As is probably clear to anybody who knows me, I'm a big reader. I read at the rate of roughly one non-fiction adult book per day (like half a book on weekdays and three on Saturday). I also read a fair number of children's books because I volunteer in the children's department of the regional library. I also a lot of medical journal articles, mostly but not entirely culled from pub med.
I've read many disquieting things about diabetes in the past few years. I've read studies whose evidence didn't agree with the conclusions authors took from them. I've read media articles promoting "cures" when the research they cite didn't support their conclusions, or there was already a reason to know it wouldn't work. I've read studies that were clearly biased by design, intended usually to show the superiority of a more expensive treatment. I've read studies in which the set up wasn't biased but the data collection was.
I've read studies showing that NPH-Regular users have A1cs as low as Lantus-Humalog users, many studies showing that drops in A1cs for people switching to pumping are typically not sustained for more than a year. I've noticed over and over a bias in that things wanting to show evidence of helping diabetes pick only people with elevated A1cs, so that even the control group, if there is one, has a reduction in A1c.
I've followed the media as it reports on wonder drugs, and I've followed the downfalls of numerous diabetes medications (mostly for type 2s).
Despite all this, I am aware that there are many conditions, type 1 diabetes among them, for which medication is essential.
Yesterday I read a book entitled Mad In America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill by Robert Whitaker. I picked it up because it was a snazzy looking paper back. It chronicles the treatment of those with mental illness- schizophrenia in particular- in the United States. It makes an extremely strong argument that taking "antipsychotic" medications WORSENS schizophrenia outcomes, and that the evidence of this has been there for all to see since the 1950s, and that the modern medical establishment has turned willfully away from the evidence.
I hoped, as I read the book, that after I finished it I would find some criticism explaining why the book was wrong. What the flaws in the arguments were.
The criticism I found was... well, it was nit picking. They complained he left out a study. Big whoop. They complained some of his analogies were simplistic- yes, but so what? None of them truly could argue that he was wrong.
Reading about the sins of companies that make some of my medications makes me scared. Reading about the willingness of doctors to do experiments clearly not in the interest of patients, ditto. It also gives me pause regarding clinical trials. Whitaker talks about clinical trials in which the trial was clearly misrepresented to patients. There have been at least a couple clinical trials for diabetes products in which patients were hurt, and it has not escaped my notice that clinical trials for diabetes often target the very newly diagnosed, who just happen to be more vulnerable to false hopes, and less aware of how livable diabetes is.
I don't know what to end this post with. I don't have a resolution. I'm just becoming more and more aware of how public perception of disease is molded by big phama, and I don't like it.