Author Topic: Dr Kendrick's summing up  (Read 344 times)

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Offline TerryJ

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Dr Kendrick's summing up
« on: 14 January 2018, 06:06:47 AM »
After a very long series on what causes CVD, he has started to pull all the strands together.
His first three bits of advice are -

   1. Do not smoke
   2. Take exercise
   3. Go out in the sun – and enjoy it.

https://drmalcolmkendrick.org/2018/01/12/what-causes-heart-disease-part-44/
Type 2 since 1999. Current meds Gliclazide
HbA1c Feb10 10.9, May10 7.7, Oct10 6.6, Oct11 6.7, Dec12 6.4, Nov13 6.9

Online Pattidevans

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Re: Dr Kendrick's summing up
« Reply #1 on: 14 January 2018, 10:22:54 AM »
Excellent piece.  I’ve been following his blog but hadn’t got around to reading his summation as yet.  Possibly because I found some of his pieces a bit hard going.  Due to your prompt I have now read his latest.  I find his comments about sun exposure very interesting, some surprises there, but pleasant ones for me as I love the sun and having a light tan.


I think it would benefit some members here to read his comments on Proton Pump Inhibitor long term use.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.


© 2015 Patti Evans

Offline everydayupsanddowns

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Re: Dr Kendrick's summing up
« Reply #2 on: 23 January 2018, 10:52:09 AM »
I love Dr K's blogs. Always make so much sense to me.

But I do wish he wouldn't average the theoretical benefit of statins (at a population level) into 'number of days per person' though. At least that's what I think he does when he says 'adds an extra 4 days' or whatever.

He quite rightly casts a very critical eye over trumpeting of 'relative risk' over the far smaller absolute risk reductions, but to average the effect of avoiding a fatal CHD event over a population seems uncharacteristically disingenuous. You either have it or you don't.

Even non-fatal stroke avoidance is not to be sniffed at. Anyone of us who has a friend or relative who is a stroke survivor will know that life can be profoundly different afterwards for that individual, whereas it goes on completely unchanged for the person that DOESN'T have it.

These are not things can can be averaged over a study population.

For me it would be far better to highlight the low effect of statins (if that is what he wants to demonstrate) by using NNT 'number needed to treat' - ie the number of people you need to give a statin to and over what period in order to avoid a single event.

I think those numbers would shine a much clearer light on effectiveness or otherwise than days of life added to everyone - which is clearly nonsense.
Mike

Type 1 since: 1991 Last HBA1c: 45 (6.3%)  Total Chol 5.0 (1.9HDL / 2.8LDL / Trigs 0.7)
Pumping NovoRapid in a MiniMed 640G
Blogging at: www.everydayupsanddowns.co.uk

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Re: Dr Kendrick's summing up
« Reply #3 on: 23 January 2018, 07:30:23 PM »
I tend to agree with you Mike.  Though I think he says about extra days to live perhaps to demonstrate to people who find the concept of NNT confusing.  Thus achieving the opposite effect for those who understand it more easily! ;)
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.


© 2015 Patti Evans

Offline himtoo

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Re: Dr Kendrick's summing up
« Reply #4 on: 23 January 2018, 08:14:12 PM »
is he taking the general population into his calcs of extra days -- when actually  people predisposed to CVD thorough long term chronic illness are a separate category of people ?

just a thought ............
T1 Dia Aug 1972 -pumping omnipod since 29/09/15  Losartan 100mg , simvastatin 40mg,Furosemide 40mg, Omeprazole 80mg , Doxazosin 8mg
Hba1c - 06/2013 6.1 02/2014 43(6.1) 07/14 42(6.0) 08/14 40( 5.8 ) 12/14 39 (5.7) 08/15 41 ( 5.9) 10/15 44 ( 6.2 ) 03/16 49 (6.6)
cholesterol --nov 2011 4.3 june 2012 4.4 June 2013 4.1 Feb 2014 4.1 dec 14 4.5 oct 15 4.4
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Offline sedge

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Re: Dr Kendrick's summing up
« Reply #5 on: 23 January 2018, 09:07:23 PM »
Quite likely I'd have thought - are the stats for 'us' recorded separately when it's something other than diabetes info?  I daresay if you have Addison's or sickle cell, the incidence of CVD wouldn't be recorded separately either.
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

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Re: Dr Kendrick's summing up
« Reply #6 on: 23 January 2018, 10:32:33 PM »
Despite who has what I think you have to bear in mind that a lot of statistics given for statin use are predicated on them distributing them like smarties.  They are not a universal panacea.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.


© 2015 Patti Evans

Offline everydayupsanddowns

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Re: Dr Kendrick's summing up
« Reply #7 on: 24 January 2018, 03:02:02 PM »
I am sure he is talking about general people without diabetes. And it is worth remembering that us lot with diabetes are at increased risk (at least 2x or 3x I think) of CHD/CVD even at low A1cs/stable BGS - at least T1s are.
Mike

Type 1 since: 1991 Last HBA1c: 45 (6.3%)  Total Chol 5.0 (1.9HDL / 2.8LDL / Trigs 0.7)
Pumping NovoRapid in a MiniMed 640G
Blogging at: www.everydayupsanddowns.co.uk

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Re: Dr Kendrick's summing up
« Reply #8 on: 24 January 2018, 03:53:10 PM »
Oh god, how depressing!   :'(
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.


© 2015 Patti Evans

Offline sedge

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Re: Dr Kendrick's summing up
« Reply #9 on: 24 January 2018, 04:26:11 PM »
Well, if it's gonna happen it will, and if it ain't it won't.

Fatalistic - yes indeed!  Life itself is finite, so why let it worry or depress anybody?
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline nytquill17

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Re: Dr Kendrick's summing up
« Reply #10 on: 25 January 2018, 02:40:12 AM »
While I'm not pleased of course about the higher risk, I think it IS an important thing to talk about. That is to say, sure there is a lot we can do to protect our own health. But if things DO go wrong, it's not necessarily all down to what we did or didn't do. Sometimes it is just down to the disease itself. I find it more useful, for myself personally (of course everyone is different!) to think of myself as a person who is trying to carve out the best possible life for herself while having diabetes, than to think of myself as constantly failing to achieve perfect health and "dooming myself" to various consequences as a result!
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  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline everydayupsanddowns

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Re: Dr Kendrick's summing up
« Reply #11 on: 25 January 2018, 10:33:42 AM »
While I'm not pleased of course about the higher risk, I think it IS an important thing to talk about. That is to say, sure there is a lot we can do to protect our own health. But if things DO go wrong, it's not necessarily all down to what we did or didn't do. Sometimes it is just down to the disease itself. I find it more useful, for myself personally (of course everyone is different!) to think of myself as a person who is trying to carve out the best possible life for herself while having diabetes, than to think of myself as constantly failing to achieve perfect health and "dooming myself" to various consequences as a result!

Absolutely agree nytquill! As my Grandad used to say... "Doctor, doctor, if I give up drinking will I live longer?" "No. But it will feel like it!"
Mike

Type 1 since: 1991 Last HBA1c: 45 (6.3%)  Total Chol 5.0 (1.9HDL / 2.8LDL / Trigs 0.7)
Pumping NovoRapid in a MiniMed 640G
Blogging at: www.everydayupsanddowns.co.uk