I can understand that in a way, but the understanding and proper diagnosis and proper treatment of ANY disease should be EVERYONE's "cause."
I guess my too main complaints are that overweight = diabetes because that dismisses the possibility that there are slim people with type 2 and medium-sized people with type 2. And of course that it ignores the hereditary factor. There are way too many children being Dx'd with type 2, yes due to changes in lifestyle, because they have the genetic risk factors.
And as someone who was mis-dx'd with type 2 because I was 30 years old, it took over two weeks in DKA coma before I got the correct Dx. Had I, as a member of the general public known about the types of diabetes, and the risk factors, I would have had a chance to question my initial Dx (no type 2 in my family and my classic type 1 symptoms) and avoided the damage from the wrong treatment and the coma.
ANd as was stated above, this guy is the head of a Diabetes Center in a very pretigious hospital - remember how proud the snobby doctor on MASH was of his residency at Mass General?
That’s the point though, again I haven’t seen the show-- but based on the discussion above it sounds like he was making broad general statements, not explaining science. As he’s the director of diabetes at one of the most prestigious hospitals in the world, I think it’s probably safe to assume that he’s probably forgotten more about the science than any of us will ever know— but again he just making general statements for a TV show this wasn’t his doctoral thesis
What bothered me most was that he implied that only kids get T1 and only adults get T2 when any age can get either type now. That was a major, major piece of misinformation. I am sure there were parents watching who were saying "but my 13 yo is diagnosed with T2." And, of course, I got T1 in my early 40s.
That is not simplifying for a 'dumb' public; that is blatant lying and can cause harm if too many take it as truth. To me, this is not about T1 vs T2 but educating the public about the increasing incidence of diabetes in most age groups. And, I do recall when no kids got T2. That age distinction no longer exists and has not since the early 90s if I am recalling correctly when it began to noticeably change. This Dr lived through that change, just as I did.
http://www2.massgeneral.org/diabetes/faculty_nathan.htm
Based on his bio here id imagine he’d be more than happy to talk anyone’s ear off about the differences that’d listen. Sounds like he’s an internationally recognized leading expert. Lets get him on live interview.
I agree. This is unbelievable- he’s director of a major
Diabetes clinic- there is no excuse for spreading such ignorance and
bad science. We should complain if there’s any way to do that.
PBS has a lot of pseudo science stuff but not usually from this type of source who should know the basic & the more complex diabetes facts.
Add my lol too 
lol
agree completely with david.
I watched the interview live and had to turn it off half way through. That so much ignorance and misinformation could come out of the mouth of an expert defies comprehension.
David Nathan is a well known researcher. He knows exactly the difference between T1 and T2 and his misspoken words likely reflect a mistake on his part to properly explain the difference to what he considers a lay audience. He can be rightly criticized for his poor choice of words but we don't really have any basis for criticizing his lack of knowledge.
What we can criticize him for is his continued championing of the Diabetes Prevention Program (DPP) claiming it "prevents" diabetes (which it hasn't been shown to do) and the fact that the DPP "harms" patients. The DPP harms patients by deceiving them. It teaches that dietary fat causes diabetes and fails to teach patients that dietary carbs raise your blood sugar and should be restricted. Most patients will still end up with full blown diabetes and they have been prepared for that outcome by being taught misleading and harmful information. Something needs to be done to protect patients.
You can view the segment on PBS.org and, if you wish, you can comment.
I saw the interview and I will give the doc a pass because the conversation driven by the interviewer, concentrated very much on T2. In the interview the doc makes an effort to mention T1 (maybe too briefly) although that was not what the interviewer was asking about, the interviewer was concentrating exclusively on T2. The doc deserves credit for bringing up T1.
The doc is an old guy, maybe almost as old as me!!!, so I don't mind him summarizing T1 as "Juvenile Diabetes" because that's what it was called just a few years ago and that's what it was called for a century before that. Obviously I'm not juvenile anymore if I'm as old as that doc!
This is extremely frustrating. I work at a medical school and am constantly amazed by the levels of ignorance in the field. I actually had a medical school professor..this is a tenured professor...tell me that he was "happy" that I was biking to work because that means I'm going to "lose my pump" in no time! Wow. A Type 1 does not have the opportunity to "lose their pump in no time." Again, amazed.
Surely Dr. Nathan knows better but is perhaps not so quick on his feet representing diabetes in a public forum. He could have said, "Type 1 diabetes is an autoimmune condition that can strike at any age." Factually true. If he had wanted to correct a common myth, he could have gone on to say, "as many cases of Type 1 are diagnosed in adults as in children so this is no longer considered juvenile or childhood diabetes."
I went to the PBS site again and watched and saw that our Melitta has commented. I put in a plug for a more in depth program on risk factors (especially the hereditary one for type 2) and how people are Diagnosed. I reminded them that November is National Diabetes Awareness month and that would be a great time...
Okay, I watched the interview carefully and in context and there is indeed much to criticize.
First, he does not actually say that T1 only strikes children and T2 only strikes adults. What he does do is use the old terms, "juvenile" and "adult onset" as convenient labels. The labels themselves are deceiving, no question. And while he does say that T2 is most commonly seen in adults, he hedges very slightly by saying that it "can occur earlier", so he's somewhat mealy-mouthed and equivocal about that. On the subject of T1, he is almost entirely silent because the interviewer is only interested in asking questions about T2.
That said, Brian's comments about his references to the DPP are precisely accurate and I won't take up space repeating them. And he does say that obesity causes T2 (the word he uses is "attributable"). The overall impression, which he reinforces in several ways, is the same old obesity-leads-to-diabetes conceit that is being called further into question each day.
So bottom line, there is almost nothing at all about T1 in this interview, and the information presented concerning T2 is seriously flawed and misleading. To that extent it is a disservice.
[He and the interviewer also make heavy use of the term "pre diabetes" which I personally consider a crock, but that's a distinct, separate topic.]
I dislike the term pre-diabetes mostly because it may encourage someone to not take it seriously. However, he makes the point that not everyone who is diagnosed with pre-diabetes gets diabetes, so perhaps it has some utility from that standpoint.
I wish the experts would say obesity and T2 diabetes are often, but by no means always seen together and that it's important to understand that concurrency does not prove cause and effect. This would provide a quick lesson on the scientific method, something that I think is needed.
From another TuD member: "The plural of anecdote is not evidence."
And he does say that obesity causes T2 (the word he uses is "attributable"). The overall impression, which he reinforces in several ways, is the same old obesity-leads-to-diabetes conceit that is being called further into question each day.
But the numbers have been shown with the Harvard studies showing that 85% of Type 2 cases being directly linked to obesity, so what he did say was actually very accurate for the vast majority of cases. While not all yes, he was trying to do this all as simply as possible for the general populace.
With studies involving over 10,000 T2 patients, backed by multiple universities and diabetic charities investing many millions on the low fat way to treat them in their early days of diagnosis showing good results for removing the layer of fat causing the insulin resistance on the pancreas in these T2 cases. So again he is accurate if over simplifying.
He can be criticised for making things to simple. But while what he says may step on a few toes around here due to their belief in some anecdotal studies without proper foundations on a proper scale, what he does say is true in a broad way.
I wish he had emphasized the hereditary risk for type 2 more. I can imagine people who are slim, with pre-diabetes and/or type 2 being the ones that don't know they have diabetes. With an emphasis on the hereditary risk factor, hopefully people will shake their family tree to see if any people with type 2 fall out. If so, get tested to catch things early. From what I understand it is usually changes in vision that cause undiagnosed type 2 people to see their MD, and then the damage is done.