This report takes a useful approach to coverage of a complicated study on diabetes prevention in high-risk groups: It focuses on one local man who participated in the study.
By describing his participation in some detail, the reporter does a good job of illustrating the protocol and the health situation the study addresses without being overly technical and abstract.
This is an excellent journalistic approach to handling a complex study and provides a richer takeaway message than many other stories reporting on these studies.
The fact that the man’s outcomes were mixed–weight loss, an active life at 78 and a controlled diet, yet status quo blood sugar levels hovering near trouble–is useful in illustrating the all-important "not-a-magic-bullet" message.
Yet the story stumbles in three significant ways:
It’s also worth noting the value of a local story that puts a national study in a local context. For local readers, it keeps a story close to the ground–and makes it more relevant. If only the story had connected the dots to provide readers with the information needed to take action.
The reporter misses an opportunity to say how much it costs to participate in a diabetes prevention program–or to take metformin.
A creative reporter could then have compared those costs to the costs of managing diabetes.
During a time when costs of health care are so much in the public’s mind, people reporting on treatments should always probe the question of costs vs benefits.
The reporter quantifies the benefits of the lifestyle or drug intervention, but never does so in absolute risk reduction terms. So when the story states risk reductions of 34% or 18%, we want to know "34% or 18% of what?"
The story fails to mention the side effects of metformin, which include gastro-intestinal side effects that can inhibit compliance. A serious condition, lactic acidosis, is a rare but significant side effect.
The study on which the story is based is riddled with caveats. Some findings baffle the researchers.
However, the reporter twice makes the mistake of saying the story "proves" certain benefits. The study suggests, or demonstrates a link, but it does not prove anything.
By using the word "proves" the reporter over-interprets the findings, exaggerating the quality of evidence. Therefore the story earns an Unsatisfactory rating under this criterion.
The story does nothing to exaggerate the prevalence or severity of type 2 diabetes.
The reporter spoke only with two study participants–an area man who was a subject and a researcher who headed local efforts.
The local researcher does offer properly moderated comments, casting the study as suggestive of benefits under certain conditions.
This is a good start for sourcing but insufficient. At minimum the reporter should have spoken with one disinterested diabetes or obesity clinician or epidemiologist who could help put the findings in context.
The study itself implicitly lays out the options to preventing diabetes–lifestyle changes, drugs or doing nothing.
But the story could have been improved significantly by indicating there are many different diet-and-exercise approaches beyond those used here, as well as numerous drug treatments and bariatric surgery.
The reporter fails to mention how and where diabetes prevention programs are available.
Lifestyle-modification diabetes prevention programs are a staple offering of hospitals, community centers, insurance companies and corporate wellness programs. The article could at least have mentioned this–and provides a local resource–to allow readers to follow up if they wanted to.
Many people with high blood sugar but not diabetes take metformin as prevention. It would be useful to know how widely used the treatment is.
No claim of novelty is made for the lifestyle or drug interventions.
There is no evidence the reporter drew inappropriately from the 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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