Choosing who to believe

[ianf0ster]

I participated in a survey for University of Sheffield a few months ago.
They wanted to know about how much use online forums were for Type 2 Diabetics.

I was able to say that in my experience 'the other UK one' was a fantastic resource and had been a great help to me in persuading me it was safe to ignore GP and DN's advice, reduce my Statins, increase my Salt and go Low Carb Higher Fat.

But some interactions both in that forum and in this one have left me wondering why it is that some others come to a different conclusion.

One of the questions asked in that U of S survey was:
'To what extent would you trust the advice you found in the forum?
My answer:
'For those members who list their Hba1c and Lipid numbers histories for more than 1 year – then yes I trust their advice.'

The follow-up question was:
'Did you check other sources for the same advice to confirm it (corroborate it)?
My answer:
'Yes, I do check other sources – though those other sources are probably influenced by the same Doctors and Dietitians'
In actual fact a better longer answer would add that I have a general scientific background and if the science and the Studies make sense to me, then I am much more likely to believe them than if I would have to take something on faith alone. My long experience of a Eatwell and 5 A Day in the form of a Mediterranean style diet with Very Low fat, High Starchy Carbs and Whole Grains, only 3 (white) meat or fish dishes per week and red meat less than once per month. Convinced me that more of the same (which was the conventional advice (along with Don't Test)
was not going to help. After all it was on this advised way of eating that I had gained over 14lbs, needed a 3 x Coronary Artery Bypass and the been diagnosed as having T2Diabetes!
Fortunately buying a Blood Glucose Meter ( a Tee2+ which is cheap with inexpensive test strip) enabled me to test which foods I could tolerate and which ones are bad for me.

 

[ianf0ster]

I was reminded of this recently both in 'the other forum' and also in this one.
In the other forum I was accused of having 'fanatical faith' in a Low Carb diet, even though I suggest people find something that suits them from the 4 basic methods which appear to work for T2 remission.
Those are: Low Carb - especially LCHF, Intermittent or longer Fasting, Crash Diets like 'Newcastle or the BloodSugar Diet, or even something simple like Slimming World or Weight Watchers, then finally Gastric Bypass Surgery.

I pointed out that with Low Carb or Fasting, or even a crash Diet, I could monitor my Blood Glucose and know if things were working - so there was absolutely no 'Faith' required. Just faith that going back to traditional Fats and Oils would not clog up my newly unblocked arteries.

 

[ianf0ster]

I wonder how others determine who to believe, both in Forums and online in general, since there are so many completely opposing theories from (supposedly qualified) Medical Doctors, PhDs in Biochemistry etc. out there on the internet, on YouTube, or selling books.

 

[trophywench]

Well Ian - frankly if you only read the conclusions of the research which Farmer et al did regarding statins, it would be a no brainer - we'd all take em and that's that. However if you read the whole paper with only an O Level Biology you wonder how the hell they could ever in the realm of pig's pudding reach the conclusion that we all should take em whatever.

I positively dread ever having a CV event since I did take preventative statins for a couple of years when they were the flavour of the month and landed up thinking I had Alzheimers since they affected my brain. That was 15 ish years ago and whilst I still have working brain cells I still won't want to take em. We all have to die; I'd rather die with my marbles in a state of play if I have any choice thanks.

 

[rebrascora]

Like you, I have participated on forums and found best advice from people who are clearly experienced and know their stuff. If you read enough posts, and have a scientific mind, you will get a feel for whose judgement you respect. I also then do my own further online research for scientific arguments and I tend to have more faith in professional scientists who have been proponents of one side of the argument and then changed their stance to the opposing camp and can explain the reason for their change of heart. To me that demonstrates an open mind and integrity, both of which are admirable traits and inspire my respect.

 

[Ralph-YK]

I wonder how others determine who to believe, both in Forums and online in general,

Generally, on tone and behaviour and:

If you read enough posts, ..., you will get a feel for whose judgement you respect.

More specifically on medical matters, I treat everything with some doubt. Or as an unknown.

 

[Bronco Billy]

It’s important to remember when reading advice that the poster is usually talking from their own experience. If having two children with type 1 has taught me anything, it’s that diabetes is a condition that is inconsistent in how it affects the individual who has it, therefore treatment will also be individual.

A better man than me, Albert Einstein, I believe it was, once said

“The important thing is not to stop questioning. Curiosity has its own reason for existing.”

 

[ianf0ster]

Like you, I have participated on forums and found best advice from people who are clearly experienced and know their stuff. If you read enough posts, and have a scientific mind, you will get a feel for whose judgement you respect. I also then do my own further online research for scientific arguments and I tend to have more faith in professional scientists who have been proponents of one side of the argument and then changed their stance to the opposing camp and can explain the reason for their change of heart. To me that demonstrates an open mind and integrity, both of which are admirable traits and inspire my respect.

Yes, I think I have mentioned that same thing about a professional scientist or Doctor who has changed their mind and can explain why. To me that is why both Dr David Unwin and Prof Tim Noakes are so convincing to me. It takes guts for a member of the scientific/medical establishment to reverse their stance 180 degrees and admit that they were wrong and thus gave poor advice for decades.
There is also one doctor (I have temporarily forgotten his name) who was a 7th Day Adventist, was medically trained at Lo Malina who finally decided that since their non-meat diet was just making him fatter and weaker (despite all his physical workouts), there had to be something better for him. He then went Keto and eventually Carnivore and ditched all the poly-unsaturated seed oils. He now has a body which would be the envy of almost any male gym goer which he maintains by only 10min of simple home exercise in addition to his Carnivore diet. Reading Belinda Fettke's research into the origins of the Breakfast Cereals under the influence of religion (to reduce men's lustful nature) soon made me reverse my opinion of the so called 'healthy' grain-based vegetarian diet.

 

[rebrascora]

Dr Peter Attia is another such professional. Have you seen his rather emotional TED talk about a diabetic patient whose foot he amputated and the assumptions he made about her because she was obese and then his own journey with diabetes and research into diet reversing that assumption. His regret about his previous attitude is very moving.

 

[Eddy Edson]

Cochrane reviews, guidance statements from major professional bodies. Work by individual research groups where the work fits within the context provided by these & looks rigorous to me.

For "public" figures, the extent to which they pass filters like this nice summary: http://www.stephanguyenet.com/quickly-assessing-the-credibility-of-public-experts/

 

[everydayupsanddowns]

Generally I think most people (and I include myself in this) largely use Confirmation Bias as their most useful method of sorting the overwhelming deluge of claim and counterclaim that is published in journals, blogs, YouTube newspapers and everywhere else.

I don’t mean that unkindly, it’s just an observation of the way my own opinions have formed, and occasionally changed, and then stuck... or changed again. And also seeing that pattern repeated in others.

We reach conclusions based on our best understanding of a topic. Then by and large we tend to receive the messages and evidence that support our viewpoint, and discard evidence or suggestions which disagree.

So this or that study or approach is either part of an immovable conspiracy by ‘them’, or is the majority view of respected voices in the field, and this or that expert is either a dangerously deluded fraud with a book to sell, or a visionary who has found the answer that Big Pharma or some other ‘them’ want to keep from you.

🙂

 

[Eddy Edson]

Generally I think most people (and I include myself in this) largely use Confirmation Bias as their most useful method of sorting the overwhelming deluge of claim and counterclaim that is published in journals, blogs, YouTube newspapers and everywhere else.

I don’t mean that unkindly, it’s just an observation of the way my own opinions have formed, and occasionally changed, and then stuck... or changed again. And also seeing that pattern repeated in others.

We reach conclusions based on our best understanding of a topic. Then by and large we tend to receive the messages and evidence that support our viewpoint, and discard evidence or suggestions which disagree.

So this or that study or approach is either part of an immovable conspiracy by ‘them’, or is the majority view of respected voices in the field, and this or that expert is either a dangerously deluded fraud with a book to sell, or a visionary who has found the answer that Big Pharma or some other ‘them’ want to keep from you.

🙂

Of course everybody is subject to confirmation bias to a greater or lesser extent in different circumstances. Competent people will recognise this of themselves and use this knowledge as one of the tools to try to self-check their opinions. Of course perfect self-knowledge is impossible.

For me, it's a bit more interesting the way people use concepts like "confirmation bias", "Dunning-Kruger Effect" etc etc as ways of tagging claims they dislike for rejection. It's a nice mechanism - allows one a feelling of superior rationality, while avoiding having to actually think about the claims.

 

[everydayupsanddowns]

For me, it's a bit more interesting the way people use concepts like "confirmation bias", "Dunning-Kruger Effect" etc etc as ways of tagging claims they dislike for rejection. It's a nice mechanism - allows one a feelling of superior rationality, while avoiding having to actually think about the claims.

I apologise if I’ve caused offence. It wasn’t intended and I wasn’t considering confirmation bias in any perjorative way (which Dunning Kruger always infers to me). I see it simply as a pragmatic way of making sense of a confusing world, particularly in the context of healthcare reporting and conflicting suggestions that circulate, plus our own n=1 experiences and sense of risk.

At least that’s what I think I do.

 

[ianf0ster]

It's unfortunate that online resources such as YouTube and Facebook algorithms deliberately search for more of the same to suggest to you. This reinforces our natural confirmation bias. Personally for any science (or political) based studies, lectures etc I occasionally actively seek out opposing viewpoints to those I have been recently seeing.
What I don't do is to ignore somebody just because of their perceived 'wrong' viewpoint on a different subject, or them being viewed as a quack or 'stone-age' by some other 'expert'. Instead I try to see if there may be some financial or other motive at work there. Though this can be difficult because Scientific studies cost money and so some wealthy person, company, charity etc must be paying for each one. And we all (should) know that (published) studies almost always (at least in the summary) validate the sponsor's aims.

Of course no mere 'experts' viewpoint can trump our own n=1 experience.

In 'the other forum' I found that the style of Moderation suppressed scientific debate / exchange of views which is what forced me to come here. This even though Diabetes UK literature handed out by my DN was far too Eatwell & 5 a Day since I had already been doing for approx. 15yrs before diagnosis so it pushed me in the direction of that other forum.

And as @rebrascora reminded me, I was also impressed by Dr Peter Attia's TED talk which I watched soon after my diagnosis (actually between the first HBA1C result and the subsequent confirmatory one).

 

[SueEK]

As someone who has been diagnosed less than a year and has a completely unscientific mind I have listened to advice from my GP, DN, dietician and this forum. I have used a combination of all the advice and use it as a tool to assist me and me alone in my ‘journey’ to improve my diabetes. I regularly check and adjust accordingly when necessary and usually only ask advice from this site. There are lots of differing opinions which is good as if one piece of advice doesn’t help then another might. Every person/carer with diabetes has there own way of managing it but for me this forum has been nothing but beneficial.

 

[trophywench]

If anyone sees reference to a bit of scientific research they would like to know more about, or wonders if any's been published about anything, can I say that 'Google Scholar' is where you'll probably find it. It was a good few years before Alan Shanley pointed me to it, so there's no guarantee that it's 'common' knowledge when you don't have a scientifically orientated life!

 

[AJLang]

I have a PhD and therefore I’m very familiar with academic literature. With regard to diabetes I limit my reading, make sure that I’m up-to-date with current thinking and then work out what I think is best for me and then reflect upon whether it works or not. What really concerns me is any suggestions that diabetics should have low carb high protein when diabetes causes risk to kidneys. My motto for 48 years of diabetes has been everything in moderation (apart from wine ) My recent cardio, kidney and liver results have all been excellent so I must must be doing something right 🙂

 

[Bruce Stephens]

If anyone sees reference to a bit of scientific research they would like to know more about, or wonders if any's been published about anything, can I say that 'Google Scholar' is where you'll probably find it.

For something that's in the newspapers, if you wait a few days it'll often be covered by https://www.nhs.uk/news/. And for some surprising result it's worth checking Cochrane to see what they found.

 

[Drummer]

I have a PhD and therefore I’m very familiar with academic literature. With regard to diabetes I limit my reading, make sure that I’m up-to-date with current thinking and then work out what I think is best for me and then reflect upon whether it works or not. What really concerns me is any suggestions that diabetics should have low carb high protein when diabetes causes risk to kidneys. My motto for 48 years of diabetes has been everything in moderation (apart from wine ) My recent cardio, kidney and liver results have all been excellent so I must must be doing something right 🙂

I'd qualify that as uncontrolled diabetes can cause risk to kidneys - for me everything seems to work better when eating low carb - and although that doesn't necessarily bring high protein, even if it does, it can be dealt with as the damaging effects of high glucose levels are not in the mix.

 

[AJLang]

Hi Drummer I think we’ll have to agree to disagree about the effect of higher protein on kidneys. It isn’t just uncontrolled Diabetes that can cause problems with kidneys it can also be having diabetes itself or long-term diabetes. Unfortunately there are diabetics who’ve had it for a short-time with excellent control who can have complications.