This Los Angeles Times story reports on a study with some tantalizing new information about connections between the brain and the body’s metabolism. The research is novel, very preliminary, and more about introducing a new avenue of study for researchers rather than a new therapy for people with type 2 diabetes. The story maintained this framing well — that the findings are useful for researchers more than clinicians at this time. However, the headline and the photo credit undermine this carefulness with phrasing suggesting a new treatment option: “may offer treatment” and “may provide alternative treatment.” Given that the headline may be the only part of this article seen by many readers, it’s an important shortcoming.
Type 2 diabetes is a chronic metabolic disease that affects 1 in 10 Americans and continues to increase. The disease is the leading cause of kidney failure, limb amputation, and blindness and the seventh leading cause of death in the US. We know many of the risk factors and have treatment options, and yet there is a lot of room for improvement in managing this chronic disease. In addition, greater understanding into the cause of the disease and ways to counteract the deficits in metabolism that are the hallmark of diabetes are much needed.
Even though deep brain stimulation (DBS) is not close to being recommended for diabetes, it is a current therapy for Parkinson’s disease and other movement and psychiatric disorders. Thus, cost information could have been included — we found estimates ranging from $35,000 – $50,000.
Of course, the costs associated with the use of this technology for diabetes might differ from the costs with Parkinson’s disease. However, our rule of thumb in these situations is, If it’s not too early to claim this approach “may offer treatment,” it’s not too early to discuss what that treatment may eventually cost.
The article did a good job describing the current evidence for deep brain stimulation on insulin sensitivity, which is still in the earliest of stages. A single patient receiving DBS for obsessive-compulsive disorder reduced his need for insulin dose by 80%. Description of more fundamental experiments were not quantitatively detailed, which seems acceptable for the health focus here.
The article did not mention side effects of deep brain stimulation, which may include brain bleeding, stroke, seizure, and mood and cognitive changes.
The article summarized a variety of evidence that supports a connection between deep brain stimulation (specifically dopamine neurotransmission) and metabolic regulation (specifically insulin sensitivity). The story also spends plenty of time establishing the preliminary nature of the research and its lack of clinical application at this time. Although this careful framing is undermined by the aggressive wording of the headline, we’ll give the benefit of the doubt and award a satisfactory grade here.
The story quotes a physician-researcher who was not involved in the study.
Because the story mentions that the new findings might “pave the way for a new approach to treating type 2 diabetes,” we think it’s important to briefly review for readers what the current approaches are, such as diet, exercise, and a variety of diabetes medications.
The story makes clear that deep brain stimulation is a current therapy, though not yet for diabetes.
The story makes clear that the novelty of this study is that it introduces a new brain area (the nucleus accumbens rather than the hypothalamus) as having regulatory control over metabolism.
The story does not seem to rely on a news 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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