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Comment by M0r13n | Hacker News Reader

> But in people with diabetes, this sensing system is dysfunctional, and the liver releases glucose even when blood levels are already high, causing a host of health problems.

I am pretty sure, that the dysfunctional glucose sensing and inappropriate liver glucose release are consequences and complications of diabetes, not the primary causes. Diabetes (Type 2) is primarily caused by insulin resistance combined with progressive beta cell dysfunction.

Therefore, treating the liver to treat diabetes seems .... weird?

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As an analogy, when my driveway is covered in snow and ice, the root cause is precipitation. But my immediate need is to get my car out, so I shovel the drive.

Yes, treating symptoms is not the ideal, but if you can fix the immediate need of getting blood sugar down, that is still helpful.

In your story, your driveway was designed to be shoveled like the body is designed to deal with small amounts of sugar.

Let's say we had a particularly bad winter that required the use of power tools, which had the effect of damaging the driveway. Your body on diabetes is like a damaged driveway.

At some point you'll need to fix the damaged driveway. It will require a change in lifestyle while the driveway is being fixed, and perhaps even a change SOP's to reduce the risk of future damage.

Most people never give up on the power tools (supplemental insulin). Most doctors don't know any better.

Your analogy doesn't really apply to anyone with type 1 diabetes, which is an autoimmune disorder and roughly 10% of all diabetes cases. A lifestyle change cannot fix type 1 diabetes.

Additionally, partial remission in type 2 diabetes has a success rate of just 0.007% per 5 year post-remission cohort. The idea that a lifestyle change can "fix the damaged driveway" is essentially a statistical anomaly - it's not grounded in evidential standards has yet to be proven.

What factors contribute to the poor success rate?

Does it matter? A success rate of 0.007% is practically a statistical error. It signifies that the method is not feasible regardless of individual factors.

I understand the treatment to address those secondary consequences and complications, not the primary causes of diabetes.

You're right. But they explicitly wrote "we examined the potential of FUS as a treatment for diabetes". So they are discussing a treatment, not just symptom relief

"Medical treatment" definitely doesn't always mean dealing with the root cause. As you've learned.

Splinting a leg is treatment, but it has nothing to do with not drinking before driving.

Are you confusing the term "treatment" for the term "cure"? Symptom relief is a type of treatment.

There is a lot of research pointing to the duodenum being damaged and not playing it role correctly. It is essentially the signaler to the pancreas and gall bladder and liver to release All The Things! There have even been some studies around a new approach that resurfaces the duodenum with a hot water balloon that brings back proper function, known as Duodenal Mucosal Resurfacing (DMR).

You are talking about more like reversing the disease

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