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Comment on Weight loss won’t prevent diabetes by medconsumers

medconsumers — Mon, 30 Jan 2012 21:51:24 +0000

Good Idea!

Comment on Weight loss won’t prevent diabetes by dlr

dlr — Mon, 30 Jan 2012 19:14:29 +0000

How about an update on the “You can be fat and fit” article? I expect there has been a fair amount of additional research on exercise and health since 2008.

Since exercise seems to be one of the few things people can currently do to actually improve their health, an unbiased overview would be extremely helpful.

Comment on Weight loss won’t prevent diabetes by medconsumers

medconsumers — Tue, 17 Jan 2012 17:45:40 +0000

Thank you, Dr. Kahn, for guiding me to the supplement. As you said, the experts who served on ADA guidelines committees did disclose their conflicts of interest and this information is available on the Web. Of the 18 experts on the committee, 12 reported that they had conflicts of interest, such as serving on the board of a drug company that makes diabetes drugs, owning patents and/or receiving consultancy fees from drug companies that make diabetes drugs. (Re the last example, some of the experts received consultancy fees from several drug companies but an asterisk appears only when the expert got more than $10,000 from the same company). I’ll leave it to our readers to decide whether this is a testament to the ADA’s objectivity. The disclosures can be accessed at http://care.diabetesjournals.org/content/35/Supplement_1/S109.full.pdf+html?sid=0a60293e-0144-4753-8176-041560f9a8b4

Comment on Weight loss won’t prevent diabetes by Richard Kahn

Richard Kahn — Tue, 17 Jan 2012 16:40:06 +0000

ADA publishes its Guidelines every year in a Supplement to its journal Diabetes Care. The Supplement lists, at the end, all the members of the Committee that produced the Guidelines and for each person, their “Conflicts ” are listed. Moreover, all guidelines published in between the production of the annual Supplement contain the disclosures of the group that produced them. It is, indeed, common for the best and brightest to also advise industry as it works to develop new drugs or understand how best to conduct studies on existing drugs. Everyone wants the best people to help them, and that is also true for the Associations who produce guidelines. I don’t think anyone wants opinions by non-experts. The goal, however, is to disclose everyones relationships with industry, and readers can make the judgment whether, on balance, the experts were not biased. Again, in my years at ADA we went to great lengths to be sure to have a wide diversity of experts on our Guideline group, we obtained advice from experts with no obvious preconceived opinions, and we had no input from industry. The widespread adoption of ADA guidelines is a testament to our objectivity.

Comment on Weight loss won’t prevent diabetes by medconsumers

medconsumers — Mon, 16 Jan 2012 20:52:22 +0000

Your paper made substantial weight loss seem impossible to me. So did the clips from the press briefing I watched on Medpage. Re the 1% statistic that you say is incorrect, it is accurately quoted from your paper, see page 3 (unfortunately, the Health Affairs journal made it clear that I cannot post the entire article). Re pharmaceutical industry influence on the establishment of treatment guidelines: Too often the experts selected for guidelines panels have extensive financial ties to drug makers, for example, consulting fees, grants, etc. Put that together with the fact that the definition of several diseases, including diabetes 2, has been expanded in the last 15 years, often making millions more Americans into potential drug customers. Here’s a study that looked at experts who served on treatment guidelines committees for organizations in the U.S. and Canada. The study found that conflicts of interest (COI) among panel members are common in guidelines issued by certain specialty organisations. The prevalence and underreporting of COI are high and transparency is incomplete among a wide range of guideline producing organisations.” The ADA was one of the organizations in this study. http://www.bmj.com/content/343/bmj.d5621.full.pdf After reading it, I looked up ADA treatment guidelines 2011, but I could find no conflict of interest disclosure statements for the experts who serve on the panel. Perhaps you can help me locate them.