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== Contradiction in Type 1 treatment discussion == | |||
Early on in the section titled "Type 1 diabetes mellitus" there is the following sentence: "Diet and exercise cannot reverse or prevent type 1 diabetes." A couple of paragraphs later, this is restated: "Currently, type 1 diabetes can be treated only with insulin, with careful monitoring of blood glucose levels using blood testing monitors." But then the next sentence contradicts: "Emphasis is also placed on lifestyle adjustments (diet and exercise)." This contradiction undermines the credibility of the article, or at least, the credibility of the treatment discussion. (Or accurately reflects confusion among physicians and researchers?) | |||
] 14:59, 25 April 2007 (UTC) | |||
Yes, the emphasis on lifestyle is obselete. It must have been based on the older insulin regimens (ie NPH) wherein you had to plan the mealtime and snack time and exercise time based upon the timing of the NPH peak. Now with the flexible techniques using insulin analogs, you can simply match your insulin to your actual need. Everyone of course benefits from exercise and a healthy diet, including all diabetics, but is really has nothing to do with treating type 1 diabetes anymore. So go ahead and fix it. <strong>]]</strong> 18:58, 25 April 2007 (UTC) | |||
:No contradiction here, and so nothing to fix. Type 1 cannot be trated (as in cured) by diet or exercise. It can be managed and symptoms controlled by medication and diet and exercise. Food is of course required, and in Type 1 must be balanced, somehow, by insulin, ideally precisely timed to match glucose uptake. Whatever sort of insulin one is using. As for exercise, it increases glucose uptake w/o regard to insulin levels. Thus lifestyle is not clinically irrelevant today, nor was it in former times. | |||
:Since there's confusion this point, perhaps a rewording is in order? However, it would be in error to state that insulin alone is clinically sufficient for type 1, as it is not. ] 02:47, 26 April 2007 (UTC) | |||
This goes again to the annoying confusion between type 1 and type 2. In management of type 2, diet and exercise are necessary and critical to controlling blood sugars. In type 1, they are no more beneficial in treatment of type 1 than they are for every person. The difficulty is to balance the insulin with the exercise and diet, regardless of what that might be. In days gone by, one had to plan the days physical activities, meal times, and carb counts with the insulin cocktail that was injected in the morning. Thankfully due to flexable insulin therapy, those days are gone. The article seems obselete to me. <strong>]]</strong> 19:06, 1 May 2007 (UTC) | |||
The root problem here is that Diabetes types 1 and 2 share a name by virtue of the fact that they share a common symptom - 'sweet' urine. The causes of each are very different, as is the treatment. If the conditions of heart attack and indigestion shared a name because they share a common symptom ('pain in chest') we would not be happy. There is a case for separating the naming, but I don't think the medical profession would like it. ] (]) 21:04, 7 January 2008 (UTC) | |||
Following on from the above paragraph, the original author of this item should re-read the whole, substituting "Diabetes Type 1" and "Diabetes Type 2" for each use of an unqualified "Diabetes" - and ask the question - is this correct? For example: "''The way diabetes is managed changes with age. Insulin production decreases due to age-related impairment of pancreatic beta cells''" - is this true for Type 1? I don't think so. ] (]) 21:14, 7 January 2008 (UTC) | |||
It is true that type 1 diabetes mangement does change with age but it is more of just changing insulin dosing and etc. But this is a result of growing since your metabolism begins to change as you age. Also I am a diabetic and i dont think that type one is normally treated with inhalable insulin... its not accurate enough. --] (]) 17:08, 19 January 2008 (UTC) | |||
As far as I can see your problems seem to be in the definition of the word "treated". If by treated you mean managing, which as far as I can see can be the only option for Type 1, then yes exercise and diet can be used to treat Type 1 if the person is aware of their body and how to look after it. If they can recognise when they are Hyperglycaemic then they can excercise because adrenaline has a simmilar effect on cells to insulin and so they can lower their BGL. As for diet, eating low GI (Glycocidic index) foods means less radical changed in BGLs and so it is easier to treat with the insulin. You can't treat Type 1 using just diet and exercise, that much is obvious. I have also found another contradition in the type 1 article, I have not changed it incase I am just being stupid and have not thought of something. "The average glucose level for the type 1 patient should be as close to normal (80–120 mg/dl, 4–6 mmol/l) as is safely possible. Some physicians suggest up to 140–150 mg/dl (7-7.5 mmol/l) for those having trouble with lower values, such as frequent hypoglycemic events" This is saying take more insulin if you are more frequently hypoglycaemic? Sure it should be only if you are more frequently hypERglycaemic? More insulin would make hypoglycaemia worse surely? --] <small>—Preceding ] was added at 07:44, 14 May 2008 (UTC)</small><!--Template:Undated--> <!--Autosigned by SineBot--> | |||
==MCOTW== | |||
I have nominated this article for the ]. This reflects my conviction that despite the current reasonable quality of the article, there is still a lot to be done here. The main concerns are article structure, referencing and prioritising content for subarticles. I will continue to nibble away at this, but ultimately it would be nice to have this article at mega quality. ] | ] 10:20, 9 September 2007 (UTC) | |||
Also missing from the articles on Diabetes and related conditions is a general overview, in lay terms, of what the disease is. The serious fault of these articles is the inability of a newcomer to the subject to understand the article (or the disease) without having to click on numerous links just to understand the jargon used in the main discussion. I understand that all of the factors in this disease complex deal with balance and feedback within the system. Perhaps a graph depicting the basic healthy system could be shown, then show what parts of the system get out of whack and how--and then what can be done about preventing its getting out of whack, or restoring the "whack" if it is out. These articles need a less technical, graphically interpretive overview with links to the more technical information. With my very limited understanding of the subject, I know that such a graph would have a depiction of a pancreas, a liver, and other glands and organs with symbols showing their analogous functions. Use analogies to things in everyday experience and also to economic terms that everyone understands. Thermostats, float valves, storage tanks, factories, pipes, pumps, money, banks, all come to mind. The graphic at pathophysiology is still for physio-nerds and we ignoramuses still need something more bonehead. Thanks. ] (]) 01:59, 11 August 2008 (UTC) | |||
== Developing type 2 == | |||
Is it possible to get it from consuming to much sugar because I had 232% of my recomended sugar intake yesterday and 355% of my recomended sugar today and btw is it just me or does 'Type 2 diabetes can be cured by one type of gastric bypass surgery in 80-100% of severely obese patients' not make sense does it work for everybody or just 80% of people<small>—Preceding ] comment added by ] (]) 18:12, 22 April 2008 (UTC)</small><!-- Template:UnsignedIP --> <!--Autosigned by SineBot--> | |||
:One day's excessive sugar intake won't do it. As for the sugrical 'cure' (still being investigated), it works for 80% or so. Why it doesn't for the rest is part of what's being investigated. Makes perfect sense if you understand how scientific ignorance is dispelled. There's always a period during which understanding is murky -- we're in one o fhtem here. ] (]) 18:21, 22 April 2008 (UTC) | |||
::I wish it was ones day sugary excess but I discoverd the breakfast Ive been having for 4 years is 92% by itself so theres a good change Ive had 1400ish days of excess <small>—Preceding ] comment added by ] (]) 21:03, 23 April 2008 (UTC)</small><!-- Template:UnsignedIP --> <!--Autosigned by SineBot--> | |||
:::OK, I'll ask. 92% of what, by itself? ] (]) 23:54, 23 April 2008 (UTC) | |||
::Please go to the ] if you have questions that are not directly related to updating and improving this article. | |||
::To touch on your question: type 2 diabetes has very little to do with sugar intake (unless you want to go into the high-fructose corn syrup controversy). Rather, it has to do with the tissues becoming so resistant to insulin that the islets cannot produce sufficient insulin to match the body's demands. Once the pancreas is exhausted and diabetes has developed, high-sugar foods can indeed cause fluctuations in the blood sugar levels. But having sugar itself doesn't really cause diabetes beyond contributing to weight gain and hence insulin resistance. ] | ] 12:43, 20 May 2008 (UTC) | |||
== Adding an External Link to JDRF == | |||
Would it be alright to add a link to the Juvenile Diabetes Research Foundation (JDRF) -- www.jdrf.org -- at the bottom in the External links section? | |||
Thanks | |||
] (]) 18:02, 16 May 2008 (UTC) | |||
:We would be more helped if that link was on the page about "]" (they really ought to update their name). This page is about diabetes in general. ] | ] 12:33, 20 May 2008 (UTC) | |||
==Alzheimer's== | |||
Many practicing doctors will have heard about the somewhat elusive entity of ]. {{User|203.10.59.12}} now wants to add an entire paragraph that basically turns Alzheimer's disease into a form of insulin resistance of the brain, and quotes researchers that maverickishly refer to AD as "type III diabetes". All very good and well, but this is not standard terminology, and frankly I find the use of diabetes terminology for AD pretty offensive. Thoughts invited on ] here. ] | ] 12:43, 20 May 2008 (UTC) | |||
== Fasting BM predicts DM == | |||
Even in people with a normal range fasting blood sugar, there is a direct relationship with the risk of diabetes. {{DOI|10.1016/j.amjmed.2008.02.026}} ] | ] 11:16, 21 May 2008 (UTC) | |||
:Very interesting. Does this then mean (or hint) that glucose itself causes tissue changes which lead to the Type 2. For instance, changes in the upper small intestine which then proceed to emit a signal which causes the insulin resistance in the periphery and thus the cascade of events which is too often Type 2? The variety of problems with assorted tissues in diabetic complications certainly suggest something like this. Again, very interesting. ] (]) 19:11, 22 May 2008 (UTC) | |||
== Protected == | |||
I have sprotected the page for a month. Every single contribution from anonymous IPs constitutes vandalism. ] | ] 15:07, 22 May 2008 (UTC) | |||
:You may want to rephrase that. There may have been vandalism from anonymous contributors, or even a lot of it, but anonymous contributions certainly are not ''per se'' vandalism. | |||
:Since you have semi-locked the page from editing, I'll leave it to do to fix the following stylistic problems in the section under "Cures for type 2 diabetes": | |||
#"precise clausal mechanisms" should be changed to "precise causal mechanisms" | |||
#In the sentence after the above, which starts with "this approach may ...", "this" should be capitalized. | |||
#In the same sentence, "some Type 2s in the relatively near future" should be changed to "some type 2 diabetes in the relatively near future". --] (]) 19:09, 7 June 2008 (UTC) | |||
Fine, you are an unusual one, Mr 71.162. I'll try to fix these errors soon. "Relatively" is not qualified - is this opinion? ] | ] 09:56, 11 June 2008 (UTC) | |||
==Chaos== | |||
ACCORD ({{DOI|10.1056/NEJMoa0802743}}) and ADVANCE ({{DOI|10.1056/NEJMoa0802987}}) have appeared online and will appear in print tomorrow. These will need to be mentioned. Why did ACCORD cause SUEs and ADVANCE not? Is it all due to the 90% on rosiglitazone? ] | ] 09:56, 11 June 2008 (UTC) | |||
:OK. I've now waited quite a while and have seen no further elucidation of the difference found. Is either true (large studies, so one expects no distortions due to too small n, but...) or are both wrong and lowering Hb1c for years causes more abduction by aliens instead, and both these studies missed it? What gives??? ] (]) 00:20, 25 June 2009 (UTC) | |||
==Treatment topic bias== | |||
I find the wording in the treatment section regarding American health care rings of a bias. No one needs to be told that the U.S. is a developed country. "Clarifying" that it's a developed country is unnecessary unless one was trying to point out something other than the U.S. as an example of a country who has privatized healthcare. To prevent that section sounding political and to protect the integrity of the article, it needs to be changed. <small>—Preceding ] comment added by ] (]) 01:52, 21 June 2008 (UTC)</small><!-- Template:UnsignedIP --> <!--Autosigned by SineBot--> | |||
:Suggest you get a username, and then {{tl|sofixit}}. ] | ] 07:39, 5 August 2008 (UTC) | |||
::I expect that the US data mentioned here was available to the writer, not that there is or was a conspiracy to denigrate other countries or population. The cure, of course, is to add comparable data for other countries or populations. Be Bold. Add it if you've got it. ] (]) 15:41, 6 August 2008 (UTC) | |||
== Management of Diabetes Mellitus == | |||
It would be helpful to emphasize the importance of blood pressure control in the management as improved glycaemic control does not reduce cardiovascular mortality though it improves the lipid profile. The benefits of strict blood pressure control are far greater thatn strict blood sugar control.] (]) 20:08, 9 July 2008 (UTC)Plasmon | |||
:I was under the impression that we had some endpoint data on macrovascular disease. But I agree that hypertension is the biggest killer in diabetes. ] | ] 07:39, 5 August 2008 (UTC) | |||
==Messing about with the introduction== | ==Messing about with the introduction== |
Revision as of 23:13, 6 August 2009
Diabetes is a former featured article candidate. Please view the links under Article milestones below to see why the nomination was archived. For older candidates, please check the archive. | |||||||||||||
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Current status: Former featured article candidate |
Medicine B‑class Top‑importance | ||||||||||
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Template:MCOTWprev Template:MedportalDYK Template:WP1.0
Messing about with the introduction
The introduction to this article has already been labeled "too long" and containing far too much detail. Over the last few days there have again been numerous edits to the intro, and I feel some of them are duplicative (e.g. intimating again and again that type 1 is due to hyposecretion of insulin) and overly detailed (e.g. wanting to state that DM1/2 are polygenic and MODY is monogenic). I have done some rejigging.
In general, this shockingly important article is still in an abysmal state. I have previously tried to interest some editors in a short-term collaboration, including MCOTW. In my mind, the following problems exist:
- We need a couple of great, widely accessible sources
- We need to decide what needs to go in subarticles, and what doesn't
- We need to discuss recent evidence-based guidelines, such as the 2008 NICE guideline in the UK
Any more wisdom? JFW | T@lk 07:44, 5 August 2008 (UTC)
- Dear User:Jfdwolff, your point of view on the INTRO is not supported by WP:LEAD; deletion with a frivolous explanation (e.g. yours "I really think...") qualifies as Blanking of WP:VANDALISM, because it was based on a private opinion, and additionally it contradicted the guidelines provided by WP:LEAD, because MODY is a distinctive type and monogenic diabetes is a distinctive group, without which diabetes is not presented completely; I divided the lead (intro) by adding a new chapter, because the complications were mentioned at the beginning and treatment is not strictly the disease, but only... the remedy. Sincerely, (162.84.184.38 (talk) 03:46, 6 August 2008 (UTC))
Firstly, please be good enough to await consensus here before redoing your edit. If you're unfamiliar with this, please have a look at WP:BRD.
I tried to explain that presently MODY is regarded as an unusual form of diabetes. Your insistence of a 1300 byte chunk of text to clarify its existence in the lead is, in my mind, a WP:WEIGHT problem. I will settle for a single sentence that notes the existence of several rare forms of diabetes, which apart from MODY would need to include Wolfram syndrome, myotonic dystrophy, Friedreich's ataxia and numerous others. But all this distracts from the fact that DM2 (and DM1) are the main forms, and together affect many more people than the rare forms. Lead sections simply need to be selective, and I think this is something that is best left outside the lead. I know you disagree, so please propose a solution that will make us both happy. I'm happy asking WP:MED to give comments. JFW | T@lk 06:24, 6 August 2008 (UTC)
- Very well, instead of discussing (why to waist time), just, please, put in your sentence in front of the paragraph with (irrelevant) 1921 and I will figure it out, what you meant and why (appreciating people's intelligence is polite); my concerns, expressed above, will be satisfied by just three words: monogenic diabetes (with the reference) and MODY (hyperlinked), though, it is up to you, how to do without polygenic; the proposed and justified division into 2 chapters made the lead (intro) easier to overview at one glance; I have no attachment (see WP:OWN), but do not like exclusions of minorities (it smells like a discrimination) especially inconsistent with WP:LEAD (162.84.184.38 (talk) 15:26, 6 August 2008 (UTC)).
- I'm one of those who have edited the intro in recent days. My motive in this recent spate of edits was to clarify some poor English, not to add to the intro length. My edits have been followed in at least a couple of cases by redits which have reintroduced odd English. The insistence on peculiar English is itself somewhat odd.
- A point had been introduced in the intro about the genetic origins of DM, and I simply left it in (with a bit of rephrasing). I'm not entirely certain it belongs in the intro, but it is after all an issue of origin and so has some claim to inclusion in an intro.
- Editor JDW has been a long time contributor to this article and has, in every instance of which I'm aware, made reasonable edits which have had at least the effect of stopping lower quality, and most of the time, increasing quality. So the objection about that his edit was based on a private opinion (what others are available in re style, after all?) and that his edit is / was frivolous, is simply not credible.
- JDFW's point about the abysmal state of the article is correct. Cruft has been added, bit by bit, for some time. A cruft clearance copy edit is certainly overdue. His point has been made, in one form or another, for a long time (see prior talk archives). One problem with his suggested program for this article is one of coverage and good style. We can have an article of first resort (as this one is) which essentially consists of a series of pointers to subarticles. If so, we will be requiring the Reader to consult many sources to compile a summary account of the disease(s). If so, we editors will have failed in our obligation to provide a summary in this article. The line between enough detail to summarize and too much referral to subarticles is not an easy one, but if it were easy, responsible Misplaced Pages editing would be trivial. ww (talk) 16:00, 6 August 2008 (UTC)
- Formal logic problems: I wrote "frivolous explanation" (of arbitrary deletion), not "edits" (themselves); official opinions, which do exist beside "a private opinion (what others are available in re style, after all?)", belong to WP:LEAD; the fact that "JDW has been a long time contributor" is irrelevant (see WP:OWN), the "the abysmal state of the article" and "cruft" are not the issue here, but a placement of just 3 words in the lead to make it complete, as WP:LEAD suggests; the rest of the 4th par. is a private opinion, not an argument (e.g. he likes red, and she - blue), and discussing taste is pointless, as already the Romans noticed (de gusibus non est disputandum); and thanks for the style corrections, but I created the compact and logical structure of the lead's 1st par., because... you were not able to do so (162.84.184.38 (talk) 22:56, 6 August 2008 (UTC)).
- IMO the content of the introduction as it stands at the moment is about right. The changes I would make are primarily stylistic: Why did we wikilink i.e.? Why are there so many parenthetical comments in the third paragraph? Do you think we need to instruct the reader -- with remarkable imprecision -- that a complication is a side effect? Why not simply link to Complication (medicine)?
- Since it's apparently been the source of some contention, I do not think that we need to go into details of cause in the intro for this article, as every subtype has a different cause. MODY should mention its cause in its intro; Diabetes mellitus would have to discuss all the causes for all the types in its intro, and this is too much information for the lead. (Compare the decision you would make for Heart disease.) WhatamIdoing (talk) 18:23, 6 August 2008 (UTC)
- It is not about mentioning causes of MODY in the lead, but just its name and 2 other words: MODY (wiki-linked) and monogenic diabetes (with the reference to the NIH's article) to make the intro complete per the WP:LEAD's guidelines. Obviously, parenthetical comments are an indication of deficiency in processing the syntax, which otherwise would require much more effort and maybe capacity; not everyone is a born editor, e.g. my style sucks, but there are many people, who can correct style, and only a few, who can synthesize for it is quite difficult, so "cruft" grows (162.84.184.38 (talk) 22:56, 6 August 2008 (UTC)).
Please, check out the minuscule addition (162.84.184.38 (talk) 23:08, 6 August 2008 (UTC)).
- I think we're getting dangerously close to personal comment on other editors here; this would be a good place to chill. As has been pointed out, tastes differ (and consensus is the standard under that rubric), and no one owns an article, including this one. All edits are subject to ruthless revision per WP policy. Doffed defense of particualar phrases is out of place accordingly. ww (talk) 23:49, 6 August 2008 (UTC)
- No, we are not (do not take it personally), and we have a good lead thanks to the common and constructive contributions unlike the discussion, which seemed to be a waste of time and effort, so making it aggressive shortened such waste; very often editing Misplaced Pages is a compensation for missing parts of life and once 6 such "nice" persons lacking advanced skills (maybe high school students) asked a 12 year old administrator to protect an article for 2 weeks under a pretext of a vandalism constituted by mere 2 meaningless pranks, and he did it closing the article for 2 advanced editors, but it took a complaint to a senior administrator to bring them to order and to remove the protection, because WP: CONSENSUS in not necessarily a result of a democratic vote or - in other words - a majority is not necessarily right; I am not going to edit anymore, because my objective was just to add monogenic diabetes and MODY, and fixing the lead just happened by chance; I did not want to add them to a badly written paragraph full of logical mistakes, so we fixed it; good luck fellows (162.84.184.38 (talk) 03:36, 7 August 2008 (UTC)).
- I've checked out the "miniscule addition" and I think it unnecessary promotion of a rare form. WhatamIdoing (talk) 05:02, 7 August 2008 (UTC)
162.84, I looked at your new version and while I appreciate your attempts to shorten it, this still smacks of WP:WEIGHT in the sense that it still places undue weight on a single type of non-1 non-2 diabetes. You also added it in a place where it is completely out of context (unless the symptoms of MODY are radically different from other forms of diabetes, which they are not).
It's a shame that you have chosen to bid us goodbye, because I'd prefer to settle this pleasantly. Generally, there is no need to use boldface (it is interpreted as shouting). Also, making random jibes at other editors for not having "advanced skills" will not endear you to anyone. JFW | T@lk 05:46, 7 August 2008 (UTC)
- This is not a popularity contest, the monogenic diabetes and MODY sentence was placed properly just after 3 most popular types, as monogenic diabetes is the fourth most popular one, and your fifth abrupt and destructive deletion (06:08, 3 August 2008; 07:24, 5 August 2008; 15:40, 5 August 2008; 06:17, 6 August 2008; 05:36, 7 August 2008) does NOT support your good-faith claim "I'd prefer to settle this pleasantly" (you declare one and do the opposite); a resolution request at Administrators' noticeboard. (162.84.184.38 (talk) 15:35, 7 August 2008 (UTC))
- JFW has provided a more than reasonable explanation of his reverts. Please be kind enough to review them before reinstating the information. It is not him reverting your edits which is the problem, it is you readding the information before consensus from other editors has been sought after. —Cyclonenim 17:41, 7 August 2008 (UTC)
- His explanation is not humanitarian, but arbitrary and inconsistent, because who said that you list only 3 most popular types, and not four, please? If only 3, then why already 6 acute signs of diabetes are listed in the 1st paragraph, please? They are also not equally popular!
- Monogenic diabetes constitutes 1-5% of all diabetes (]) 18 M cases in US; see ] (230 M worldwide; see ]), so - 180,000-900,000 cases in US (2.3-11.5 M worldwide), and he claims that it does not deserve a mention in the lead. So, how many millions of cases are needed for it to deserve the lead, please? The number is rapidly rising, and it may be appropriate let say in 2011 or 2013!!! Like to play God: you are good, and you are not good enough, please? 162.84.184.38 (talk) 21:18, 7 August 2008 (UTC)
- It is indeed not a popularity contest, but if you repeatedly assume bad faith, make incivil comments or edit disruptively you are unlikely to achieve your desired outcome.
- MODY is rare. So are numerous other forms of non-1 non-2 diabetes. If we were to devote space to these forms in the lead, we would have to cover all of them, thereby exceeding the reasonable length for the intro. JFW | T@lk 19:04, 7 August 2008 (UTC)
- All three your accusations are false!
- The lead after years of editing and before my first 00:12, 29 July 2008 contribution was a disgrace full of repetitions and logical errors. The 1st paragraph now is more meaningful than the previously two. Every my edit was constructive and accommodative to edits by the others. There was not a single deletion. How does it qualify as assuming bad faith (WP:AGF) by me, please?
- Your argument of me making incivil comments (WP:CIVIL) contradicts your initial statistical reason: "this still smacks of WP:WEIGHT". That WP:CIVIL argument means that your application of WP:WEIGHT was NOT based on merit, but depended on the tone of my comments. In other words, by listing WP:CIVIL among arguments in support of your position for WP:WEIGHT, you admit that my comments (and not merit) influenced your consideration of WP:WEIGHT, so your editing is about you, and not Misplaced Pages, which is not considered a social club by everyone!
- As far as the third argument, would you give one example of my disruptive edit of diabetes, just one, please. 162.84.184.38 (talk) 21:18, 7 August 2008 (UTC)
- Characterizing other editors positions as accusations is not helpful. We are enjoined here to assume good faith, if not to agree on every point. Further, a demand to demonstrate in detail how the supposed accusation is justified is, essentially, an invitation to detailed dispute. We are enjoined to find consensus by WP policy.
- The situation here can be summarized as an idea that MODY and its genetic difference from more common forms of DM should be in the introductory lead in. Opposition to that position notes that MODY is only one of a number of rare varieties of diabetes, even of dibetes mellitus and that as such it doesn't justify such special treatment. Such a difference of view certainly doesn't justify claims of accusations and demands the accusations be demonstrated in even one detail.
- "Loaded words" aren't helpful in discussions of how to improve any article, much less one which is as important to so many people as this one. Everyone should take a deep cleansing breath... 67.86.173.246 (talk) 17:19, 10 August 2008 (UTC) oops, this was actually me and WP helpfully had logged me out it seems sorry I didn't notice it before. ww (talk) 00:03, 7 September 2008 (UTC)
Sorry 67.86.173.246, but the facts do not support the premise of the summary above, and with a false premise, the conclusion not credible. The key is an actual frequency represented by hard numbers, and not a feeling of commonality.
Monogenic forms (or "MDM"), constituted by frequency almost entirely by MODY and accounting for 1-5 % of all DM, are in comparison to the 3 most popular forms (type 1, 2, and gestational), or "PDM", less frequent by an order of magnitude, at 1 %, and up to the same order of magnitude at 5 %. So they cannot be called "rare", which means "not frequently encountered; scarce; unusual" or "uncommon, i.e. singular, extraordinary". The hard numbers, as quoted and argued in ]), illustrate it:
"Monogenic diabetes constitutes 1-5% of all diabetes (]) 18 M cases in US; see ] (230 M worldwide; see ]), so - 180,000-900,000 cases in US (2.3-11.5 M worldwide). If not included in the lead, how those hundreds to millions of people will find its existence otherwise, please? Just one little sentence reading "Less common (1-5 %) are monogenic forms of diabetes, e.g. MODY.". Why from 180,000 people with monogenic diabetes in US to 11.5 M worldwide have to be discriminated against in easy access to a basic info in Misplaced Pages, because a few people selected such fate for them (not popular enough), please? Is the eugenics back or worse?"
The second argument, even more important, is that MDM are grossly "under-diagnosed" causing also a false impression of their (un)commonality. Many, if not most, physicians are not able to distinguish MDM from PMD, so they may falsely claim that MDM are rare. Because of prevailing misdiagnosing in from hundreds of thousands to millions of cases, MDM and MODY belongs to the intro to make people aware of their existence and to give them a chance to inquire.
On the other hand, all other forms of diabetes are actually rare, i.e. less frequent than the most common PMD by approx. two orders of magnitude, and - so - they really do NOT belong to the WP:LEAD. 162.84.184.38 (talk) 19:52, 6 September 2008 (UTC)
- The point I was making had to do with tone, not facts. Granted all of the facts you cite re MODY frequency as compared to others types, there is still an issue with the intro. Stylistically, it's not possible to include even brief mention of all aspects of DM. Consensus has established the intro you came to, and your edits to it have not won consensus on mostly stylistic grounds. I'd like to see the reference you cite mentioned in the body of the article where less common types are covered, though. ww (talk) 00:03, 7 September 2008 (UTC)
- You practically admitted that you are wrong! The WP:LEAD says:
- "The lead serves both as an introduction to the article below and as a short, independent summary of the important aspects of the article's topic. The lead should be able to stand alone as a concise overview of the article."
- I have proven statistically, numerically, and on the humanitarian ground (see my second argument above) that mentioning monogenic forms (MDM), incl. MODY, in just one short sentence belongs to the intro, because it meets the criterion of important aspects required by WP:LEAD, and also the criterion of allowing the lead to be a complete overview (stand alone), because without MDM other forms are NOT represented in the lead, and they are a significant part of the article.
- On the other hand, your stylistic argument, contrary to mine, has NO base in the principals of WP:LEAD what so ever, because it is purely esthetic and emotional, though popular!!! Please, note, that WP:CONSENSUS is NOT WP:POLLING, and that logic is, what matters, and not popularity! 162.84.184.38 (talk) 18:19, 7 September 2008 (UTC)
- Practically isn't the same as actually. And in any case, this is not about the 'facts'. It's about the style of the intro section in light of multiple WP policies admonitions, all of which is to be settled by consensus per WP policy. You have mis taken my comments here and hared off on a wild goose chase. Please reread them and consider that I was talking about something other than your interpretation. In the meantime, I've reverted again, as it seems to me beyond clear that consensus had been reached on this point (see the discussion above, if you will). ww (talk) 20:49, 7 September 2008 (UTC)
- (1) You have missed that I also corrected a serious logical error in the intro (see );
- (2) There is no substance in your above argument full of the indeterminate forms: a style, policies, admonitions, all of which, per a policy, a wild goose chase, something other, this point;
- (3) "Practically" means "for all practical purposes; in effect; virtually" and is an equivalent to "actually"; the way you wrote above indicates carelessness or serious problems with English and/or formal logic; please, treat the discussion seriously!
- (4) Your revert again, without a serious consideration of my correction of the logical error, may be close to vandalism, because WP:CONSENSUS (please, read there) is not a popularity contest, and formal logic takes president over a point of view of a majority; 162.84.184.38 (talk) 14:13, 8 September 2008 (UTC)
- 162.84..., This long siege has degenerated to the extent that it requires external intervention.
- I have accordingly requested such. ww (talk) 16:20, 8 September 2008 (UTC)
Could I encourage 162.84.184.38 not to make any further edits to the lead until the mediation is underway? The case is at Misplaced Pages:Mediation Cabal/Cases/2008-09-08 Diabetes mellitus. To remain with the issues: current statistics show that MODY and other monogenic forms of diabetes are rare. Therefore, to emphasise them against the must more common forms of diabetes amounts to overemphasis. That has nothing to do with discrimination, and inflammatory language (as well as boldface and endless lawyering of policies) is unhelpful. You have been encouraged to make contributions to the article body, where there is plenty more scope for discussing the rarer types of diabetes, all of which are encyclopedic and need to be mentioned in full detail - especially if the diagnosis or treatment is radically different from the usual forms. JFW | T@lk 20:35, 8 September 2008 (UTC)
- Not true: (1)"Monogenic diabetes constitutes 1-5% of all diabetes (]) 18 M cases in US; see ] (230 M worldwide; see ]), so - 180,000-900,000 cases in US (2.3-11.5 M worldwide)."
- and
- (2) Because the WP:LEAD says:
"The lead serves both as an introduction to the article below and as a short, independent summary of the important aspects of the article's topic. The lead should be able to stand alone as a concise overview of the article."
- so I have proven statistically, numerically, and on the humanitarian ground (see my second argument above) that mentioning monogenic forms (MDM), incl. MODY, in just one short sentence belongs to the intro, because it meets the criterion of important aspects required by WP:LEAD, and also the criterion of allowing the lead to be a complete overview (stand alone), because, without MDM, other forms are NOT represented in the lead, but they are a significant part of the article.
- (3) The sentence "The two most common forms of diabetes are due to either a diminished production of insulin..." illogically introduces arbitrary and unnecessary "forms", when it actually refers there to the two main causes, etc. 162.84.184.38 (talk) 03:39, 9 September 2008 (UTC)
I will not respond to your arguments here, because the case has been referred for mediation. JFW | T@lk 18:48, 9 September 2008 (UTC)
- But, your 8 September 2008] reversal - of my correction in WP:CONSENSUS ("the logic may outweigh the logic" screemed false, because nothing can outweigh itself; see the discussion) - summarized by your insinuation, that the revision by me was "used for wikilawyering on Talk:Diabetes mellitus", seems to be a bit too much. 162.84.184.38 (talk) 19:36, 9 September 2008 (UTC)
- ...and Misplaced Pages:Mediation Cabal/Cases/2008-09-08 Diabetes mellitus seems to be a good idea; thanks! 162.84.184.38 (talk) 19:44, 11 September 2008 (UTC)
Will you please stop reverting to your version, which has no support at present, until the mediation case is completed? I face the decision of asking for the page to be protected or asking an administrator to consider blocking your access to Misplaced Pages. JFW | T@lk 20:15, 13 September 2008 (UTC)
multiple edit revert this date
I have just reverted multiple edits by an anon poster, all of them based on claims that Type 2 is curable (80% was the citation) by special diets. In addition, the edits also deleted useful content. As they were not discussed here, and were a kind of POV in any case, I judged deletion was indicated.
Since the reversion didn't preserve my edit summary, I thought it useful to explain here.
Anon poster, if you would like to include those claims, please source them and include them in the cure for Type 2 section along with the bariatric surgery which has recently made such a splash. Otherwise, I suspect your edits will be found POV in future as well. ww (talk) 19:06, 5 September 2008 (UTC)
archiving clashes with mediation
This article has been referred to the Mediation Cabal (see tag at the top of this page), and just as that happened, Coro did one of his period archive sweeps of this page. This has changed the easily available e record of this page to the inconvenience of the Mediation process. Coro has been requested to unarchive for the duration of the mediation.
Mediators, please stand by... ww (talk) 16:45, 9 September 2008 (UTC)
The archived discussions for the end of 2007 have been restored to the top of the page for easy re-archival. --Coro (talk) 21:33, 9 September 2008 (UTC)
MEDCAB mediator
Hi all! :-) Can all parties please give me a quick version of their view of the matter? Please keep to less than 400 words if you can (each). Thanks! Fr33kman 04:47, 14 September 2008 (UTC)
MEDCAB
I am sorry but due to personal events I have to leave for a short while. I have relisted the case on MEDCAB. Thanks and Good Luck! :-) Fr33kman 01:29, 17 September 2008 (UTC)
Hypertension
In DM1, poor glycaemic control is associated with an elevated risk of hypertension, again confirming the role of insulin in blood pressure regulation. http://archinte.ama-assn.org/cgi/content/full/168/17/1867 JFW | T@lk 20:55, 22 September 2008 (UTC)
MEDCAB (2nd go)
Hello all! I a going to retake this case (if that is acceptable to everyone). I need a quick overview of the dispute in order to understand it better. Could each person involved please fill in their view (less than 250 words) in the relevant section below. Please do not respond to or edit another editor's response. There will be ample opportunity to discuss this, I just need to know each editors position. You can be technical in this mediation, I am a medical student. Thank you - fr33kman -s- 22:08, 29 September 2008 (UTC)
Editor 1
See Misplaced Pages:Mediation Cabal/Cases/2008-09-08 Diabetes mellitus for my account of the business which has gottne us here. In the period since submission to Med Cab, the back and forthing has subsided. Perhaps it will not resume? ww (talk) 18:40, 30 September 2008 (UTC)
- Should we close the case, and open it again if needed? fr33kman -s- 20:06, 30 September 2008 (UTC)
- In my opinion, no. There were several instances after I thought consensus reached, but was disabused of my optimism in short order. Let's carry the process through, now that you're back on the case. My pious hopes for settlement shouldn't influence anybody; my delusions are my own, not to be taken seriously. Welcome back, incidentally. ww (talk) 21:21, 30 September 2008 (UTC)
Editor 2
The following changes (also just added to the lead) have been opposed without a cause. The 3rd sentence of the lead:
The two most common forms of diabetes are due to either a diminished production of insulin (in type 1), or diminished response by the body to insulin (in type 2 and gestational).
is faulty, because it unnecessarily refers to types of diabetes (1 & 2) as forms, which they are not; they are types, as their names indicate it. So it was replaced by the following sentence avoiding the word "forms" and saying practically the same:
Diabetes develops due to a diminished production of insulin (in type 1) and resistance to its effects (in type 2 and gestational).
The 4th sentence remained unchanged.
The 5th sentence:
Monogenic forms, e.g. MODY, constitute 1-5 % of all cases.
was added, because:
(1)"Monogenic diabetes ("MDM") constitutes 1-5% of all diabetes (]) 18 M cases in US; see ] (230 M worldwide; see ]), so - 180,000-900,000 cases in US (2.3-11.5 M worldwide)."
and
(2) MDM are grossly "under-diagnosed" causing also a false impression of their (un)commonality. Many, if not most, physicians are not able to distinguish MDM from type 1 or 2, so they may falsely claim that MDM are rare. Because of prevailing misdiagnosing in from hundreds of thousands to millions of cases, MDM and MODY belongs to the intro to make people aware of their existence and to give them a chance to inquire.
and
(3) The WP:LEAD requires:
"The lead serves both as an introduction to the article below and as a short, independent summary of the important aspects of the article's topic. The lead should be able to stand alone as a concise overview of the article."
and it has been proven statistically, numerically, and on the humanitarian ground (see the 2nd argument) that mentioning monogenic forms ("MDM"), incl. MODY, in just one short sentence belongs to the intro, because it meets the criterion of important aspects required by WP:LEAD, and also the criterion of allowing the lead to be a complete overview (stand alone), because, without MDM, other forms are NOT represented in the lead, but they are a significant part (a chapter) of the article.
My 162.84.184.38 (talk) ID changed to 71.247.12.83 (talk) 08:30, 2 October 2008 (UTC).
Editor 3
Editor 4
Editor ...
Thank you in advance! :-) fr33kman -s- 22:08, 29 September 2008 (UTC)
Mediator
I think that the lead section should contain any form of DM that affects at least 2% of the population of patients. 2% (indeed less) is a medically significant figure (if 2% of patients a surgeon . If this were an article about religion in Unnameistan then a 2% population of adherents to a minority religion might not qualify for inclusion in the lead, but it's not; it's about a medical condition. The various type should be called "types" and not forms. The reason for this is that this is an encyclopaedia, the reader is what matters, not the editors! We (experts) don't write Misplaced Pages for our own use, we write it for the layperson. This article must be understandable by the non-expert reader. Experts shouldn't be coming to Misplaced Pages for sources: frankly it would be professionally weak to do so and no peer reviewer would look kindly on a researcher using a Misplaced Pages article as "evidence" in any publication of note (indeed at my university, citing Misplaced Pages is an automatic failure for any piece of work submitted to med-school!). This place is for the high-school student, the worried new patient, the news reporter looking for a quick snippet to include in an article: the layperson. As such, we have to keep it understandable by that audience. Also, the only mention of a cure should be surgical (although endocrinologists and other physicians would not call such a cure per se, but a surgeon would ). Any true, medical, cure for DM would need to be peer reviewed and would earn the discoverer a Nobel prize and would be so widely reported in the lay-press that there would be no question here as to its validity! Comments? fr33kman -s- 15:52, 6 October 2008 (UTC)
- I'd also ask if people are ready to propose compromises? fr33kman -s- 17:55, 6 October 2008 (UTC)
- Thanks ...man for the clarification, which is exactly, what I have been suggesting for months; monogenic forms constituting 1-5 % of DM (average = 2.5 % per the best estimation from NIH) seem to pass the min. 2 % criterion, and nothing rearer. I hope, the little sentence will not be removed again. 71.247.12.83 (talk) 21:44, 7 October 2008 (UTC)
- Re cure: there is a long discussion on exactly this point in the talk above. Clearly there are different views (even among the medical folk contributing) regarding the exact definition.
- Re form v type: pretty much a distinction without a difference in this context. Plato's not involved after all, and we're using English, a language in which there are multitudes of synonyms or near synonyms. And in a non technical article not meant for professionals perhaps it's being too over careful.
- Re compromise. I personally have little trouble with whatever style derision on this point is established by consensus amongst editors. I may disagree, but my opinion is not determinative. In this case, there being on the order of 50 sorts of diabetes and many sorts of DM, it's not clear where the line should be drawn in the lead. I think, attempting to speak on behalf of our Average Reader, that the lead should definitely be about establishing that DM is not just one thing, that the dominant type/form is <xx> (and maybe the second most common too as reinforcing the pint about non singularity), but no further, as it is the 'lead' not the body. But without consensus, WP policy does not favor campaigning for content or style consensus has deemed inappropriate. Hence this mediation, no?
- Sorry to hear about your med school's policy re WP. Surely there's something here an embryo doc can usefully learn from!
- Re technical language surplusage. Yes I agree, Each of the diabetes articles I partol has been becoming more and more specialized -- partly I suspect due to fear of fact tag bombing -- and so less readable to our target audience, the average Reader. Without personally rewriting them every so often, I don't see a good way out of this trend. All articles should, of course, regardless of the high (or lower) proportion of technical terms, be accurate. This requires a general quality of prose not usually available in the technical fields (would that all were as scintillating as Lewis Thoms or Peter Medawar! Als, not likely.) and hard to find on WP after edits from all against whatever might have been present at one time. ww (talk) 17:53, 7 October 2008 (UTC)
- Of course it's semantics regarding "type" versus "form", but again, I feel that the reader is the important person here. They will be more familiar with the term "type" as this is what most clinicians will refer to them as. Cure, there will always be controversy on that term (for all diseases, not just DM); but again it's the reader that's important. The term "cure implies (rather strongly in an encyclopaedia) that the disease is curable (as in "I don't have it any more and have no symptoms or treatment at all; ie: it's gone!") Regarding the lead, it should be a stand-alone mini-version of the article (as much as is practicable) and I do think that any type that has a significant number of patients should be listed: very rare types should probably be left for the article with a pointer in the lead such as; "Although there are many types of DM but the most common forms are ...
- There is a difference between type and form especially in application to DM. Type is close to a specific illness, and form refers to a group with a common feature, e.g. monogenic form or polygenic form. Not everyone is proficient in the proper terminology, but it was provided (by myself) and the only burden there was NOT to oppose it... for months... with a benefit to everyone and no cost. Btw, I do edit Existentialism.
- The inclusion of relatively new MODY has been on a humanitarian (statistical) ground. Percentages of the three main types of DM are in double-digits, MODY - single-digit, other types - in fractions of 1 %. The unsupported argument held for months of drawing somewhere a line excluding MODY was shared by just a few (maybe only 3) conservative editors. The one minuscule sentence inclusion has been balanced by a reduction in size of the 3rd paragraph causing the total size of the lead to actually decrease. I did the work and its acceptance would be a kind of professional courtesy.
- Sometimes you need to fight for what you believe on Misplaced Pages (or indeed any area of life). There are loads of people with a vested interest in an article such as DM: physicians, naturopaths, homoeopaths, Christian Scientists, herbalists, patients, families of patients etc., with such a diverse group of editors (and beliefs or needs), there is bound to be contention: sometimes months after the initial edit, when that contending editor first sees it. fr33kman -s-
- Obviously, Misplaced Pages is NOT a scientific source especially in the lead part of articles, but it can be written properly, with respect to types and forms, and in a simple language, which requires more effort than convoluted one. The argument: "Each article has been becoming more and more specialized" sounds more like entitlement than a lame excuse that the articles became complicated by themselves. And the conclusion after opposing for months the simplification: "I don't see a good way out of this trend." calls for the answer: Do not block advanced edits by using consensus among a few friends, please! Or, do work harder and not block for months edits, like mine, when I am willing to put an additional effort to simplify text and make it more available to average reader, please! How many articles could have I simplified instead of wastefully arguing for months here about one little sentence, please? 71.247.12.83 (talk) 10:06, 9 October 2008 (UTC)
- I agree that I don't see a quick way out of the complex creep that is occurring all over Misplaced Pages. As a challenge to any of you, or all of you: try expanding the article over at simple wikipedia whilst keeping to their rules over the use of Simple English! That's quite a challenge, especially when the article over there is actually too complex as it stands today! :-) fr33kman -s- 14:11, 9 October 2008 (UTC)
- Misplaced Pages needs more experts, who are not available, in addition to dedicated editors it already has, who sometimes get "too focused", but they actually create the bulk of articles. Sometimes, editing goes smoothly and appreciative, like with microprocessors, where each lead got fixed within just a few hours without a single word of discussion, but just by constructive contributions and compacting trivia by myself and without reverting or deleting anything by others, who did not feel offended by my effort, but happy that the article they like will be simpler and complete; adding a TDP rating was my motive. Unfortunately, almost nobody has a capacity and patience to compact, so the complex creep grows. I have not given up with DM, because my friend got it prompting to make the lead better for millions, like her, to have something simple and comprehensive up front, but I do not have such motive for poor Existentialism; do read the 1st sentence and tell, if you understand anything, but the editors there are very dedicated too... . 71.247.12.83 (talk) 22:49, 9 October 2008 (UTC)
- Status?
Do we feel that we have a solution at this point? Are there other concerns remaining? fr33kman -s- 14:11, 9 October 2008 (UTC)
- I think so; after compacting the 3rd par., the MODY addition has not increased volume of the lead. Thanks! 71.247.12.83 (talk) 22:49, 9 October 2008 (UTC)
- I do not, on stylistic grounds, agree that there is a solution. Form v type I think is mere quibble and I don't care much about that either way as I think there is little risk of losing/confusing our Reader. However, introducing the idea that monogentic types (or forms, whatever) are 1-5% of cases in the lead raises the question in the Reader's mind of what is 'monogenetic'.
- "Must be important because it's in the head paragraphs, above the TOC. From the word form used here I suppose there must be 'bigenetic' or 'polygenetic' types, but they're not mentioned. Why not? And does it matter? I've no idea since the mention has no context I can see. ..."
- The cost (in words) of providing the context is too much to expend in an intro and so inappropriate. The lead says there are lots of types (two most prominent are mentioned to illustrate that point) and the discussion continues with other general issues regarding diabetes all of which are appropriate in an intro. Nothing else belongs in a brief lead -- it's a point about writing style, about clarity, about serving the Reader, ... NOT a point about content.
- So there's still no real reason to add this to the introduction, and most especially not in the particularity brief form it now has. If MODY is to be in the intro, there must be sufficient context there for it to be understood. Thus, I object to the current status of its inclusion on stylistic grounds. A prior version of that edit was more satisfactory on these grounds, but objectionable on other stylistic grounds in not being appropriate to the intro (too long).
- Since contentious edits were to have been suspended during the Mediation, I shall not correct the problem, but it shouldn't have been added anyway, which is another aspect of the problem. Consensus was reached, the editor immediately above ignored it, characterizing it derisively with a good bit of policy lawyering -- not collegial WP behavior. Re-inclusion during the Mediation process is illustrative. There has been non-collegiality, degenerating to personal attack on occasion, in re this aspect of the intro. It continues, in somewhat muted form; eg, it is wholly irrelevant re WP editing participation whether I, or JDFW, or anyone else, was, are, might be, ought to be, or should not be, "conservative" as claimed. And whether the editor in question is admirably and virtuously advanced, liberal, radical, or whatever, in contrast. It's equally irrelevant. Furthermore, whether those who disagree are merely a 'few friends' conspiring together is merely poisoning the well: I know personally no other WP editor at all, do not correspond with any outside of WP talk pages (with one exception re password strength where the issue was primarily technical, not stylistic), have never been to the Netherlands (JDFW's practice location per his User page) and have been in Iowa only once in my life (Alterprise' practice location per his User page -- actually, without re-reading the entire business, I can't now remember whether Alterprise was involved). The claim is demagoguery and false to fact, certainly with respect to myself.
- The article matters, the Gentle Reader matters, and WP matters; the personal, and suspicions of conspiracy against one, and rules lawyering do not. There has been trouble on all these fronts. ww (talk) 23:40, 10 October 2008 (UTC)
- I do not, on stylistic grounds, agree that there is a solution. Form v type I think is mere quibble and I don't care much about that either way as I think there is little risk of losing/confusing our Reader. However, introducing the idea that monogentic types (or forms, whatever) are 1-5% of cases in the lead raises the question in the Reader's mind of what is 'monogenetic'.
Case has been Closed
It would appear that the case has been closed as of December 16, 2008. Assuming no objections, I intend to archive the last of 2007 over the weekend.--Coro (talk) 01:21, 30 January 2009 (UTC)
ayurvedic medicine missing -- it has cures for DM
Why is Ayurveda not mentioned anywhere as an alternative treatment? This is shocking, that there is not mentione of ayurvedic cure. Yes it cures diabetes. I see atleast 2-3 people getting cured every month in a Yoga camp in my city. They are just cured by doing pranayama yoga and following a diet of raw vegetables for 18 days. After that there is a 3 day detox treatment. Forget all that Himalaya Company is selling diabetec management capsules made from herbs in the USA too. There are enough research papers available on the net. I am not adding it becuase i have tried adding information before to wikipedia and someone edits it out because they say it is "POV". Even if there is a link they say that the way I am writing it is "POV". These "editors" just delete the content, they make no attempt to remove any "POV" reference. This article makes wikipedia one big joke. —Preceding unsigned comment added by 122.167.227.4 (talk) 15:29, 14 November 2008 (UTC)
- Well, I think the answer to this question has to do with evidence based medicine -- of whatever type. Have any of these claims been credibly investigated? Is there as credible source which can be cited?
- Second, if there were an ayurvedic cure, I have to think that the rapidly rising rates of DM type 2 in India would not be the problem it has become.
- The only way these can be reconciled is, I think, to posit a conspiracy among conventional (ie. "Western scientific") medicine to suppress the results achieved by ayurvedic practice. And this is an extraordinary claims whihc requires extraordinary support, which appears to me to be lacking.
- Finally, it's important to note that Misplaced Pages has no censor board keeping out such claims. It does have policies forbidding POV and original research, and they are enforced by the editors generally, including the anon poster, should he/she care to participate. If these claims are either personal opinion / evaluation of the virtues of ayurvedic medicine in the context of DM, or original research, then they don't belong here. They should be sourced to a credible third party source in order to be included; this was the import of the first paragraph above. ww (talk) 16:47, 19 November 2008 (UTC)
There currently is no known cure for DM, so claims of ayurvedic medicine being a "cure" are scientifically and anecdotally spurious. End of discussion! Bigdumbdinosaur (talk) 16:38, 11 December 2008 (UTC)
Effect of Diabetes on Male Sexual Performance
In the article is was stated that DM may result in male impotence. Technically this isn't quite true. DM, if sufficiently progressed, may prevent one from achieving an erection of any kind, let alone one sufficient for sexual penetration, which condition we would refer to as erectile dysfunction (ED). It does not mean, however, that said individual cannot experience sexual arousal, orgasm and ejaculation. I have not been able to determine in researching available literature whether true impotence is directly related to DM itself.
The term impotence refers to the inability to sexually perform, and while many dictionary definitions simplistically consider impotence the same as ED, the relationship is not that cut–and–dried. Impotence often has psychological origins that have nothing to do with the general health and well-being of the subject person. For example, during periods of high stress—due to money problems, acrimonious breakup with his girl friend or wife, etc.—a man may become temporarily impotent. He can't relax and "let loose," which is a necessary precursor to sexual arousal. His ability to achieve an erection has not been physiologically impeded in any way, so by definition, this would not be a case of ED.
Impotence could also result from episodes of pedophilia experienced in childhood, causing one to experience apprehension or outright fear when the possibility of sexual activity looms. In such a case, all the Viagra or Cialis in the world will be of no help.
It may be that other factors that are responsible for impotence are aggravated in some fashion by DM. Again, there is an apparent paucity of research on that matter. Obviously, the medical community's focus on DM has been one of attempting to control the disease and thus mitigate the damage it can cause, rather than that of addressing its annoying but otherwise "harmless" effects. Although younger readers might be inclined to think that inability to have an erection is indeed harmful, I can assure you—speaking from personal experience—that relative to the other things DM can do to you, not being able to get it up when sexually aroused is a minor consideration in the scheme of things.
I edited the article to remove the reference to impotence and instead directly reference ED.
Bigdumbdinosaur (talk) 17:46, 11 December 2008 (UTC)
Pls add this topic to the article
Diabetic retinopathy--165.228.190.54 (talk) 03:38, 16 December 2008 (UTC)
- Already in the article. See the chronic complications section. ww (talk) 16:07, 16 December 2008 (UTC)
I'd love to see more information on the CD4T+ cells response and similar pathway for destruction of beta cells in the article. At a minimum, could we have a small section listing autoimmune response? My Doctor, 30 years ago, stated my diabetes was due to an autoimmune response. I think providing the root cause of the immune response to beta cell destruction would be beneficial. —Preceding unsigned comment added by 98.67.81.17 (talk) 16:38, 26 February 2009 (UTC)
Diabetes Is Reversible! per the webpage: Can a doctor look into this and make this news helpful to all?Bold text —Preceding unsigned comment added by Robertisonline (talk • contribs) 19:09, 10 July 2009 (UTC)
Cancer mortality
Owgh. Having diabetes increases the risk of a cancer patient dying by 40%. http://jama.ama-assn.org/cgi/content/abstract/300/23/2754 JFW | T@lk 22:50, 16 December 2008 (UTC)
Yes, and "butter will kill you..." Statistical data applies, but don't take it as law. Individual results will vary. :) —Preceding unsigned comment added by 98.67.81.17 (talk) 16:40, 26 February 2009 (UTC)
"dietary treatment" link in the introduction
The current link to diet (nutrition) is not very useful and a dead end. Please change it to Diabetic diet. Thanks.76.97.245.5 (talk) 01:17, 19 December 2008 (UTC)
beta blockers
should something be mentioned about using beta blockers with caution in diabetes? —Preceding unsigned comment added by 24.99.86.24 (talk) 15:36, 29 January 2009 (UTC)
- Possibly, but it's not a solidly established result as I understand it. And in any case, we'll need a citation for it. At most a line or two, I'd think. ww (talk) 09:22, 20 April 2009 (UTC)
removal of 'Benefits' section
This text was removed from the article today:
- Benefits
- Diabetes and the use of insulin is a huge benefit to body builders. It is very dangerous to use insulin if not a diabetic, but is still abused in the sport of body building. Insulin is sought after and used much like anabolic steroids. It is used to control blood glucose ranges, so that the body cannot store elevated glucose as fat. Type 1 diabetics usually have a normal bmi and if bulk up easily with minimal weight training. Having diabetes is not always a bad thing.
This is factually wrong (the reference to storing elevated glucose as fat) and clinically wrong (diabetes mellitus is dangerous and the drugs used in its treatement are not benign). If you want this to remain in the article, please discuss it here. ww (talk) 09:22, 20 April 2009 (UTC)
- ww, you are absolutely right to remove this section. The paragraph, as written, has no business being here. If there is a reliable citation for this information, it belongs under an "Abuse" heading in the Insulin therapy article (without the positive spin shown here). But if we're going out on a limb to call it a Benefit of diabetes, we might as well add some other so-called benefits (easy access to syringes, can't be drafted in the military, etc) - an addition I also strongly oppose.-Sme3 (talk) 12:33, 20 April 2009 (UTC)
Contradiction in worldwide numbers
From the first paragraph: "Diabetes affects aproximately 18,000,000 children and adults in the United States, and perhaps 420,000,000 persons worldwide."
From the second under "classification": "The World Health Organization projects that the number of diabetics will exceed 350 million by 2030."
It seems that one of these figure must be in gross error.
Felosele (talk) 19:28, 6 May 2009 (UTC)
Mechanism of Damage
I added section about AGEs with explanation. KeithBeltham (talk) 05:47, 4 June 2009 (UTC)
- I have removed it temporarily. I think this is relevant but should probably be discussed in the context of the complications and it needs some jolly good sources (there was a review in JAMA a few years ago). JFW | T@lk 07:17, 7 June 2009 (UTC)
Image gone awry
In Signs and Symptoms, there is presently an image of a torso with various locations of complications and such, mixed with presenting symptoms and signs. Aside from mixing apples and oranges (a presenting symptom or sign might not (and isn't in some present cases) a complication), the image leaves out one of the most common and dangerous complications, diabetic ulcers, especially on the feet. This is a major cause of amputation even in the developed world with diabetics under treatment. Perhaps the image can be expanded, added to, or even replaced by a stick figure with appropriate annotations? Not satisifactory as it stands. ww (talk) 00:40, 25 June 2009 (UTC)
- Try and persuade the chap in the image not to plaster himself over large numbers of pages. The images have no merit; nobody can alter them directly, the words are not clickable etc etc. JFW | T@lk 09:50, 5 July 2009 (UTC)
Treatment
In the treatment section, please mention the drug AR9281 (originally found by Bruce Hammock) —Preceding unsigned comment added by 91.182.203.223 (talk) 16:23, 2 July 2009 (UTC)
- Not unless it is about to be approved by the FDA. We couldn't possibly list all experimental diabetes treatments, as the majority will fall by the wayside rather than get marketed. JFW | T@lk 09:50, 5 July 2009 (UTC)
A proposal
Please see Misplaced Pages talk:WikiProject Medicine#The diabetes quagmire for a proposal on how to organise the diabetes content on Misplaced Pages. Comments invited on that page please. JFW | T@lk 09:59, 5 July 2009 (UTC)
Need to link to all diabetes-related articles:
An explanation of why the top of the article is now very crowded. Article "Diabetes Mellitus" is the "main" article to which a search on "Diabetes" links. Additionally, there are over 15 related articles on diabetes. Most of them now appear in Template:Diabetes. That template needs to be at the top of the article so a user can see what other articles exist.
To accommodate many with diabetes and impaired vision (see WT:ACCESS) will have ramped up 800x600 resolution and/or have an electronic reader device. Only in very high resolution does the Diabetes template even begin to stand out unless it is placed at the top.
An alternative is to move down the article series box with the large diabetes blue circle (which should be smaller). However, that move was reverted on 7/3/09. Other suggestions welcome. Afaprof01 (talk) 04:54, 7 July 2009 (UTC)
- Not only does the template make the top crowded, it is also very ugly now. I think you should stop trying to shove absolutely everything in the first few inches of article, and appreciate that this article is meant to be a stepping stone to all diabetes content rather than a disambiguation page.
- I think the template should be positioned at the right margin, and I would strongly encourage its placement in the first section (i.e. "Classification"). The interested reader will not object to reading a few lines if this will enlighten them in the process. Please await the opinion of other contributors before making any further change. JFW | T@lk 18:45, 8 July 2009 (UTC)
- While I think many of Afaprof01's edits have been improvements to the article, I agree with Jfdwolff on this one -- the template doesn't belong at the top. Either a hatnote of some sort linking to the template or a disambig (disambig-like) page, or moving the template lower, would be a better option. -Sme3 (talk) 20:10, 8 July 2009 (UTC)
- Whilst I appreciate Afaprof01's point, his idea doesn't really work for cosmetic reasons. I might try and ask someone to make a drop-down box (like the one already there) for the bottom of the article to include all the Diabetes articles, they're much more common than these weird templates being shoved around at the top. They're more common in usage too. The idea to have it at the top is hardly a life saving one, if anyone needs immediate information on diabetes they should be contacting there physician, and that's that in my honest opinion. An infobox at the bottom would be more suitable, equally accessible and better looking cosmetically. Regards, --—Cyclonenim | Chat 23:04, 12 July 2009 (UTC)
intro changes
I know I havent looked at this article for years, and perhaps some of these have already been thrashed out, but what I just changed included some flatly false statements or major omissions, even for a brief intro. If I have stepped on toes or upset a delicate consensus, I apologize. If anyone needs more detail as to why a change was more accurate, please ask and I will be happy to explain. PS, I agree with keeping links to the far left or the end. alteripse (talk) 00:36, 13 July 2009 (UTC)
Insulin resistance and saturated fat
I made small changes to the intro to mention resistance. Searching google ect ... looks like consumption of saturated fat (cells saturated with saturated fat are insulin resistant) is a key problem ... lead me to "Dr. Neal Barnard's Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes Without Drugs" Cites peer reviewed studies ect ... as many as 80% of type 2 diabetics can come off medication if they cut out fats. Any comments?Zinbarg (talk) 16:21, 31 July 2009 (UTC)
- "Monogenic Forms of Diabetes: Neonatal Diabetes Mellitus and Maturity-onset Diabetes of the Young". National Diabetes Information Clearinghouse (NDIC). National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Retrieved 2008-08-04.
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