This is an extremely well-done story about bariatric surgery used not to support weight loss in the morbidly obese, but to treat diabetes in people of more moderate weight. The reporter has made good use of the unusually generous amount of space granted by quoting a variety of sources, citing high-quality research and sketching the history and controversy of the surgical application. He also illuminates the financial self-interest that may motivate advocates.
The article itself is well-supported by two infographics, and is extended a bit by an entry on the newspaper’s blog featuring an additional interview and some more facts.
The story’s one significant shortcoming is its failure to create a point of comparision by describing conventional diabetes treatment in more detail. A less troublesome problem is the anecdote about the surgery patient; it is slightly off-point and potentially confusing. The woman interviewed is a diabetic who qualified for surgery as a weight-loss treatment. Given the context, the remission of her diabetes is assumed to be due to the surgery, when in fact it may have been due to the weight loss.
Kudos to this newspaper for affording this topic the space required to present such a balanced story.
The report states that the operation is costly, about $25,000, and that insurance coverage is not guaranteed. It also indicates that at this time surgery purely to treat diabetes, not reduce body weight, is unlikely to be covered.
The report adds useful context by stating that conventional diabetes care costs $10,000 per year.
The article opens with a claim that studies show over 75 percent of diabetics who get bariatric surgery "see their disease disappear." While this sounds like an exaggerated claim, it is backed up by two specific citations of remission data from credible journals later in the story.
The reporter makes clear the serious risks of surgery, including death rate, and their frequency not well-known.
It would have been useful to include the risks of death and serious side effects for the more invasive intestinal surgery likely to be used on diabetics. The story states that one reason for the decline in bariatric surgery risks generally is increased use of the less invasive procedure.
Since this article is not based on the results of a single research study, the reporter makes references to several papers. This is handled in the form of a narrative indicating how the research has progressed. The studies are described in sufficient detail to help readers understand their relative credibility.
The two studies referenced at the end are especially well handled. The reporter indicates that the international studies are too small and recent to support a conclusion, and that the study that will answer the key question most directly–do diabetics who are not sufficiently overweight to qualify for the surgery as a weight-loss treatment see remission of diabetes symptoms?–is well-designed and just underway.
The story does an excellent job of detailing the effects of uncontrolled diabetes, and the risks of the surgery, in a clear, factual manner.
The reporter interviews both supporters and critics of the diabetes surgery. He also makes clear that the surgeons who advocate using bariatric surgery for diabetes have a big financial stake in the issue. The published papers he cites all appeared in credible journals.
The article would have been stronger if it had described the range of treatments for Type 2 now in use, from diet and exercise to medications and insulin. This would have helped readers understand the choices diabetics face–a challenging lifetime regimen that is not always successful, or a somewhat risky surgery that might provide permanent relief.
The article makes clear that the surgery is widely available and increasing in frequency. It also indicates the populations for which it is currently recommended.
The reporter emphasizes that the proposed treatment is an extension to a new patient population of an existing procedure. The story does a good job clarifying the differences between the two major types of bariatric surgery and their histories.
There is no evidence the reporter has drawn information from a press release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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