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GidMK's profile
Health Nerd
Health Nerd
Health Nerd
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@GidMK

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Health NerdVerified account

@GidMK

Epidemiologist. Writer (Guardian, Observer etc). "Well known research trouble-maker". PhDing at @UoW Host of @senscipod Email gidmk.healthnerd@gmail.com he/him

Sydney, New South Wales
theguardian.com/profile/gideon…
Joined November 2015

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    1. Michael Mindrum‏ @MichaelMindrum 21 May 2019

      We did better with the Look Ahead Trial in 2012 with intensive lifestyle intervention using a healthy low fat diet that outshined "usual care" but remission rates remained modest. You can see decrease in prevalence in remission over time from ~12% at one year to ~8% at 4.pic.twitter.com/eDbaqw4VHv

      1 reply 0 retweets 3 likes
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    2. Michael Mindrum‏ @MichaelMindrum 21 May 2019

      a sobering finding is the duration of remission waned over time in Look Ahead:pic.twitter.com/kwJLIMlXZ2

      1 reply 0 retweets 3 likes
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    3. Michael Mindrum‏ @MichaelMindrum 21 May 2019

      and that the durability of remission from year one to 4 was poor despite a very intensive model of behavioural change:pic.twitter.com/wmGZB81ZtP

      1 reply 0 retweets 3 likes
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    4. Michael Mindrum‏ @MichaelMindrum 21 May 2019

      even those w/ a 10% weight loss (many would presumptively have T2D remission) at 1 yr had a 20% RRR in MACE --> a significant value which supports notion that T2D remission would likely lower events (still points toward residual risk) https://doi.org/10.1016/S2213-8587(16)30162-0 …

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    5. Michael Mindrum‏ @MichaelMindrum 21 May 2019

      Then the DiRECT trial came out and at one year with a very low energy diet with initial meal replacement system, they discovered something remarkable -- a 46% remission rate! This was durable at 2 yrs at which time it was 36% (>3 fold more than Look Ahead)!pic.twitter.com/oUFok6Jj89

      1 reply 1 retweet 9 likes
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    6. Michael Mindrum‏ @MichaelMindrum 21 May 2019

      And meanwhile Virta with a innovative clinical model utilizing remote care, advanced technology, artificial intelligence, and the 'technology' of nutritional ketosis is similarly seeing remarkable results at 2 yrs with 53% partial remission & 17% complete https://www.frontiersin.org/articles/10.3389/fendo.2019.00348/abstract …

      3 replies 2 retweets 10 likes
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    7. Michael Mindrum‏ @MichaelMindrum 21 May 2019

      Granted I think others such as @GidMK are bringing up useful criticisms of the study design. If Virta's study was carried out within an RCT with proper statistical comparisons, how would it compare to Look Ahead trial which left us feeling a bit disappointed?

      2 replies 0 retweets 5 likes
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    8. Health Nerd‏Verified account @GidMK 21 May 2019
      Replying to @MichaelMindrum

      TBH my biggest criticism of Virta is that everyone paints it as a "keto" intervention, but it's also a massive lifestyle intervention as well which makes that unhelpful

      1 reply 0 retweets 0 likes
    9. Health Nerd‏Verified account @GidMK 21 May 2019
      Replying to @GidMK @MichaelMindrum

      When I tell colleagues about Virta, they are excited until they hear about the price-tag. No one is surprised when I say that people go into remission quite often when you have to spend $5,000 AUD per year on the program!

      1 reply 0 retweets 0 likes
    10. Miriam Berchuk MD‏ @MiriamBerchuk 21 May 2019
      Replying to @GidMK @MichaelMindrum

      What does a year of dialysis cost? I work in tertiary care. The downstream costs related to T2D complications are astronomical. We've just come to accept them.

      2 replies 0 retweets 1 like
      Health Nerd‏Verified account @GidMK 21 May 2019
      Replying to @MiriamBerchuk @MichaelMindrum

      Oh that's absolutely true. I'm more pointing out that Virta is an intensive, expensive lifestyle intervention that includes but is not limited to a keto diet

      8:01 PM - 21 May 2019
      • 1 Like
      • Miriam Berchuk MD
      1 reply 0 retweets 1 like
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        2. Health Nerd‏Verified account @GidMK 21 May 2019
          Replying to @GidMK @MiriamBerchuk @MichaelMindrum

          I don't think you can say, based on the Virta study, that "keto" is effective for diabetes revision per se. What you can say is that an intensive intervention costing $5,000 a year that includes a keto diet may be effective although this should probably be confirmed in an RCT

          1 reply 0 retweets 1 like
        3. Jacob Gudiol‏Verified account @JacobGudiol 21 May 2019
          Replying to @GidMK @MiriamBerchuk @MichaelMindrum

          An important difference here is also that they participants are paying for the treatment out of their own pocket That of course increases the likelihood of you getting patients with high compliance compared with the dialysis that is payed for by the government in most countries

          1 reply 0 retweets 0 likes
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