"I went to have my eyes checked a while ago as part of my standard diabetic review; I’ve never had any laser treatment but have mild non-proliferative background retinopathy. All was well; with no changes. The consultant thought I had the eyes of someone who had had diabetes for half the time that I have.
I thought it would be worth asking the consultant’s view on supplements for eyes in particular lutein as I’m quite keen on them. She initially said there was some evidence that they improved the condition of the eye in diabetics, but then thought about it and said she didn’t advise me to take any because there were no long term studies on their safety; I thanked her and thought that’s a familiar answer.
It is of course the go-to response that people who don’t like low-carb use and you also get it in relation to pretty much anything positive in diabetic care but unorthodox. Just because a study shows a benefit we are told isn’t the whole picture; we don’t know what a decade or more of this would do to someone; and on the balance of probability you should therefore ignore the positive evidence. That sounds more than fishy to me; you can’t patent a vitamin and some vitamins compete directly with pharmaceuticals, they are therefore the enemy and need to be discredited and bumped from the market place to protect the margins on those expensive pills we are offered.
But does this work the other way? How many long term studies were there for statins before they became ubiquitous?
How many long term studies are there on anything that cannot be patented and sold? Very few because they are very expensive and then when there are (say saturated fats and heart health as looked at in the Framington meta-analysis) they get ignored if they are not orthodox (that Framington study said that there was no suggestion of a relationship between saturated fats and heart disease).
There are a number of argument strategies that you can immediately ignore, for instance; ‘the thin edge of the wedge’ argument is just saying; let’s not discuss the point in hand let’s think about what would happen if we escalated the situation to a ridiculous level and judge that. Well, I think we can now ignore any ‘no long term studies’ arguments because at best it is saying ‘we don’t know and therefore it will harm you’ and at worst it is a method of not looking at the evidence to hand because that evidence fails an artificial test that may well be meaningless. How many long term studies have there been on the consumption of water for instance? None, I bet; certainly a lot of anecdotal evidence about what happens if you don’t have any or if you are unlucky enough to have far too much; but how about the steady day to day consumption of it? Not a sausage, yet I don’t see any warning signs on taps…
Best
Dillinger (for whom there have been no long term studies on)"
Eddie
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Well your 'old gangster mate Dillinger' offers a good or several good and thoughtful points.
ReplyDeleteJames
Now that is an argument I can agree with. If there is some evidence that there is a benefit then surely one of the diabetes charitties should be performing a study simply because no pharmaceutical could ever justify such an exercise to its shareholders. What are charities for if nor to persue remedies irrespective of profitability?
ReplyDeleteI have been saying the same thing for a very long time.
ReplyDeleteI really don't know how HCPs have the nerve to quibble about supplements etc when they have no compunction about forcing toxic meds on us,
I have noticed that they seem to be ever warier about expressing an opinion.
They don't like it when you query the meds though -but are quite prepared to mislead about safety I have noticed.
Kath
Thanks for posting that Eddie.
ReplyDeleteI have no evidence but I really wouldn't be surprised if HCP's problems with supplements come from drug company 'information' about the benefits of their wares.
It also fits right in with the sadly too common (HCP) view that HCP's are experts and their patients are idiots; if a solution is coming from a non-medical route then it must be suspect.
Every time I see an article saying vitamin supplements are useless/dangerous I think well what about vitamin d? You are probably vitamin d deficient in the uk and vitamin b1 for diabetics? You are probably vitamin b1 deficient - vitamin b1 levels have been shown to be 76% lower in people with type 1 diabetes and 75% lower in people with type 2.
Speaking of which; here's some links about d1 (thiamine); I think we should all be taking some:
http://news.bbc.co.uk/1/hi/health/6935482.stm
http://news.bbc.co.uk/1/hi/health/7796073.stm
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376872/
Note by the way what our friends at Diabetes UK say; "However, we would like to stress that it's still too early to come to any firm conclusions about the role of vitamin B1 and we would not advise that people look to vitamin supplements to reduce their risk of kidney complications at this stage." Sound familiar?
Best
Dillinger
When I was first diagnosed I asked if the dr could recommend any supplements which might help. He said no because some of them reacted badly with medication I might be given.
ReplyDeleteI do wish they would give the same care to prescribed medicines as they do to supplements.I suppose they just rely on the pharmacist with prescriptions.
Pharmacists must know something of supplements too so it might be better to advise the patient to enquire at a pharmacy. I have never bought supplements at Boots , I wonder if they are good with this sort of advice.
I worry a little about some other places selling supplements - I somehow don't feel that the staff will have the necessary training.
I just feel the GPs particularly are now so afraid to pass an opinion because of he away things are organised that it is difficult for them to advise the patient on anything outside he strict parameters of the consultation.
Mine are all terrified when I even mention my diabetes-related eye problems! It is sometimes relevant!
Kath