Curious to see if it's just me.
I came across this summary on AHRQ's website (AHRQ is a U.S. government agency that, among other things, conducts and summarizes health care research). I'm used to seeing generic references in the media to "diabetes" and being annoyed by it, but AHRQ is a reputable entity involved in health care research, so I found this disturbing.
The original study (by Jason M. Fletcher, PhD, and Michael R. Richards, M.D.) appeared in a recent Health Affairs journal. In summary, they found that people with "diabetes" had lower lifetime wages and higher high-school dropout rates. In the full article, the authors briefly mention that they didn't attempt to differentiate among the various forms of diabetes, and kind of acknowledge that there may be some variation depending on the form of the condition in terms of effect. But they stop there (why, I don't know).
What really bugs me is how AHRQ presents the information on their website. They do the classic "diabetes is rising with obesity" schtick, as well as stating that prevention, especially for children, is important because of these negative effects of diabetes. Now, while I know the rates of type 2 diabetes are growing in the U.S., my understanding is that type 1 diabetes is still the more common form of the condition diagnosed in children. And as far as we know, type 1 diabetes cannot be prevented.
I am annoyed on so many levels by this piece on AHRQ's website. As a T1, I know that the driving factors that affected my education and career choices were largely due to my ability to get health insurance and enough money to buy insulin and the other stuff I need to stay alive. This has HUGE implications in the health policy world, but it seems to be largely ignored when looking at "diabetes" in this generic way.
Does anyone else get annoyed with studies like this? I just find them so...irresponsible. Is it wrong to think that physicians should realize that they are dealing with multiple conditions, all of which can have different methods of management and impacts?
So, I wrote AHRQ and pointed out not just the limitations of the study, but also the fact that their blurb mushes all "diabetes" together, with implications that T1 can somehow be prevented. They emailed me back pretty quickly and have made significant revisions to the info on their site, both to clarify the limitations of the study and differentiate between T1 and T2.
Hooray!! I love it when the powers that be listen to constructive feedback. And kudos to you for writing to them about your concerns.
great work and thank you.
I am glad that AHRQ recognizes the limitations of their study. I have read whole studies on "diabetes" that do not even define the people they are studying. By this I mean they do not define T1 or T2 diabetes or even mention which ones are used in their report. It frustrates me to no end. Now, if a publication does not describe what type of diabetics they are or are not using then I just consider it junk science. If you cannot figure out the basics of who will be included/excluded in your study, then it is all going downhill from there on.
Yep, I wholeheartedly agree! All studies have limitations. Research of just about anything can never be perfect. As long as those limitations are clearly laid out, I'm good. But when blurbs are made without stating what the limitations are, that's a whole different issue. I am very glad that AHRQ listened and made the correction. Someone coming across that blurb now will have a clearer picture of what the study is about.
On another note, I had actually emailed the authors of that study when it appeared in Health Affairs telling them that I was disappointed to see they were drawing conclusions about causality without teasing out the different effects of T1 vs. T2. One of the authors immediately responded back and said they would take that into consideration if they did any further work on the topic.
It just bugs me because I feel like research that lumps all diabetes together does a disservice to everyone. It does a disservice to all people with diabetes (T1, T2, LADA, MODY) as well as health care professionals. I keep encountering health care professionals who don't know the basics about this cluster of conditions we call diabetes, and it scares me that in the event I need medical care and cannot speak for myself, I won't receive proper treatment.