabetesTalkFest.com to vote there.

Listed below are several diabetes studies that were done published in prominent medical and/or scientific journals during 2006 that quite frankly, were a complete waste of money to either prove the obvious, or worse, just plain dumb. Need an example? See below, as I have provided summaries (as well as the full journal publication if you're interested) and then vote for the study you believe was the dumbest. The winner will receive publicity on their accomplishments, and, if they want it, a packet of Sweet & Low.

1. Childhood obesity and type 1 diabetes
The results of a study conducted at Wake Forest University School of Medicine in the USA, published in the February 2006 issue of Diabetes Care, searched desparately to find a link between obesity in children and the younger average onset of type 1 diabetes. The relationship, however, was found only in children whose production of insulin had already been significantly reduced, and most patients diagnosed with type 1 were significantly below the average weight. Low birth-weight was also indicated as a possible factor in accelerating the development of type 1 diabetes. The study was part of the 'Search for Diabetes in Youth' initiative, which aims to identify the prevalence and incidence of childhood diabetes in the USA.
http://care.diabetesjournals.org/cgi/content/abstract/29/2/290

2. Cord blood islet autoantibodies are related to stress in the mother during pregnancy
The researchers' objective of this study were not disclosed in the extract, but it seems that they were trying to identify whether something that occurs during gestation might be responsible for the development of immune-mediated (type 1) diabetes. They conclude that "associations with increased worries by the mother remained in newborns with high type 1 diabetes mellitus (T1DM)-human leukocyte antigen (HLA) risk, but not in non-HLA risk children -- in other words, if there was a family history of type 1 diabetes, then stress appears likely to elevate the child's risk for type 1 diabetes, but it doesn't if there is no family history. The researchers note that prospective follow-up on these children will determine the importance of this early IA for postnatal islet autoimmunity, type 1 diabetes, or both. There are many "suspected" triggers for type 1, but seeking for blame of the mother without a means to correct the situation seems unworthy of this costly research.
http://www.annalsnyas.org/cgi/content/abstract/1079/1/345

3. Effect of Medication Nonadherence on Hospitalization and Mortality Among Patients With Diabetes Mellitus
The reported reasoning for this study was because "Medication nonadherence may reduce the effectiveness of therapies. To our knowledge, the association between medication nonadherence and mortality remains unexplored outside the context of clinical trials." The authors conclude that "Medication nonadherence is prevalent among patients with diabetes mellitus and is associated with adverse outcomes. Interventions are needed to increase medication adherence so that patients can realize the full benefit of prescribed therapies." Did we need a study to "prove" that people who don't take medicines prescribed will have worse outcomes?
http://archinte.ama-assn.org/cgi/content/abstract/166/17/1836

4. Effects of chili consumption on postprandial glucose, insulin, and energy metabolism
The reported objective of this study was to investigate the metabolic effects of a chili-containing meal after the consumption of a bland diet and a chili-blend supplemented diet. The authors in Australia studied 36 individuals, and concluded that regular consumption of chili may attenuate postprandial hyperinsulinemia.
http://www.ajcn.org/cgi/content/abstract/84/1/63

5. Idiosyncratic Personal Explanations for Blood Glucose Events Are Associated With Poorer Self-Management and Glycemic Control
The reported objective of this study was to examine whether spontaneous causal attributions for blood glucose events were associated with blood glucose control (HbA1c [A1C]), self-management, and adjustment to diabetes. Wasting money on the research seems to be all that was accomplished.
http://care.diabetesjournals.org/cgi/content/abstract/29/6/1208

6. Impact of Glycemic Control on Survival of Diabetic Patients on Chronic Regular Hemodialysis: A 7-year observational study
The reported objective for this study was "to investigate the impact of glycemic control during regular hemodialysis on the survival of diabetic patients with chronic kidney disease". However, while this sounds like a doctor-designed study, the reality is that maintaining glycemic control, especially among patients with type 1 diabetes, becomes notably more difficult without fully-functional kidneys because of significantly increased risk of hypoglycemia. Also, the idea of avoiding complications seems lost on patients already experiencing kidney failure.
http://care.diabetesjournals.org/cgi/content/abstract/29/7/1496

7. Lifestyle Intervention Is Associated With Lower Prevalence of Urinary Incontinence: The Diabetes Prevention Program
This study revealed that reducing the liklihood of developing urinary incontinence was a more powerful motivator for many obese women to lose weight than developing type 2 diabetes. Some researcher was up very late at night asking whether the threat of having to having to buy Depends was stronger than the threat of having to pierce your fingers to test for elevated blood glucose levels? But wait, this implies that many of these people would actually be motivated to control their diabetes, and the fact is that if someone who does not "feel" sick is motivated to take care of themselves, then there is less motivation than losing control over one's bladder. Again, common sense, not earthshattering research here. The real question we should be asking why did someone spend our money to study this? Was there a research grant from Depends?
http://care.diabetesjournals.org/cgi/content/abstract/29/2/385

8. Mealtime Interactions Relate to Dietary Adherence and Glycemic Control in Young Children With Type 1 Diabetes
This study's objective was to examine the relationships between parent-child mealtime interactions and dietary adherence and glycemic control in young children with type 1 diabetes. It was hypothesized that young children who exhibited disruptive mealtime behaviors would have more dietary deviations (poorer dietary adherence) and poor glycemic control. It was also hypothesized that parents of young children who used ineffective/coercive parenting strategies at mealtimes would have children with more dietary deviations and poor glycemic control.
http://care.diabetesjournals.org/cgi/content/abstract/29/5/1002

9. Obesity in Middle Age Raises Heart Disease and Diabetes Risk
The reported objective of this study was "to assess the relation of midlife body mass index with morbidity and mortality outcomes in older age among individuals without and with other major risk factors at baseline". Obesity at any age is a known risk factor for a wide variety of ailments. Was a research study really necessary to prove that even among people without apparent cardiovascular risk factors, obese people were at higher risk for cardiovascular disease and diabetes than people who are normal weight? Simply stated, it is well-known that obesity is not healthy. Did we really need yet another study to prove it?
http://jama.ama-assn.org/cgi/content/abstract/295/2/190

10. Prevention of Hypoglycemia During Exercise in Children With Type 1 Diabetes by Suspending Basal Insulin
The reported objective of this study was to focus on this because strategies for preventing hypoglycemia during exercise in children with type 1 diabetes had not been well studied. This study was conducted to determine whether stopping basal insulin could reduce the frequency of hypoglycemia occurring during exercise. However, as the researchers should have expected, the risk of high blood sugar (hyperglycemia) increased.
http://care.diabetesjournals.org/cgi/content/abstract/29/10/2200

***** Editor's Note: The following study was the 2006 Winner! *****
11. Short legs related to excess weight and diabetes
Researchers from Johns Hopkins University conducted a cross-sectional analysis of 7,424 adults aged 40–74 years, from the third National Health and Nutrition Examination Survey (NHANES) and concluded that being short - specifically having short legs and a low leg length-to-height ratio - is linked to an increased type 2 diabetes and obesity risk in middle age. They recommend "early intervention" to improve childhood nutrition in diabetes prevention. While this was a meta analysis, it still suggests that the parents are to blame for adults getting type 2 diabetes, which may be a flawed conclusion.
http://care.diabetesjournals.org/cgi/content/abstract/29/7/1632

6 comments:

BetterCell said...

Hello Scott....I onced worked in a Medical Research Facility where grant awards were given to those Researchers whom the Director personally "liked" as an important variable in determing the awards. Sometimes little attention was paid to the applied practicality of the study with more to the theoretical instead.

Lyrehca said...

I missed last year's poll, but this year's contenders are excellent candidates for idiocy. Nice work, Scott.

Bernard Farrell said...

If you could find out how much each of these studies cost, we could come up with some useful ratio of study cost to stupidity.

After all if it's really stupid but costs only a little, isn't that better than something that's somewhat stoopid but costs a lot?

Gentle reader: please note this is a rhetorical question.

Scott said...

Once again Scott, you've proved that fact really is stranger than fiction.

Effects of chili consumption?! Wow.

I really appreciate your ability to stay up to date with all this stuff, and to break down all of the medical, political and marketing mumbo-jumbo so that the average Joe (i.e. me) can better understand it.

Thanks for all you do!

...chili consumption..? Wow...

Scott said...

FYI - I'm just waiting on my account activation over at talkfest, then I'll cast my "official" vote.

The lead so far in my book is the chili consumption. I just can't get over that one...

Scott said...

Thanks. I should note that DiabetesTalkFest (DTF) recently added "account activation" as an effort to address the prevalent snake-oil salesmen/spammers who seem to prey on some with diabetes. Its an unfortunate issue with the Internet, but I would just add that having a DTF ID & password will also enable you to participate on various online chats that are held online periodically, so its useful to have!