Thought for the Day

Friday, February 5, 2010

Pay No Attention To That Man On Oprah

Let me put these two disclaimers right up front.

First: I am not a doctor. I have no other medical background than being a diabetic for close to 36 years, and keeping my eyes open for information that might help me survive. I read the occasional article on the subject of diabetes.
If I was going to do a show about diabetes, I would have to bring in experts, like maybe an endocrinologist.
I am not an egotistical, know-it-all cardiologist who can glibly and confidently talk down to a studio audience and millions of home viewers.

Second: I didn't watch the Oprah Diabetes Show, America's Silent Killer. I only learned a little about it from friends and went to her web site to try to get a transcript. She is selling transcripts for $20. I didn't think it was right that I should pay $20 to her just because my friends were so incensed by her show that I wanted to see what they were so upset about.
So I did the next best thing and read the article on her web site. I figure this is fair, since it would be much easier to make this article accurate than a verbatim transcript of the show. My statements about the show are based on the articles about the show and the videos on the web.

So, somehow Dr. Oz did this whole show focusing on type 2 diabetes without mentioning insulin resistance. Bob Greene talks about it, and seems to understand it, but not Dr. Oz.
Dr. Oz also did not mention carbohydrates except to say that sugars are also referred to as simple carbohydrates. Neither did he mention the glycemic index.
There was no endocrinologist on this show about diabetes.
I know that if you, like me, have been discussing diabetes with other diabetics you find this hard to believe. How did they do a whole show? What did they talk about? How did they avoid subjects like these?

The American Diabetes Association lists the 10 most prevalent diabetes myths. The Oprah show actively reinforced four out of ten.
I will edit and summarize:
Myth: If you are overweight or obese, you will eventually develop type 2 diabetes.
Fact: Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.

Myth: Eating too much sugar causes diabetes.
Fact: Type 1 diabetes is caused by genetics and unknown factors that trigger the onset of the disease; type 2 diabetes is caused by genetics and lifestyle factors.

Myth: People with diabetes can't eat sweets or chocolate.
Fact: They are no more “off limits” to people with diabetes than they are to people without diabetes.

Myth: If you have type 2 diabetes and your doctor says you need to start using insulin, it means you’re failing to take care of your diabetes properly.
Fact: Using insulin to get blood glucose levels to a healthy level is a good thing, not a bad one.
Concerning the other six myths, except for the first one, Dr. Oz did not address them. The first Myth on the ADA web site is:
Myth: Diabetes is not that serious of a disease.
The Oprah show seemed to be concentrated on sensationalizing the complications of diabetes to the extent that it seems it spent more time on that than on prevention, diagnosis, and treatment. They called it America's Silent Killer, after all.

I went through the article counting up things I knew to be wrong. I marked off 25. For example:
"Most diabetes is preventable," he says. "It is treatable, even reversible."
No, diabetes is treatable but not "reversible."
TYPE 2* diabetics can often control their blood sugar through diet and exercise. But if they discontinue the regimen of diet and exercise to control the diabetes, the high blood sugars, and the complications, will return.
The diabetes is not "reversed." They are not cured. They have simply found a way to control their diabetes.
They have found an effective treatment. They have reversed the symptoms of diabetes.
If they discontinue the treatment, the symptoms of diabetes return. This is the difference between diabetics and non-diabetics.
Note that the difference is not obesity. The difference between a diabetic and a non-diabetic is that behaviors that don't cause high blood sugar in a non-diabetic do cause high blood sugar in a diabetic.

*Why doesn't he say TYPE 2 when referring to type 2 diabetes and diabetes when referring to all diabetes?
"There are two types of diabetes: type 1 and type 2."
This very article contains reference to gestational diabetes, which is not type 1 or type 2.
In addition, there are many people with diabetes who are not easily put into either category of type 1 or type 2 diabetes.
Type 1 diabetes, formerly known as juvenile diabetes, affects 10 percent of Americans diagnosed with diabetes. "[You're] not making enough insulin."
Not making enough? Most type 1 diabetics make absolutely no insulin. Before the full onset of the disease, there may be a "honeymoon" period during which a type 1 diabetic produces a trace of insulin.
Some people make very little insulin, and that is one way someone might not fit into either category of type 1 or type 2.
"That's generally from genetic reasons because your pancreas just doesn't work correctly,"
Generally from genetic reasons?
The pancreas just doesn't work correctly?
Is this wrong, or just dumb?
Let's just say it. I don't think Oprah's viewers are too dumb to understand. Does Dr. Oz?
Type 1 diabetes is usually caused by a person's immune system malfunctioning and killing off the insulin-producing cells in the pancreas.
Type 2 develops from lifestyle issues.
There is always a genetic component in type 2 diabetes, just as in type 1. It is not just caused by lifestyle choices.
Remember the ADA says, "Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight."
"[Patients] have a lot of belly fat and the like, and they have enough insulin," he says. "But it's not listening anymore...."
No, insulin resistance, however it is caused, is not the only cause of type 2 diabetes. Many type 2 diabetics are not producing enough insulin. In fact, many type 2 medications promote the production of insulin for this very reason.
Diabetes, particularly type 2, is the fastest-growing disease in history because of one thing—sugar.
Obesity is a problem, and the rise in type 2 diabetes is related to the rise in obesity. But sugar is not nearly the sole cause of all of these problems. That's ridiculous.

At this point I have to break off quoting Dr. Oz. He is wrong on generalities. He is wrong on specifics.
He is so full of crap on things I actually know something about, that I don't believe him on anything I don't know about.

The whole Oprah diabetes show was a giant, steaming pile of misinformation and mythology, stereotypes and sensationalism.

Oddly enough, Dr. Ian Smith and Bob Greene were apparently able to discuss diabetes sensibly, without any falsehoods, stereotypes, or myths, to make it clear when they were talking about obesity, type 2 diabetes, or diabetes in general.
So it can be done, even on Oprah.

UPDATE: It's been suggested, and it seems like a good idea, that all of the blogs on this topic include a link to comment to Oprah.


Jen said...

Round of applause for my friend Jerry here. Well said.

PJ said...

As an overweight African American, and therefore in about the worst possible scenario for developing Type 2 diabetes (African Americans are 70% more likely to get type 2 diabetes), you'd think Oprah would want to get it right. Maybe she'll be forced to some day....

There is nothing more frustrating than sitting there as a "patient" watching a so-called expert get everything wrong except maybe this:

"You are diabetic? But you're not fat! Oh wait, that's probably because you can't eat sugar now, right?"


Mike said...

I totally second and third your thoughts here! Awesome blog!

Anonymous said...

Very very well said. I am a T1 (for 11 yrs)...and I paid the $16.95 to get the transcript. I am appalled at what crap came out of Dr. oz's mouth.
I applaud the effort to educate...but when doing so, educate with the CORRECT info!!!

Bee said...

Ahaha! I didn't even think or realize until you pointed it out that they actively reinforced myths straight from the ADA!

Well written!!

Carol said...

When I first heard people complaining about the airing of this show, I thought it was diabetics who did not have much trouble complaining about diabetics whose cases were more complicated. Now that I have seen some of the information, I have to say that I totally agree. My daughter was diagnosed as a type 1 diabetic in 2003 at age 15. The onset episode nearly took her life. Since then, she has been diagnosed as a "true brittle" diabetic. Complicating matters are some overlapping diagnoses in addition to the diabetes that will be with her for life. She has been hospitalized over 30 times since 2003. Her pet peave is that it never fails... when she is in the hospital, at least one professional will comment about her not taking care of herself. Little do they know the efforts she makes each day. She counts carbs, reduces fat, avoids trigger foods, follows her insulin routine, tries to avoid stress, tries to manage her other illnesses, and tries to avoid common illnesses such as colds and flu. On occassion, she gets staff who know her and understand her case while she is in the hospital, but shifts change 2-3 times a day and that is when someone ignorant of the facts shows up. Or worse, someone who thinks they know about diabetes and follows old school rules, or treats her like a type 2 as if she brought on her own diabetes. At least her primary care physician, and her endocrinologist know her well enough, and once she is past crisis will give the order for hospital staff to allow her to chose her own food and tell them how much insulin she needs, much to their chagrin.

k2 said...