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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. Health Nerd‏Verified account @GidMK 18 Apr 2018

      Been meaning to do this for a while but had 0 time to do it, so here goes: Follow here for a tweetorial on diabetes epidemiology!

      2 replies 7 retweets 14 likes
      Show this thread
    2. Health Nerd‏Verified account @GidMK 18 Apr 2018

      There's going to be a bunch of polls and stats in here, and you'll probably learn some depressing things.

      1 reply 0 retweets 1 like
      Show this thread
    3. Health Nerd‏Verified account @GidMK 18 Apr 2018

      First up: how do we define diabetes? In Australia, we go by the ADA guidelines which recommend a diagnosis based on blood glucose and an HbA1c of

      1 reply 1 retweet 1 like
      Show this thread
      Health Nerd‏Verified account @GidMK 18 Apr 2018

      Whilst that's going, I should add an important note: this is NOT true of gestational diabetes, for which the threshold is lower

      4:13 PM - 18 Apr 2018
      • 1 Like
      • Joe Warbington
      1 reply 0 retweets 1 like
        1. New conversation
        2. Health Nerd‏Verified account @GidMK 18 Apr 2018

          The reason I put that poll out is because of an important fact: diabetes recommendations change! They've changed a LOT over the last two decades Currently, the recommendation is HbA1c>6.5% with a fasting blood glucose corroborating this if necessarypic.twitter.com/WoDquBnX5F

          1 reply 0 retweets 3 likes
          Show this thread
        3. Health Nerd‏Verified account @GidMK 18 Apr 2018

          So bearing that in mind, what do you think the diabetes prevalence was in the 90s? (FYI, a lot of figures are going to be based on Australia because that's where I am, but they are fairly similar to most OECD countries especially UK/US)

          1 reply 1 retweet 1 like
          Show this thread
        4. Health Nerd‏Verified account @GidMK 18 Apr 2018

          And given those diabetes rates, what do you think the rates of DIAGNOSED diabetes are today?

          1 reply 1 retweet 1 like
          Show this thread
        5. Health Nerd‏Verified account @GidMK 18 Apr 2018

          It's important to remember that we are mostly talking about DIAGNOSED diabetes here. People are often undiagnosed with type 2 diabetes for years, or even decades!

          2 replies 1 retweet 5 likes
          Show this thread
        6. Health Nerd‏Verified account @GidMK 18 Apr 2018

          So a few votes rolling in (remember to vote it's fun). For the figures above, what's the ratio of type 1 diabetes to type 2?

          1 reply 0 retweets 1 like
          Show this thread
        7. Health Nerd‏Verified account @GidMK 18 Apr 2018

          Health Nerd Retweeted Health Nerd

          Going back to the 90s, most people are pretty close. The answer is about 1.5% prevalence of diabeteshttps://twitter.com/GidMK/status/986746545889423360 …

          Health Nerd added,

          Health NerdVerified account @GidMK
          So bearing that in mind, what do you think the diabetes prevalence was in the 90s? (FYI, a lot of figures are going to be based on Australia because that's where I am, but they are fairly similar to most OECD countries especially UK/US)
          Show this thread
          1 reply 0 retweets 2 likes
          Show this thread
        8. Health Nerd‏Verified account @GidMK 18 Apr 2018

          Health Nerd Retweeted Health Nerd

          Now, the big reveal. How much have diabetes rates increased in the last 20 years?https://twitter.com/GidMK/status/986746821857886208 …

          Health Nerd added,

          Health NerdVerified account @GidMK
          And given those diabetes rates, what do you think the rates of DIAGNOSED diabetes are today?
          Show this thread
          1 reply 0 retweets 2 likes
          Show this thread
        9. Health Nerd‏Verified account @GidMK 18 Apr 2018

          Not quite as much as everyone thinks, but enough It's about 6% now So a fourfold increase in diabetes rates since the late 90s

          1 reply 0 retweets 3 likes
          Show this thread
        10. Health Nerd‏Verified account @GidMK 18 Apr 2018

          BUT remember what I said above about changed diagnostic criteria? Yes, diabetes rates have shot up, but a part of that increase is to do with what we call 'diabetes'

          1 reply 0 retweets 2 likes
          Show this thread
        11. Health Nerd‏Verified account @GidMK 18 Apr 2018

          Health Nerd Retweeted Health Nerd

          And this increase is largely being driven by one thing: type 2 diabetes! The answer here is ~roughly~ 10:90, with type 1 making up 1 in 10 patients with diabeteshttps://twitter.com/GidMK/status/986750411221577729 …

          Health Nerd added,

          Health NerdVerified account @GidMK
          So a few votes rolling in (remember to vote it's fun). For the figures above, what's the ratio of type 1 diabetes to type 2?
          Show this thread
          1 reply 0 retweets 3 likes
          Show this thread
        12. Health Nerd‏Verified account @GidMK 18 Apr 2018

          So, diabetes rates have gone from 1.5% to 6% in only two decades This is bad

          1 reply 0 retweets 3 likes
          Show this thread
        13. Health Nerd‏Verified account @GidMK 18 Apr 2018

          But wait! Remember, these figures are only for DIAGNOSED patients What percentage of people with diabetes are currently living undiagnosed?

          1 reply 0 retweets 1 like
          Show this thread
        14. Health Nerd‏Verified account @GidMK 18 Apr 2018

          And the answer is... Trick question! What you see above is a list of estimates, but the answer is we don't really know

          1 reply 0 retweets 2 likes
          Show this thread
        15. Health Nerd‏Verified account @GidMK 18 Apr 2018

          The WHO says it's probably around 20%. Work done by my team found it to be more like 33% in a high acuity patient population. More recent work done by me is looking to be 12-15% in the general population http://apps.who.int/iris/bitstream/handle/10665/204871/9789241565257_eng.pdf;jsessionid=CB03C43BE57BBF27E96366E2E2E9E9C8?sequence=1 …

          2 replies 0 retweets 3 likes
          Show this thread
        16. Health Nerd‏Verified account @GidMK 18 Apr 2018

          But the basic answer is: a lot. Even if the number is only 15%, you're still pushing that 6% estimate up to 8 or even 9%

          1 reply 0 retweets 2 likes
          Show this thread
        17. Health Nerd‏Verified account @GidMK 18 Apr 2018

          Diabetes is going up. This is VERY BAD. What is the main driver behind this increase?

          2 replies 0 retweets 1 like
          Show this thread
        18. Health Nerd‏Verified account @GidMK 18 Apr 2018

          Identifying the main driver behind increased diabetes rates is ~very important~, because they are predicted to go up. And up. And up.pic.twitter.com/tKeQAIJrXQ

          1 reply 1 retweet 4 likes
          Show this thread
        19. Health Nerd‏Verified account @GidMK 18 Apr 2018

          In Australia, we're looking at a potential 30% (!) prevalence of diabetes by the year 2050 That is truly unsupportable

          1 reply 0 retweets 2 likes
          Show this thread
        20. Health Nerd‏Verified account @GidMK 18 Apr 2018

          Why is it unsupportable? This is whypic.twitter.com/0no3JnVbyq

          1 reply 2 retweets 4 likes
          Show this thread
        21. Health Nerd‏Verified account @GidMK 18 Apr 2018

          When diabetes rates go up, so too do the rates of diabetes complications. Macrovascular (heart) disease, retinopathy/blindness, and amputations skyrocket

          1 reply 0 retweets 2 likes
          Show this thread
        22. Health Nerd‏Verified account @GidMK 18 Apr 2018

          Now, something raised by @timsenior already - socio-economic drivers of diabetes To put it briefly: disadvantage and diabetes go hand-in-hand

          1 reply 4 retweets 3 likes
          Show this thread
        23. Health Nerd‏Verified account @GidMK 18 Apr 2018

          Work from my team has shown this time and again. This map in particular paints a sad picture. Red=diabetes, blue=less diabetes. The wealthy areas are near the sea, the poorer areas further awaypic.twitter.com/2m3csvlaaW

          1 reply 3 retweets 3 likes
          Show this thread
        24. Health Nerd‏Verified account @GidMK 18 Apr 2018

          And we have new data (upcoming study plug!) that shows this even more starkly. The poorer your neighborhood, the more likely you are to have diabetes

          1 reply 4 retweets 4 likes
          Show this thread
        25. Health Nerd‏Verified account @GidMK 18 Apr 2018

          Unsurprisingly, this links very well with other socially-determined disease like cardiovascular problems and eventually death Social disadvantage killspic.twitter.com/s3YzyvP5UR

          3 replies 3 retweets 3 likes
          Show this thread
        26. Health Nerd‏Verified account @GidMK 18 Apr 2018

          And we see these issues in every data source. Here's the graph of a wealthy are (left) compared to a rural/disadvantaged area (right) for diabetes ratespic.twitter.com/XuGZFxi29A

          1 reply 0 retweets 1 like
          Show this thread
        27. Health Nerd‏Verified account @GidMK 18 Apr 2018

          I've talked a lot about wealth here. What is another major social determinant of diabetes? #SDOH

          1 reply 1 retweet 1 like
          Show this thread
        28. Health Nerd‏Verified account @GidMK 18 Apr 2018

          Health Nerd Retweeted Health Nerd

          Probably worth coming back to this, because the answers are somewhat linked. As you've correctly identified, the answer is all of the abovehttps://twitter.com/GidMK/status/986758774873468928 …

          Health Nerd added,

          Health NerdVerified account @GidMK
          Diabetes is going up. This is VERY BAD. What is the main driver behind this increase?
          Show this thread
          1 reply 0 retweets 1 like
          Show this thread
        29. Health Nerd‏Verified account @GidMK 18 Apr 2018

          The thing is, the main driver of diabetes increases - increases in average population weight - is closely linked to social disadvantagepic.twitter.com/WSstr6vBsw

          1 reply 0 retweets 1 like
          Show this thread
        30. Health Nerd‏Verified account @GidMK 18 Apr 2018

          Less wealth = more obesity = higher rates of type 2 diabetes

          1 reply 0 retweets 1 like
          Show this thread
        31. Health Nerd‏Verified account @GidMK 18 Apr 2018

          But something else we're seeing in Western Sydney particularly is an issue I haven't really touched on yet Gestational diabetes And here, rates are SKYROCKETINGpic.twitter.com/jZjK3GvSnY

          1 reply 1 retweet 2 likes
          Show this thread
        32. Show replies

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