This story lacks appropriate context. There has been an enormous amount of research in the past decade on the mechanisms behind surgery-induced diabetes remission. The story implies that a major breakthrough has been made, when in fact many prior research studies have provided far more evidence than this one.
The story failed to report on the cost of treatment, how likely it is that diabetes resolves, or how commonly diabetes reoccurs as a chronic condition requiring management.
It simply didn’t give readers sufficient information to evaluation the treatment reported on.
Type II diabetes is a common chronic illness and in evaluating treatments, readers need more complete information about the chances for benefit, harm and costs to determine value in a particular treatment.
Although there was an acknowledgment that it simply wasn’t possible to offer gastric bypass surgery to everyone with type II diabetes, there was no discussion about the costs of gastric bypass surgery.
The story reported on the impact of gastric bypass surgery on diabetes in a very small group of patients (10) in which all of them experienced improvement in their diabetes. However – there are numerous larger studies which have been conducted that have examined the impact of this surgery on diabetes. While the impact on diabetes is good, rather than all patients demonstrating benefit, broader experience indicates that about 80% of those with type Ii diabetes will see improvement.
The story also implies that there could be some benefit to readers of knowing that branch chain amino acids are reduced by surgery. There is no quantifiable benefit to this piece of the puzzle.
While the story did mention some of the common side effects that occur following gastric bypass surgery, it actually neglected to mention some of the serious side effects of surgery.
In addition, since the story was about the impact of gastric bypass surgery on diabetes, it also should have mentioned that resolution of diabetes is not guaranteed to be permanent and reoccurs in as many as 30 out of 100 people who had improvement.
The story reported on a preliminary study to compare amino acid profiles in individuals with type II diabetes losing following gastric bypass surgery or solely through caloric restriction. But it never adequately explained the significance of changing amino acid levels – bouncing from a statement in one sentence that these amino acids are associated with insulin resistance and cardiovascular disease, to a news release-lifted statement in the next sentence that we don’t understand how the amino acids influence diabetes risk. Since the story – in its subhead and body copy – focused so much on the change in amino acids, it should have emphasized that there is no quantifiable benefit to this piece of the puzzle.
And the story could have done a better job describing the much broader substantive research that has been done on this same topic.
The story does not engage in overt disease mongering.
In addition to two authors of the study reported on, a spokesperson from the American Diabetes Association commented on the impact of gastric bypass on type II diabetes.
The story briefly mentioned the difference in short term improvement in diabetes in those having gastric bypass and those losing weight through caloric restriction. But it really didn’t quantify the benefits and harms of the two alternative approaches.
It’s clear that gastric bypass is a readily available surgical procedure.
Gastric bypass is not novel and the story – in reporting that 200,000 people have it each year – did not portray it as such.
Turning improved understanding about branched chain amino acids impacting diabetes into an effective treatment for diabetes is at this time hypothetical and was discussed as having potential for use.
The story indicated that it drew some of its information from a news release. But it also included interviews with one of the researchers and with an American Diabetes Association official. So it did not appear to rely solely on a news release.