Thursday, July 25, 2019

Retrospective #159: While Rome Burns, the GACD fiddles and the Chinese nap

Please excuse me if once in a while I tear into a rant. I get frustrated and then very cynical with some of the things I read. I also know that, individually, I have so little power to influence outcomes beyond my own…and, if I’m lucky, a few others. But I still have to get some things off my chest. So, the best thing for me to do is to write about it. What set me off this time was a piece in The Lancet, “Funding: Global Alliance for Chronic Diseases tackles diabetes.”
Here’s what the report said: “To meet the challenge in emerging economies, the Global Alliance for Chronic Diseases (GACD) has launched a call for research proposals to prevent and treat Type 2 diabetes. The GACD is an alliance of some of the world’s biggest publicly funded research organizations, ranging from the UK’s Medical Research Council to China’s Ministr­­y of Health and the European Commission.” Okay, that’s benign enough; it’s an employment program for writers and government scientists, a kind of job security. Here’s what set me off:
“Refreshingly, GACD members have realized that the science of Type 2 diabetes is well understood; this is no high-spending, high-tech initiative but a strict focus on implementation of existing policies, present knowledge, and proven interventions.” It is reading arrogant bull$#%& like this, I think, that gives me high blood pressure. LOL.
So, these government bureaucrats, who know all about how to treat Type 2 diabetes, are going to disseminate their message to “low-income and middle-income countries, such as China, India, and South Africa where the biggest emerging problems are to be found, but where success might pay the highest dividends.” That’s just great!!! The developed world, where this Type 2 diabetes problem arose as a result of modern methods of processing and manufacture of the very “foods” that made us sick, is now going to fix the problem. Sell the problem, and then sell the solution!
Boy, that’s irony for you, but the author doesn’t see it that way. He’s “refreshed.” It doesn’t occur to him that existing policies and present knowledge have not led to proven interventions. They have produced the growing and out-of-control epidemic of not only Type 2 diabetes, but obesity (an outcome, NOT a cause of T2DM), dyslipidemia (i.e. low HDL, high triglycerides, and Pattern ‘B’ LDL particles), and hypertension, all aka Metabolic Syndrome.
Okay, Ivory Tower researchers live in a special world – a world in which a primary duty is to write and “call for research proposals” from other “publically funded research organizations.” They are isolated from the real people-populated world in which we mere mortals spread the word about the most effective intervention “to prevent and treat Type 2 diabetes” - Eat Real Food.” Now that would be “refreshing.” ­­­­­But where’s the money? No drugs to market. No processed foods to manufacture and sell. Simply small-scale farming – just like they already do now in low-income and middle-income countries like China, India and South Africa!
So, the best thing that “developed” countries can do is stay the hell out of the management of Type 2 diabetes in the underdeveloped and developing world until they get the message right. I’m not hopeful, though. This is not likely to happen so long as Agribusiness is so thoroughly insinuated in the interstitial tissue of our nation’s and the world’s advisory and regulatory bodies. I do not soon see an end to their insidious and pernicious influence.
My favorite news flash, though, came from Diabetes in Control: “Afternoon Napping Tied to Increased Risk for Diabetes.” It begins, “Since afternoon napping is very common in China, Fang et al. conducted a study to determine if the duration of a person’s nap affected their risk for developing diabetes or an impaired fasting blood glucose.” Their conclusion: “Napping duration was associated in a dose-dependent manner with IFG and DM.” “This finding suggests that longer nap duration may represent a novel risk factor for DM and higher blood glucose levels.”
Perhaps the Chinese scientists will now apply for a grant to determine if the outcome observed by Fang et. al. can be attributed causally to the blood glucose crash (and resulting longer naps), after eating a bowl of overcooked white rice, by some of the 27,009 participants. Maybe the researchers will “refreshingly” (?) discover Insulin Resistance (IR). Whew!

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