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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

      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
    2. 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
    3. 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
    4. 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
    5. 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
    6. 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
    7. 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
    8. 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
    9. 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
    10. 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
      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%

      5:08 PM - 18 Apr 2018
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      1 reply 0 retweets 2 likes
        1. New conversation
        2. 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
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        3. 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
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        4. 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
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        5. 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
        6. 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
        7. 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
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        8. 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
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        9. 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
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        10. 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
        11. 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
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        12. 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
        13. 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
        14. 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
        15. 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
        16. 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
        17. Health Nerd‏Verified account @GidMK 18 Apr 2018

          This graph shows raw numbers, but the number of live births in Western Sydney has only slightly increased in this time, which means the rate has almost tripled in a decadepic.twitter.com/6WQGCyPTOP

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

          But when we look at causes, we found something interesting: Unlike type 2, the increase is not predominantly due to weight gain!

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

          What do you think it was down to?

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

          I'll give you a hint - every woman who is pregnant has been given an oral glucose tolerance test in our region for a long time

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

          While that poll is filling in (remember to vote!), I'll tell you why it's important Basically, gestational diabetes is a red flag for future rates of the diseasepic.twitter.com/yV0hSzFByl

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

          Obviously you have to treat pregnant women, and this is a big focus. But increasing rates of gestational diabetes pretty much guarantee that our rates will keep increasing no matter what we do

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

          The main drivers? Interestingly, what we've found is that it's likely to be related largely to a change in the ethnicity of our population

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

          Something many doctors aren't aware of is that a variety of minority populations (such as people of SE Asian descent) may be at much higher risk of developing diabetes, and at a lower weight too

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

          Now on to some of my own work. Given that the estimated POPULATION prevalence of diabetes is ~9%, what would the prevalence IN HOSPITAL be?

          1 reply 0 retweets 1 like
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        26. Health Nerd‏Verified account @GidMK 18 Apr 2018

          Another hint: this is a much sicker population of people than your general person

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

          So everyone seems to be going high - which is good. Our figures put the proportion at roughly 20%, which is similar across the country

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

          But this is different for different places in the hospital. For example, what's the prevalence in a cardiology ward?

          1 reply 0 retweets 1 like
          Show this thread
        29. End of conversation

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