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GidMK's profile
Health Nerd
Health Nerd
Health Nerd
Verified account
@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 18 Aug 2019

      We can't have health at every size but we can experience dignity at every size. We can appreciate and care for others at every size. We need to understand the risks imposed by excess adiposity & deliver effective compassionate treatment. We need to heal weight bias & stigma.

      12 replies 39 retweets 210 likes
    2. Dr. Adele Hite‏ @ahhite 19 Aug 2019
      Replying to @MichaelMindrum

      Agree/disagree. The problem is that we don't know at what point adiposity becomes "excess" for any given individual & we certainly can't use predetermined measures like BMI (which was never meant to be applied to individuals as a demarcation of good/bad health) to find it.

      2 replies 0 retweets 8 likes
    3. Harriet Carroll: To be decided...‏ @angryhacademic 19 Aug 2019
      Replying to @ahhite @MichaelMindrum

      Couldnt you say this for lots of diseases, eg. Fasting glucose > 7 mmol/L or BP > 120/80 mmHg or smoking 20/d might be ay okay for some, but on average this is bad for health...? Also i thought BMI was designed by insurance companies exactly for health demarcation reasons?

      1 reply 0 retweets 1 like
    4. Dr. Adele Hite‏ @ahhite 19 Aug 2019
      Replying to @angryhacademic @MichaelMindrum

      Yes to smoking 😉. The rest is speculation. Weight-height tables were used by insurance companies to predict mortality. This is an associative, not causal relationship. BMI has a long & twisted history, with an origin in stats, not biology. See Hite & Carter 2019. 😉

      3 replies 0 retweets 5 likes
    5. Michael Mindrum‏ @MichaelMindrum 19 Aug 2019
      Replying to @ahhite @angryhacademic

      Adele - there is strong data to show that there is increased health risk with rising blood pressure or increased fasting plasma glucose - hence the definition of the diseases hypertension and diabetes which may not cause a person a problem until the end organ complication occurs.

      1 reply 0 retweets 2 likes
    6. Dr. Adele Hite‏ @ahhite 19 Aug 2019
      Replying to @MichaelMindrum @angryhacademic

      This is what I get for tweeting in the grocery store check-out line. It's the cut-points that are speculative, not the overall natural history of the disease that ultimately results in organ damage. Those goalposts have been moved several times and 1/2

      1 reply 0 retweets 3 likes
    7. Dr. Adele Hite‏ @ahhite 19 Aug 2019
      Replying to @ahhite @MichaelMindrum @angryhacademic

      it is not clear whether lowering these cut-points (the goalposts move ever closer to what was formerly "normal," not in the other direction, that I am aware of) improves "prevention" or just increasingly medicalizes us so that everyone is "pre-" something.

      2 replies 0 retweets 5 likes
    8. Michael Mindrum‏ @MichaelMindrum 19 Aug 2019
      Replying to @ahhite @angryhacademic

      thanks Adele - agree. As far as the recent hypertension story I think the pharmaceutical forces overstepped in trying to capture a larger population and glad that there was loud pushback.

      1 reply 0 retweets 4 likes
      Health Nerd‏Verified account @GidMK 21 Aug 2019
      Replying to @MichaelMindrum @ahhite @angryhacademic

      As far as diabetes goes, spoke recently to some of the people responsible for identifying the HbA1c guidelines. "Diabetes" cutoff was based primarily on appearance of retinopathy and peripheral neuropathy, "pre-diabetes" on macrovascular complications

      5:05 PM - 21 Aug 2019
      • 3 Likes
      • Harriet Carroll: To be decided... Jasmin Levallois, MD Michael Mindrum
      2 replies 0 retweets 3 likes
        1. New conversation
        2. Health Nerd‏Verified account @GidMK 21 Aug 2019
          Replying to @GidMK @MichaelMindrum and

          ...as well as risk of developing diabetes. However, there's some debate currently as to whether 5.7% cutoff for pre diabetes is correct, given that few people between 5.7-6 develop significant complications/diabetes

          1 reply 0 retweets 0 likes
        3. Health Nerd‏Verified account @GidMK 21 Aug 2019
          Replying to @GidMK @MichaelMindrum and

          Good chance the pre- diabetes cutoff will be raised to 6 in the next year or two, watch this space!

          1 reply 0 retweets 0 likes
        4. Show replies
        1. New conversation
        2. Michael Mindrum‏ @MichaelMindrum 21 Aug 2019
          Replying to @GidMK @ahhite @angryhacademic

          neat. I know for for A1c, FPG, 2 hr GGT all were created at the increased inflection point for retinopathy. I thought pre-DM was based on increased risk of T2D over the next 5 yrs - I know they're at ⬆️ risk of macrovascular events but not aware of a clear "inflection" point.

          2 replies 0 retweets 0 likes
        3. Health Nerd‏Verified account @GidMK 21 Aug 2019
          Replying to @MichaelMindrum @ahhite @angryhacademic

          From my understanding it was a combination of the two. I've heard some calls to abolish pre-diabetes completely and just make 6 diagnostic for diabetes

          1 reply 0 retweets 0 likes
        4. Show replies

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