Talk:Diabetes/Archive 7

Diabetes prevention needs some help.

I started to address the errors in this section, but my changes were removed. Rather than put them back in, let's discuss the issues.

First, a clear distinction between type 1 and type 2 is needed. Type 2 is preventable for many people (not all), with diet and exercise. For the newly diagnosed, it is possible for many type 2 diabetics, if well motovated, to control and reverse their condition by loosing weight and eating fewer carbs. This is medical fact, backed by countless studies. There is a great deal of news about the epidemic of "diabetes" (meaning type 2) in the US because of fast food, upsizing the fries and beverages, spending too much time in front of the TV etc. Unfortunately people who hear this information (and many reporters and writers who present it) do not understand that this prevention is not applicable to type 1.

Type 1 on the other hand has no known preventive cure. It certaintly has nothing to due with french fries or television.

Second, there are several popular misconceptions, including these unprooven concepts: T1 can be prevented by rejecting required pre-school vacines (particularly those with thermasol): T1 can be prevented by breastfeeding your children; T1 can be prevented by not getting chicken pox (which means getting the vaccine??). For each of these controversies, there are studies for and against with no conclusion yet possible.

I suggest that the article either remove the prevention section, or address these shortcomings.

Mbbradford 04:12, 9 November 2006 (UTC)

Mbb, I've made some edits which may help with your concerns, with which I basically agree. I've tried not to touch existing content (ie the references) leaving that to someone with better experience and knowledge of the research literature. Comments? ww 23:13, 9 November 2006 (UTC)

Sorry, but that didn't do it for me. While there are many benefits to breastfeeding, preventing type 1 is not proven to be one of them. Read the articles already cited in the cows milk section above, and you will see that the research is controversial. Some articles say there is <2% reduction in risk of type 1 if you breastfeed. Other articles say that it is inconclusive. IMHO a controversy does not belong in an enclycopedia, unless at least you admit the controvery and show both sides. Also IMHO, an article that shows 1.5% reduction in risk of developing type 1 due to breastfeeding should conclude that there is a lack of strong correlation, not that there is a protective benefit. I know that many mothers who have breast fed their kids that still developed type 1 later anyway will tell you that a study about a few percent improvement in risk is not a breakthrough, so we should keep looking for other causes. If you are a brave soul, post a question at www.childrenwithdiabetes.com on the mailing list for parents, and ask the question of the moms yourself. I will also tell you that mothers with type 1 kids who did not breastfeed are greatly offended when they read these statements. My other complaint with this prevention section was the lack of good information about the prevention of type 2. Much is known about prevention of type 2 (related to diet exercise and obesity) that should be given some generous space in the prevention section. Instead it gives space to say that nursing mothers have a reduced chance of getting type 2 diabetes themselves. It seems like there is a hidden agenda built in here. Mbbradford 07:44, 10 November 2006 (UTC)

Mbb, Well, ... There existed several statements I thought over the top, I weasel worded them (all?) and cleaned up the phrasing. I take no position on the studies cited, but I'm really skeptical about claims of prevention or remission, given the snake oil hisotyr. Sorry you weren't happy. I think all that can be sid is that there is some evidence for <good effects> of diet, exercise, and losing weight (for most), but that there is nothing clear about it. As for type 1, there's some talk about a vaccination which might stop the auto-immune attack... Lots of stuff here I don;t think belongs here, but I didn't want to start an edit war by deleting it. Your warning about the forums at childrenwithdiabetes.com is well taken and I was ducking already.

And, in any case, DavidReuben cam along and delelted most of what I'd done anyway. It survived but a few minutes.

I tried. ww 10:28, 10 November 2006 (UTC)

Again, with the breastfeeding as a protective benefit in the prevention of type 1 diabetes, I followed the guidelines from the Wiki article on citing sources, and removed the claim that breastfeeding protects your children from diabetes.

Tagging unsourced material

If a particular claim in an article lacks citation and is doubtful, consider placing ^{[citation needed]} after the sentence or removing the claim. Consider the following in deciding which action to take:

If it is doubtful but not harmful to the whole article, use the {{Fact}} tag to ask for source verification, but remember to go back and remove the claim if no source is produced within a reasonable time.

If it is doubtful and harmful, you should remove it from the article; you may want to move it to the talk page and ask for a source, unless you regard it is as very harmful or absurd, in which case it shouldn't be posted to a talk page either. Use your common sense. Don't be inappropriately cautious about removing unsourced material; it is better for Wikipedia to say nothing on an issue than to present false or misleading material.

So I ask you, to find a supporting source of medical science, and this means from a peer reviewed medical journal. Going to PubMed and finding a epidimeological survey that concludes there might be a protective benefit does not support your article.

Since the statement has alrady been added back in after I removed it, I'll appeal to you again with only the request to cite your soure. Based on the guidelines however, it should simply be removed as harmful to the article.

There are many prooven benefits to breastfeeding. Preventing type 1 diabetes is not one of them. Absurd! mbbradford 20:22, 5 April 2007 (UTC)

Have a look at my comment below. And please WP:AGF and remain WP:CIVIL. We're not out to get you. JFW | T@lk 00:02, 6 April 2007 (UTC)

I've reviewed my comments for any signs of uncivility. I don't see them, except perhaps for the fact that I do not agree with you. As for assuming good faith: first it goes both ways, and second good faith it where I started 6 months ago when I edited the article, had it immediatly reverted, posted my concers on the talk page above, and generally ran into a roadblock. Recently I removed that poor conclusion again, only to have it immediately reverted again. I do not believe that I have been uncivil or acted in poor faith. I have however challenged you on the facts, questioned your sense of balance with repect to the controversy, and tried to enlighten you as to the insult that is implied in your bias. Mothers who are considering breastfeeding will go to wikipedia for the breastfeeding article, and be encouraged to breastfeed for the well being of their infant, even if not all benefits have been medically prooven. But the people likely to come to wikipedia and read diabetes articles are most likely the newly diagnosed, including in the case of the children with type 1, their mothers. Why offend them with a statement which is not supported by uncontroversial medical evidence? mbbradford 21:03, 6 April 2007 (UTC)

contradictory opening lines.

The article starts of saying "Diabetes mellitus is a metabolic disorder...", then the very next line this "It is a disease". Is it a disease or a disorder? A local hospital here claims that Diabetes is not a disease but a disorder. Idleguy 17:38, 6 December 2006 (UTC)

I would have thought the two terms are synonymous. So, Idleguy, could you give us a definition of these terms? Google gives 59,000,000 entries for "Diabetes disease" and 4,800,000 for "Diabetes disorder", so let's scrap the "disorder", never mind the local hospital (you did not give us a source for that).  Andreas  ^(T) 14:35, 10 December 2006 (UTC)

No it is definitely as metabolic disorder. I called it a disease in an essay recently and was told by an expert that it was wrong. SenorKristobbal 14:27, 11 December 2006 (UTC)

It is something like HIV and AIDS. Recently everyone is classifying/calling it as a disorder. The hospital I was referring to is MV Diabetes, Chennai, (well renowned hospital) which says "Diabetes Mellitus is a chronic metabolic disorder." It does however lead to other diseases that affect the organs etc. Idleguy 15:00, 11 December 2006 (UTC)

Who was that expert? We need citable sources. Maybe the term metabolic disorder is a special term, as opposed to disorder alone. In any case, according to ICD 10-14, diabetes belongs to the class of "Endocrine, nutritional and metabolic diseases", so it is definitely a disease. Medline plus writes: "Diabetes is a life-long disease marked by high levels of sugar in the blood. " Similarly for emedicine. Only Britannica writes "a disorder of carbohydrate metabolism". Britannica: disease: an impairment of the normal state of an organism that interrupts or modifies its vital functions. [Britannica dictionary] disorder: an abnormal physical or mental condition. According to Britannica thesaurus, disorder is a synonym of disease. Imho just leave the opening phrase as it is.  Andreas  ^(T) 15:08, 11 December 2006 (UTC)

You know, I really think it doesn't matter too much. I've checked some thesauruses and dictionaries, and disease and disorder are fairly interchangeable. —The preceding unsigned comment was added by 68.113.126.198 (talk) 20:40, 11 December 2006 (UTC).

I think disease isn't P.C. much like you can't call people "diabetic" anymore its "people with diabetes". Disease suggests people are having a bad time of things which isn't necessarily the case. Disorder suggests there is a problem but its not going to have a huge effect on you. Stupid I know but thats how P.C. works we'll have to call it something else in a couple of years. SenorKristobbal 20:29, 13 December 2006 (UTC)

There has already been some back and forth on the question of diabetic vs people with diabetes. Please see prior talk (probably archived by now). It was resolved to the current article terminology. ww 06:12, 3 April 2007 (UTC)

vandalism in footnote requires removal

Note 1 has some cretinist vandalism, but I can't figure out how to delete it. Someone with some more familiarity with the mechanisms should correct it. Too bad the irresponsible and childish are ever present. ww 22:08, 19 January 2007 (UTC)

I don't see anything, but I've been removing a bunch of other vandalism. I patrol this page from time to time. Is it there there? --Mdwyer 02:06, 20 January 2007 (UTC)

I can't see it now, so someone must have removed it. But I don't see the edit. Mysteries of WP, eh? ww 01:22, 21 January 2007 (UTC)

Misconception of health

Transfered from the article:

There is a major missconception that good management and proper treatment for this disease will not lead to a happy healthly life style. Constant checking of blood sugar level's and eating the right diet can help lead to a better lifestyle. Better treatment is coming very soon and ways to help manage your blood sugar levels are already here.Tarrom 09:22, 24 January 2007 (UTC)Matthew Tarro

I've transfered Tarrom's posting from article to here in talk space. Aside from the trivial point of signing talk page edits, it does not WP:Cite from WP:Reliable sources to WP:Verify that there is a misconception. Also the piece was written as if giving advice or speculating on the future. For most patients these days in countries with developed heaslthcare provision, the emphasis is less on good diebetic control, and more on reducing cardiovascular risks that remain (allbeit at lower levels) even with tight control (i.e. chasing ever tighter blood pressure or cholesterol targets). Some of Tarrom's intensions would be worthwhile keeping, i.e. trying to put things into perspective, but this might be better up in the introduction and needs a good source to cite - any thoughts ? David Ruben ^Talk 13:35, 24 January 2007 (UTC)

Diabesity

I can find no reference saying that Harvard coined this term, but LOTS of references to the fact that "Shape Up America" has tradmarked it. That being said, it really doesn't add anything to the article. NipokNek 19:38, 4 February 2007 (UTC)

If you've ever worked in a diabetes clinic you will find that there are many type II diabetics who are not obese at all. There is clearly more than just obesity to that fascinating condition. "Diabesity" is a nice neologism, but it is not useful in this article. JFW | T@lk 20:33, 4 February 2007 (UTC)

I thought WP:V was one of the key deciders of article content not what one editor's evaluation of "useful" is... Cburnett 21:29, 4 February 2007 (UTC)

Uh, Cburnett, I was addressing an additional problem. Even if the concept exists, do we need to mention it as a matter of course? JFW | T@lk 22:34, 4 February 2007 (UTC)

I can easily verify who won the Super Bowl last year, but it wouldn't necessarily belong in an article about making footballs. NipokNek 21:44, 4 February 2007 (UTC)

"Diabesity," a phrase trademarked by Shape Up America founder and former Surgeon General C. Everett Koop, reveals a frightening connection between the dual problems of obesity and type 2 diabetes. This new catch-phrase is further presented in a "call to action" book, Diabesity: The Obesity-Diabetes Epidemic that Threatens Americans--and What We Must Do to Stop It, recently written by Dr. Francine Kaufman, past president of the American Diabetes Association and head of the Center for Diabetes, Endocrinology, and Metabolism at Childrens Hospital Los Angeles. In her impassioned portrayal of personal and clinical accounts surrounding the world of diabetes and obesity, Dr. Kaufman offers critical advice for our generation: "To stop the diabesity epidemic, the new normal must become not just an individual but a societal choice."

Certainly obesity is not the only cause of Type II but it is the leading cause. I think it has merit in the article. Harvard does claim to have used it first, but I can't find credit for that, so default should go to Koop since he now owns the trademark to it.Julia 21:24, 4 February 2007 (UTC)

Please consider moving this to Diabetes mellitus type 2. JFW | T@lk 22:34, 4 February 2007 (UTC)

Actually, please don't add this anywhere. This kind of victim blaming isn't what people need. "Diabetes mellitus type 2 is presently of unknown etiology" which means that medical science has yet to figure out what causes it. Without some pretty stunning verification, statements like "...obesity is not the only cause of Type II but it is the leading cause" will not add anything of value to the article. NipokNek 15:19, 5 February 2007 (UTC)

Notability of TexasDiabetesInstitute.com

A user has tried to add this link twice. I'm not convinced it is notable so I have reverted it twice. Can anyone else assert its notability? Mdwyer 18:07, 15 February 2007 (UTC)

No reference to Diabetes Cure (text moved here)

It is rather disturbing to see no reference to people actually having been cured of diabetes. It is a fact. Patients I have and have had using 20 to 40 units of insuline a day have been monitoring their blood and as they changed their diet, had treatments with cadmium a precursorfor the enzyme that creates insuline, and acupuncture treatments, some using Alpha Lipoic Acid, saw the reduced need for insuline and lowered their intake accordingly. I requested they do so under the insulin prescribing doctor. Does chemical medicine have a monopoly and that is why research is not being done on alternatives. (user:michael)14:10 19 Feb 2007. HTW§§§§

I would submit to you that a "reduced need for insuline" doesn't actually qualify as a cure, just a different form of treatment. NipokNek 17:57, 19 February 2007 (UTC)

By the way, I reverted this text because I'm apparently incapable of telling the difference between a talk page and an article page. I'm very sorry for that, and I appreciate the other editors catching my mistake. --Mdwyer 18:01, 19 February 2007 (UTC) to nipokNek, The first line refers to the cure, the line you mention refers to the method. These people are without medications for months. no signs of needing insulin, as their continued monitoring indicates. Treatments with Acupuncture continue at less and less frequent intervals. Their cure includes exercise, proper nutrition, and acupuncture. (user: michael) 13:25 21 Feb 2007. HTW§§§§

It is common for people in the early stages of type 2 to achieve a remission of insulin needs after a period of better glucose control by using insulin, or by losing weight and doing other things to improve insulin sensitivity. This is certainly healthy and to be desired and (contrary to your conspiracy theory) is the first thing that doctors tell their patients. Unfortunately, it is difficult to predict the duration of improvement, and over time most people have continued loss of beta cell function. Calling this response to early treatment a "cure" is foolish and misleading, as is accusing doctors of prescribing drugs instead of letting their patients in on the "secret" (which you probably think is being closely guarded by the drug companies) that healthier eating and increased exercise might greatly improve their pancreatic function. PS: Acupuncture works for diabetes only if the needles contain insulin. alteripse 12:40, 21 February 2007 (UTC)

Intro

At the risk of bloating the intro again, I have reinserted the important message that diabetes control is not just about the sugars and the HbA1c/glyco-Hb but equally at preventing end-organ damage through blood pressure control and weight management. In the prevention of nephropathy, BP control is more crucial still than glycemic control.

I have also added that diet and tablets are also treatments, to remove the impression that a diagnosis of diabetes means one is sentenced to subcutaneous insulin. With the incidence of DMII so much higher than DMI on the Western World I think this is a justifiable change.

There's probably still a lot of work to do, but the present format of the article is really not all too bad. Is there any hope of getting this MAJOR health topic up to WP:FA? JFW | T@lk 14:28, 25 February 2007 (UTC)

I think we're near that point. it has been more or less stable for a while, modulo random bits being added now and then. You want to propose it? Now, DKA on the other hand is a very very long way from any quality levle... ww 07:45, 26 February 2007 (UTC)

Treatment/management

I'd just like to point out that the treatment/management section of the article says absolutely nothing about insulin or other anti-diabetic drugs.

I'll take a look. ww 10:47, 9 March 2007 (UTC)

removed paragrah

I removed this paragraph:

Currentley, there are several well researched herbs and nutritional supplements used for both the treatment and prevention of Types I and II Diabetes. Gymnema sylvestre, known for its bitter taste, has been shown to suppress glucose uptake, stimulate beta cell production in the pancreas, and improve insulin sensitivity in Type II Diabetes (source needed). Chromium, Biotin, Bitter Gourd, Vanadium, and Alpha Lipoic Acid (Thioctic Acid) have also been shown in clinical studies to significantly improve sensitivity in diabetics, lower serum cholesterol and tryglyceride levels, and improve HbA₁C (source needed).

Aside from difficulties with the language and formatting, this makes claims which are not actualy supported by research. Any of which might well earn the discoverer a Nobel, there having already been 4 related to DM already. There are currently no cures for DM (save pancreas transplant for Type 1) The other claims for the listed products are also not credible per current research. In fact, this reads more or less like an advert for a 'natural' rememdies sotre. Problematic edit, so I pulled it. Anyone care to comment? ww 10:47, 9 March 2007 (UTC)

a much longer removed edit

This edit, perhaps from the same poster -- I didn't check -- was also removed and for essentially the same reason. See wikitext comment left in its place.

--snip--

There are natural treatments that exist for Type I and II Diabetes. Gymnema sylvestre leaf has been used by natural clinicians in India for centuries to support healthy blood sugar levels.^29,30 In India, it has a common name Gumar, meaning 'destroyer of sugar', perhaps because the taste of the Gymnema plant suppresses the ability to detect sweet tastes.^31,32 The important plant constituents of Gymnema are the saponins, especially the gymnemic acids.³² Gymnema extracts containing an appropriate amount of saponins (gymnemic acids), help maintain a healthy pancreas. This supports healthy pancreatic function and the normal production on insulin in the body. Gymnema may do this by supporting the integrity of the pancreatic beta cells²⁹ (These beta cells produce insulin. Insulin removes glucose from the blood and helps with the storage of glucose (as glycogen and fats), thereby helping to regulate the supply of energy.)

When combined with a balanced diet, Gymnema supports healthy blood glucose levels within a normal range²⁹ As well as supporting the pancreas, Gymnema also promotes normal absorption of glucose from the intestine and a healthy metabolism.³³

While supporting healthy glucose metabolism, Gymnema may also help maintain cholesterol and triglycerides in the blood within a normal range.²⁹ A healthy diet (low in saturated fat and refined carbohydrates and sugar) combined with regular exercise and healthy cholesterol and glucose levels, helps maintain metabolic and circulatory systems.

Gymnema supplements are sold throughout the world. Standarization of the herb is important in determining the dosage (usually 100 mg gymnemic acids per 400 mg of Gymnema leaf). Typical doasage ranges from 400 mg- 6g.

Other supplements that may aid in preventing insulin resistance, Syndrome X, or other diabetes-related complications include Chromium, Biotin, Niacin and Thiamine, Fenugreek Seed, Vanadium, NAC (N-Acetyl Cysteine), and Bitter Gourd Extract.^{source needed}

Alpha Lipoic Acid (thioctic acid) has also been immensley helpful in treating diabetic neuropathy. It also enhances glucose uptake in non-insulin dependent diabetes and inhibits glycosylation.^{source needed}

Phospatidylcholine (PC) and other 100% pure, GMO-free sources of phospholipid complexes have been shown to improve diabetes related dyslipidemia.³⁴ —The preceding unsigned comment was added by Ww (talk • contribs) 18:46, 9 March 2007 (UTC).

29. Shanmugasundaram ER, Rajeswari G, Baskaran K et al. J Ethnopharmacol 1990; 30(3): 281-294

30. Shanmugasundaram KR, Paneerselvam C, Samudaram P et al. Pharmacol Res Commun 1981; 13(5): 475-486

31. Medline Plus: Trusted Health Information for You. Gymnema (Gymnema sylvestre R. Br.). Available via www.nlm.nih.gov/medlineplus/druginfo/natural/patient-gymnema.html.

32.Suttisri R, Lee IS, Kinghorn AD. J Ethnopharmacol 1995; 47(1): 9-26

33. Hirata S, Abe T, Imoto T. J Yonago Med Assoc 1992; 43: 392-396

34. Lee SH, Han YM, Min BH, Park IS. Cytoprotective effects of polyenoylphosphatidylcholine (PPC) on beta-cells during diabetic induction by steptozotocin. J Histochem Cytochem. 2003 Aug; 51(8): 1005-15. PMID 12871982

--snip--

Let's discuss this people. Does this sort of thing, or only some of those mentioned, belong here? Comments? ww 18:51, 9 March 2007 (UTC)

"Eschew the remote control" deleted

That eschewing the remote control would lead to more exercise sounds too obvious, even silly. Besides, walking to the television and back doesn't make a big difference - the reader should read the whole article on exercise instead. Mortsggah 11:27, 28 March 2007 (UTC)

And besides, I defy anyone to properly control a modern day cable box or TiVo without using the remote control. :) NipokNek 22:33, 10 April 2007 (UTC)

External Links

I would like to add these links to the "External Links" section, but I am having some resistance...

• Diabetes Life Lines
• Your Guide to Diet and Diabetes
• Recipes for Diabetes
• Flavor Fiesta - Traditional Hispanic Recipes for People with Diabetes

Moved the links to Diabetic_diet#References, seems like a more suitable place for them after comments from Nbauman.

Alessandro Bellina 02:20, 27 March 2007 (UTC)

I looked at the sites and agree with Jdf. The problem isn't that the information is not "reputable" but that the sites are pretty mediocre and non-notable. How many pieces of information can you find in them that are not already contained in the links we have? Nearly every hospital in the country with a diabetes service has stuff like this posted, and we could fill this encyclopedia with links like this. I am sure it seems arbitrary to you, but we try to be somewhat selective about this type of link since there is an endless amount of these out there. Does your perseverance reflect some sort of direct or indirect personal connection with these sites? alteripse 02:42, 27 March 2007 (UTC)

Alessandro Bellina, why don't you add those links to Diabetic_diet#References instead? They cite several books (most of them British), but they don't have any on-line references. Hispanic recipies are particularly useful, given the epidemiology of diabetes in the U.S. Nbauman 03:17, 27 March 2007 (UTC)

Thanks for your comments! I am really new to Wikipedia as an editor and want to learn how to do edits so they are accepted, not rejected. This is what I thought it was more like, multiple people taking part of the conversation. I will look at the section you have suggested Nbauman, thanks for that! Alessandro Bellina 11:42, 27 March 2007 (UTC)

Wine

It has been said that red wine and help prevent diabetes type 2, can any 1 comfirm this

Whoever said this is less informed than would be ideal. Alcohol (ie, ethanol, as there are lots of different kinds of alcohols, at least one frankly poisonous (methanol)) is generally a toxin and is as well a central nervous system depressant. In addition, its metabolites are also toxic. So, in more than moderate quantities, the damage alcohol does is well known. Not so well known is that alcohol interferes with the liver's processing of glucose (storage as glycogen, conversion from glycogen and putting deconverted glycogen glucose back in the blood). This is one of the causes of heavy drinkers systemic health problems.

There is no observed credible evidence that alcohol prevents or cures or alleviates Type 2 diabetes. In fact, there is no known benefit of alcohol save some calories and perhaps some social lubricant, except for the French paradox. This is not well understood, but the effect is clear. Small quantities of alcohol (some claim red wine is especially helpful, whtout solid grounding) lead to reduced rates of cardiovascular disease. Since the French have eaten a high fat diet for a long time, their rates of cardiovascular disease should be higher than they have been. It seems that small, but steady, alcohol consumption may be the reason for this. The mechanism remains unclear. BUT, this a dangerous approach for the difference between beneficial doses and damaging doses is quite small. Anything more than a drink or two a day (depending on body size) causes more damage than benefit. Thus, sixpacks of beer should last a week or more at a helpful consumption rate.

You might want to consult the most recent edition of Bernstein's (poorly named) Diabetes Solution. It is by a doctor with type 1 who was an electrical engineer before medical school; the approach is less anecdotal than most such books, and yet is not opaquely technical for most readers.

However, note carefully that Wikipedia is 1) not a source of reliable medical advice (faddists/enthusiastists/snake oil peddlars are sometimes not easily distinguishable from the knowledgable for many readers, perhaps especially in medical matters), and 2) such questions should be directed to the Reference Desk in any case -- not here. ww 06:06, 3 April 2007 (UTC)

Breastfeeding and DM1

Mbbradford (talk · contribs) has taken issue with the claim that breastfeeding may reduce risk of DM1 in the infant. Before I insert a reference, I'd like to present some here so we can select the best one:

• PMID 6150150 (the Lancet 1984 study that seems to have sparked this line of research)
• PMID 14668264 (rather thorough Am J Clin Nutr review that lists all the evidence until then)
• PMID 8773632 (a negative trial 1996, JAMA) - in PMID 8664407 the same team suggests the link is due to a methodological blip rather than a real association
• PMID 9051384 (a negative trial 1997 from Italy)
• PMID 15037991 (oddly worded abstract suggests exclusive breastfeeding >2 months reduces risk)
• PMID 16249566 (introduces the TRIGR study which is much larger than the above and will give much more information, as well as assessing risk re diabetic mothers)

I think we need to mention both the 1984 study and the Norris et al 1996 study, as well as perhaps the 2003 Am J Clin Nutr study. Alternatively, we can find one review that would support the following sentence: "Some studies have suggested that prolonged exclusive breastfeeding is a protective factor against type 1 diabetes mellitus, but other research has cast doubts on this link. Ongoing research is being conducted into the importance of breastfeeding in the prevention of DM1." JFW | T@lk 21:30, 5 April 2007 (UTC)

Doesn't the fact that some of the studies support while some negate the fact in question tell us that there is a controversy? I appreciate the rewording above, which now at least reports the controversy. The TRIGR study looks like good science, but, there are no results yet. The question then becomes: why report it at all?

How about this rewording:

As little is known on the exact mechanism by which type 1 diabetes develops, there are no preventive measures available for that form of diabetes.

In other words, the article sticks with what we really know about the ability to prevent type 1 diabetes. mbbradford 22:42, 6 April 2007 (UTC)

It's been 2 weeks without any new discussion. I will rewrite the type 1 prevention paragraph again, perhaps encouraging more input. mbbradford 05:06, 19 April 2007 (UTC)

I have reinserted the nutritional links, with good references. The Norris study doesn't explicitly disprove the breastfeeding link. We are talking about risk modification, so an argument that breastfeeding did not prevent a particular case of DM1 is with little merit.

I have removed the link that suggests that we can predict the development of DM1. It is an interesting page, but it doesn't deliver on the main premise: can we screen for future DM1 and immunosuppress them to prevent DM1 from developing and salvage beta cell reserve? JFW | T@lk 10:38, 20 April 2007 (UTC)

I'm disappointed that you have again edited the article to include the protective benefit of breastfeeding and represent it as fact. It is not necessary to disprove the breastfeeding study you cited because it was based upon epidemiology. A study which looks at statistical information of a subset of the population and then shows a possible relationship overall never offered any "proof" in the first place. Rather the possible relationship is useful only as a basis for making a hypothesis. In the 25 years since your cited study, the subject has been contradicted by other epi-studies and is controversial. The consensus in the medical community is that while breastfeeding should be encouraged for many reasons, there is no proof that it prevents or reduces risk of type 1 diabetes. The webpage that I cited was from the Barbara Davis Center for Childhood Diabetes, which is highly respected, and the charts in particular are teaching materials for doctors. It stated "At present we can predict the development of type 1A diabetes but do not have a safe and effective preventive therapy." By the way, your own reference says "There is little firm evidence of the significance of nutritional factors {including breastfeeding} in the etiology of type 1 diabetes" which you have rephrased to "various other {beyond breastfeeding} nutritional risk factors are being studied, but few have a strong link with the development of type 1 diabetes." mbbradford 18:39, 23 April 2007 (UTC)

Diabetes Wiki link

I'd like to add a link to Diabetes Wiki -- it's a Wikia-hosted site for people with diabetes to share their information and stories. The information on Wikipedia is often very technical; the idea of Diabetes Wiki is that the writing is more accessible for people with diabetes. Still, the site's just starting out, and it isn't an official/authoritative source. Would it be okay to add this link? -- Danny (talk) 21:29, 6 April 2007 (UTC)

Well, nobody seems to mind, so I'll add the link. If there's any problem with it, then please let me know. Thanks! -- Danny (talk) 19:04, 9 April 2007 (UTC)

Mountains for Active Diabetics

I want to add the external link www.mountain-mad.org to the wiki site, but am having no luck!!!! MAD is the global resource site for all tings related to diabetes and mountains, and we have an extensive list of academic and other references with regard to this. We hold an annual symposium with www.IDEA2000.org members, called MADiDEA, which is this year being held in Montana. We are not a commercial organisation, but purely funded by passion and enthusiasm. Pease help.

Links of this type would bloat the article beyond recognition. Could you think of other ways to advertise your organisation's activities. JFW | T@lk 10:22, 20 April 2007 (UTC)

Semi protect

If that amount of vandalism happens more ofthen as is doing in the past day or so, may a semi protection thing be added? petze 01:23, 20 April 2007 (UTC)

Done. JFW | T@lk 10:19, 20 April 2007 (UTC)

Sugar is bad

doi:10.1016/S0140-6736(06)69700-6 indicates that even slightly raised blood sugar levels predispose for cardiovascular diseases. I'm not sure if it needs to be included here or elsewhere.... JFW | T@lk 09:24, 23 April 2007 (UTC)