Adult-onset diabetes, obesity cured in lab mice, scientists report | Hacker News Reader

Adult-onset diabetes, obesity cured in lab mice, scientists report

sciencedaily.com

66 pointsnot_that_noob22 comments

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The article itself is light on details. The IU report, here:

http://news.indiana.edu/releases/iu/2014/12/dimarchi-diabete...

Is equally useless, nearly a copy/paste. The older report, here:

http://news.indiana.edu/releases/iu/university-wide/2013/10/...

Makes it very clear that this is a treatment for diabetes, not a cure.

Thank you for explaining the background to this eye-catching submission. Many, many submissions to HN are based at bottom on press releases, and press releases are well known for spinning preliminary research findings beyond all recognition. This has been commented on in the PhD comic "The Science News Cycle,"[1] which only exaggerates the process a very little. More serious commentary in the edited group blog post "Related by coincidence only? University and medical journal press releases versus journal articles"[2] points to the same danger of taking press releases (and news aggregator website articles based solely on press releases) too seriously.

The most sure and certain finding of any preliminary study will be that more research is needed. All too often, preliminary findings don't lead to further useful discoveries in science, because the preliminary findings are flawed. The obligatory link for any discussion of a report on a research result like the one kindly submitted here is the article "Warning Signs in Experimental Design and Interpretation"[3] by Peter Norvig, director of research at Google, on how to interpret scientific research. Check each news story you read for how many of the important issues in interpreting research are NOT discussed in the story.

[1] "The Science News Cycle" http://www.phdcomics.com/comics.php?f=1174

[2] "Related by coincidence only? University and medical journal press releases versus journal articles" http://www.sciencebasedmedicine.org/index.php/related-by-coi...

[3] "Warning Signs in Experimental Design and Interpretation" http://norvig.com/experiment-design.html

P.S. The sparsity of details in the press release recycled by ScienceDaily reminds me of the many past complaints from Hacker News participants about the poor quality of ScienceDaily as a source. ScienceDaily is just a press release recycling service, nothing more. I learned from other participants here on HN that there are better sites to submit from.

Comments about ScienceDaily:

http://news.ycombinator.com/item?id=3992206

"Blogspam.

"Original article (to which ScienceDaily has added precisely nothing):

http://www.washington.edu/news/articles/abundance-of-rare-dn...

"Underlying paper in Science (paywalled):

http://www.sciencemag.org/content/early/2012/05/16/science.1...

"Brief writeup from Nature discussing this paper and a couple of others on similar topics:

http://www.nature.com/news/humans-riddled-with-rare-genetic-...

http://news.ycombinator.com/item?id=4108603

"Everything I've ever seen on HN -- I don't know about Reddit -- from ScienceDaily has been a cut-and-paste copy of something else available from nearer the original source. In some cases ScienceDaily's copy is distinctly worse than the original because it lacks relevant links, enlightening pictures, etc.

" . . . . if you find something there and feel like sharing it, it's pretty much always best to take ten seconds to find the original source and submit that instead of ScienceDaily."

This is a bit harsh on Science Daily. In fact, Science Daily is much better than many other sites of its kind because it does consistently give its sources and provides citations as it did here.

I wonder if earlier comments on news aggregation sites (like Hacker News, but probably more influentially Reddit) may have changed the practices at some of the press-release recycling services. Maybe they are getting better (although I would still much better like submissions of actual independently reported journalistic stories about science here) because people have been complaining.

Over the years that I have looked at Science Daily it has always provided sources and citations. I don't think there has been any change.

I find the terminology of 'cure' for diabetes distracting, if not confusing. My understanding is that type-2 diabetes has a genetic component and environmental component (typically obesity). You can treat the obesity and assuage the symptoms, but the genetic component/risk remains and if obesity returns, the symptoms would likely return.

Since these hormones don't change the genetic risk, it is a treatment which can have lasting effects, but unless obesity is suppressed, it is no cure. Also, the symptoms can happen without obesity and this wouldn't be a cure for them, but could be a treatment.

Anybody know otherwise?

Here is the paper in question (PDF): http://f.cl.ly/items/460P2Z471N1m241q3439/nm.3761.pdf

From the paper's abstract (published by Nature Medicine, 08 December 2014):

"These preclinical studies suggest that, so far, this unimolecular, polypharmaceutical strategy has potential to be the most effective pharmacological approach to reversing obesity and related metabolic disorders."

> essentially cured [...] fully potent [...] unprecedented [...] unparalleled

Is anybody else getting a strong "too good to be true" vibe from all these unqualified superlatives?

"New single-cell molecules with triple-hormone action" sounds like somebody's already planning the marketing campaign.

It would be amazing if this works in humans without worse side effects than just suffering type 2 diabetes.

At this point... highly insulin resistant, and very hard to keep blood sugar in check, the side effects of diabetes are starting to get pretty bad.

Some side effects of uncontrolled diabetes

- Sufficiently poor circulation to extremeties that they may require amputation - Progressive loss of vision - Kidney Failure - Increased risk of severe infection - Heart Disease (and death from it)

Both obesity and type 2 diabetes are for the vast majority of sufferers voluntary conditions. These people choose to suffer these conditions, and further, every day make the choice again to continue to suffer these conditions. Even very late in the process type 2 diabetes can be turned back by aggressive use of low-calorie dieting [1]. Obesity can be reversed just by the exercise of willpower in the very same way.

It is a fascinating statement on the human condition that research for medical methods of treatment that do not require a patient to try to alter their lifestyle or calorie intake receives so very much funding in comparison to, say, meaningful research into aging, or any one of hundreds of medical conditions in which the patient has absolutely no choice in the matter.

[1]: http://www.bbc.co.uk/news/health-13887909

What you are really saying is that we should held people accountable for their own choices and, as a society, attempt to help those who cannot make those choices.

I agree, to an extend, but the reality is that there are a series of factors, besides the moral or 'self-evident' reasons, that make companies/governments fund these projects.

Moreover, forget about these factors for a second. The bottom line is that very few people would care if you found the cure for a very rare and destructive disease. Lots of people would pay a lot of money to avoid being fat.

And by the way, why exactly do you think that those lifestyle choices are easy to change? Very few people want to have diabetes (I assume). So there must be something else besides pure will that we should take into account when thinking about this issue.

It's actually an array of choices that have to be made consistently every day for many years, and which vary in difficulty from person to person. The choices could include changing homes, jobs, friends, all depending on their influence over the person's other choices. Nobody literally chooses to be obese and diabetic.

For anyone with the ability to govern what they eat, obesity is always a choice. Trying my damnedest on the day of an exam and really wanting to pass is not the measure of whether I chose to pass the exam but, rather, how I prepared myself in the time preceding.

Stop. Please. Obesity and diabetes are not the eighth and ninth deadly sins. Nobody wakes up in the morning as you so assert and chooses to gain weight, become insulin resistant, or have their pancreas fail.

Further, your uninformed opinion excludes people like myself who are thin but diabetic (type 2). It also excludes people who have LADA 1.5.

I guess because anyone who has diabetes is morally bankrupt they shouldn't expect any help. Is that right?

Yes, people who find themselves in poor health through their own repeated deleterious actions should have their treatment prioritized below that of those whose conditions result from chance or circumstances outside their control.

Further, your uninformed opinion excludes people like myself who are thin but diabetic (type 2). It also excludes people who have LADA 1.5.

The parent comment specifically stated that only the majority, not the entirety, of people with such conditions have them because of voluntary actions. Stop lying.

If I recall correctly 80-90% of people with T2 diabetes are obese. I'm not saying this was the case with your illness, but lifestyle choices are overwhelmingly the cause of both of these problems.

There are giant social costs stemming from obesity and T2 diabetes.

The above facts cause frustration for those of us not facing these issues.

For example, if my health insurance rate was based on my specific level of risk, I would likely pay 10% of my current premium. Yet, someone 150lbs heavier than me, same age, sex, etc. is much more likely to have health problems yet pays the same premium.

In other words, there is the perception that those who chose to create these problems aren't bearing the cost themselves, all of us are being forced to foot the bill.

Assuming you are voluntarily healthy, you'll be happy to learn that smokers and obese people are footing the bill for you. [1] Because healthy people live longer, they consume more health care dollars. Time to find something else to hate on..

(1)http://www.nytimes.com/2008/02/05/health/05iht-obese.1.97488...

The Harvard School of Public Health demurs: http://www.hsph.harvard.edu/obesity-prevention-source/obesit...

And the argument that the longer lifespans of healthy people means they will consume more healthcare dollars sounds quite specious on the face of it. After all, healthy people do not have chronic conditions whereas the obese & smokers can spend 20-40 years being treated for hypertension, diabetes, heart failure, arthritis, emphysema, COPD, etc. How could people living, on average, an extra four to seven years without such chronic care possibly wind up costing more? As it turns out, the study you reference was not based on data from actual patient outcomes but is a mathematical model: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fj...

David Strip calls into question the validity of the model thusly:

"Much in line with the response by Mittendorf, the validity of the results lies very strongly on key assumptions that are not demonstrated. The analysis assumes that the cost of an incidence of the 22 key diseases is independent of the risk factors being tested. Likewise, remaining health care costs, which account for 85% of health-care spending in the Netherlands , are assumed to be uncorrelated to risk factors. Given that this latter class of spending dwarfs the former, the importance of demonstrating the lack of correlation is particularly important. The incidence of numerous co-morbidities with obesity argues, in fact, that one might reasonably expect to find that the annual health costs are higher in the obese and that the cost of treatment in the last months preceding death may be quite different from the non-obese.

Kim McPherson, emeritus professor of public health at Oxford, wrote in response to the van Baal study here: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fj...

In a sense, Van Baal and colleagues' study is a useful antidote to current concerns. But let us be clear: it does not attenuate them. Obese people cost less because individuals die younger and hence with less chronic morbidity associated with old age. This is a useful thing to know, but how might it affect public health strategies for obesity? In particular, does it mean that concerns about increasing population obesity are misplaced, as least as far as health-service costs are concerned?

Sadly not. Examine an obese population and a lean population of the same age and sex distribution, and the former will incur far greater health-care costs throughout the life course. Much more diabetes, and more cardiovascular disease and cancer will occur amongst the obese—even amongst the older obese [3]. Compare health-care costs now with those thirty years ago, and—holding everything but obesity constant—the current population costs much more to the health sector than it did then [4]. Moreover, quite apart from health-care costs, the other costs to society from obesity are also greater because of absences from work due to illness and employment difficulties; these costs amount to considerably more than health-care costs [5]. It is not clear that these extra costs are intrinsically related to health-care costs, but they are currently estimated to be around four times as great in obese than in lean people [5].

Thank you for sharing that.

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