Dec 15 2016

Abusing Science You Don’t Understand

insulinInterpreting scientific studies is difficult. You need to have a thorough working knowledge of scientific methodology, statistical analysis, and the specific field of the science itself. Individual studies also need to be put into the context of all the other studies that touch upon the same question.

It also has to be recognized that all scientific studies are imperfect and only look at a slice of a larger question. Even scientific experts can therefore honestly disagree about how best to interpret the evidence, until that evidence becomes overwhelming (and even then there are often outliers with minority opinions).

If you have an agenda other than understanding the best interpretation of all available evidence, it is easy to find evidence you can twist to serve your preferred narrative. You can then (falsely) claim that your position is supported by science. You can also rely on the fact that most of the public will not be sufficiently scientifically savvy to see the flaw in your reasoning.

A recent article by Edward Morgan on the alleged risks of GMO insulin is a great example of this phenomenon. The title is: GMO Insulin Causes Type 1 Diabetes in Type 2 Diabetics, Study Finds. That is not what the study found.

The author has a clear anti-GMO agenda and so they are trying to argue that insulin which is made from genetically modified bacteria (which is how almost all insulin is made today) is dangerous. They do this by cherry picking studies they clearly don’t understand and then misinterpreting them.

The first study, which is not the one referred to in the headline, is a 2013 study looking at various outcomes in Type II diabetics based on the treatment they are receiving:

Patients comprised 84 622 primary care patients with T2DM treated with one of five glucose-lowering regimens: metformin monotherapy, sulfonylurea monotherapy, insulin monotherapy, metformin plus sulfonylurea combination therapy, and insulin plus metformin combination therapy. There were 105 123 exposure periods.

They found that a number of negative outcomes, including all-cause mortality, was highest in the insulin monotherapy group. Morgan reported that this study showed that insulin therapy caused these negative outcomes. Again, that is not what the study showed, and is a great example of why you need to understand clinical trial design before you can have any idea what the results mean.

Morgan should have had a clue from the last line of the conclusion:

Differences in baseline characteristics between treatment groups should be considered when interpreting these results.

This was a retrospective study, meaning that the researchers were looking back at medical records to see what had already happened. They were not randomizing patients to different treatment groups and then seeing how they do. This is a critical difference, for the very reasons the authors state. It is possible that patients who receive insulin monotherapy are not the same at baseline as those who receive metformin. There is good reason to think this is the case, as in Type II diabetes patients who receive insulin are generally sicker and have worse diabetes control overall, otherwise they would not have resorted to insulin. If they could be controlled with metformin alone, which is a oral medication, they would have.

Type II diabetics have insulin resistance. They can make insulin (unlike Type I diabetic who don’t make insulin) but their cells do not respond to insulin normally. This leads to hyperinsulinemia, which has its own negative outcomes. Taking insulin is therefore a last resort, and used only when the blood sugar is dangerously high. So of course patients with Type II diabetes taking insulin had worse outcomes than those managed with oral medication.

It is also quite possible that Metformin has some protective effects, and if you are taking insulin alone you are missing out on those protective effects.

The bottom line is that you cannot conclude from this uncontrolled retrospective study that insulin is causing any of the negative outcomes measured. You may also notice that the words GMO never appear in this study, and there was no comparison between GMO-derived and animal-derived insulin.

The more recent study is a small study from Japan, involving only 6 patients, titled: Insulin Administration May Trigger Type 1 Diabetes in Japanese Type 2 Diabetes Patients With Type 1 Diabetes High-Risk HLA Class II and the Insulin Gene VNTR Genotype.

Again you will notice that there is nothing in this study about GMO derived insulin. The purpose of this study was to look for genetic characteristics that might help predict which patients will develop an immune reaction to exogenous insulin. In some, but not all, of the patients studied they found they had a genetic predisposition to type I DM. If these findings hold up with more data it may provide a way of identifying patients who should not receive insulin, or for whom insulin use should be minimized, because they have a genetic predisposition to develop an immune reaction that will result in type I DM.

This is a complicated area of genetics and diabetes. The two genetic variants looked at in the study exist in a minority of patients, especially if you consider those who have both genotypes. Also having both genotypes magnifies the risk of Type 1 DM. So, if this study holds up to replication and further investigation, it seems that having a double dose of genetic predisposition to DM may also confer a higher risk that insulin therapy can trigger an antibody reaction that leads to Type 1 DM.

This says nothing about the majority of patients who do not have this genetic predisposition, and it saying absolutely nothing about GM insulin vs animal-derived insulin. Yet, somehow Morgan extracted from this study an anti-GMO narrative. He states that narrative specifically in his conclusion:

Also, diet is the #1 factor in the pathogenesis of most chronic conditions that afflict the modern world; more specifically, the consumption of foods or food-like products that deviate from our ancestral diets generate the physiological conditions that produce disease in the first place.

There is no evidence to support this position. Of course, diet is extremely important in Type 2 DM. That is why such patient are placed on a diabetic diet, and encouraged to exercise and lose weight. In many patients Type 2 DM can be reversed with diet and exercise. But Morgan is not referring to the science-based approach to DM, but rather to “magical” natural foods and an appeal-to-nature fallacy that somehow “regenerates” tissues and cures diseases.

This is all nonsense, and the evidence he cites does not support his position. The only thing we can conclude from his article is that he is not able to understand the scientific articles he is citing, or he does not care to really understand them. They are a rhetorical device only.

11 responses so far

11 Responses to “Abusing Science You Don’t Understand”

  1. daedalus2uon 15 Dec 2016 at 10:17 am

    Well, everyone who has developed a modern disorder has been eating a diet. If you don’t eat a diet, you won’t have any of the modern disorders, at least not after the acute effects of death from starvation, which is (mostly) not a modern disorder. 😉

  2. WyseMDon 15 Dec 2016 at 10:40 am

    The scary thing is that patients or “alternative” practitioners may shy away from optimal treatments based on baseless articles like this. I went to the site that this article came from and it is filled with complete and utter nonsense. Honestly Steve, I don’t know where you find this stuff. I never knew it existed until I became aware of skepticism 2 years ago. It amazes me that these people can function in daily life.

  3. Bill Openthalton 15 Dec 2016 at 11:36 am

    Well, Morgan read what he wanted to read, and disregarded the rest (with apologies to Simon and Garfunkel). People with an ideology-based mindset are selectively blind. And unfortunately, it would seem the standard mindset of a large majority of humans. PZ Meyers’ rantings on Trump are a cringingly good example. Froot Loops, anyone?

  4. MaryMon 15 Dec 2016 at 2:58 pm

    I added your post and Kevin Folta’s prior one on the same nonsense over in the PubMed comments for both articles. That way if people go looking for the original studies they’ll see that there are science-based commentaries about them.

    There’s a lot of anti-GMO nonsense, but this kind of stuff is particularly dangerous. I don’t care if you want to pay more for organic food, but talking people off proper treatments is really loathsome.

  5. tb29607on 15 Dec 2016 at 4:10 pm

    There are enough challenges with medication compliance among diabetics as it is. If I ever meet Edward Morgan I will be sure to thank him for adding to the frustration.

  6. Haggardon 15 Dec 2016 at 5:12 pm

    “Whatever The Question, Love Is The Answer” -Edward Morgan

    You have to be digging pretty deep to dredge up this kind of garbage. I mean, not the love part that he has for a byline. I think that’s sweet. Why not inject a little more love in the world? Go for it.

    But, how is an article posted on a site dedicated to “The Event” to be taken seriously enough for critical review? Anyone who is not completely off their nut will instantly realize that just about anything “published” on a site like this is absolute crap. The whole thing looks like a joke.

    For example:

    “The ‘Event’ is when the rising of the planetary frequencies will be accompanied by the planned mass arrests of the worldwide criminal cabal, politicians, big bankers and others who have committed numerous crimes against humanity. This will happen in a legal manner, and the accused will be given fair trials. As a result of this legal action there will be a worldwide reset of our financial system, of our energy and food production, our media, and the whole structure of society in general. Clean technologies which had been previously suppressed by big corporations will be released, the natural abundance of this planet will be distributed for everybody, our eco-systems cleaned and this planet, along with all its inhabitants, finally healed and liberated.”

    Seriously?

    “Please be aware that at the time of “The Event” this site will be getting perhaps millions of hits and sign up for groups will increase tremendously. We hope you will be active and take your role seriously and be a force for peace, truth and understanding at the time of “The Event”. The PFC Team Thanks you!”

    I suspect they are laughing their assess off. Either because they are insane, or it really is a big joke and it’s probably pretty funny to see people respond to it.

    Perhaps I am missing something and this is an article that has been republished on the “Prepare For Change” web site with origins in something more serious or mainstream.

    If not, why even bother talking about it? If people are this fucking stupid, it is hard for me to imagine anything sensible reaching them. I guess I can see the harm of something like this article making a “mainstream” impact, but the big question is how is that even possible? Who could possibly reference something like this with a straight face in anything mainstream that would get widespread use? You’d get fired!

    Anyway, it all seems like a joke to me. Genuinely so. Maybe you’ve been taken in?

  7. Steven Novellaon 16 Dec 2016 at 7:07 am

    Haggard – see Poe’s law. My guess is the site takes itself seriously, I think you underestimate how nutty some people can be.

    But – none of that matters. The current reality is that articles like this get passed around on Facebook and few check the source. Articles float around detached from their origin. It is useful to get critical responses in the Google search.

    Further, it’s an exercise for critical thinking.

    And, I have resided myself to the fact that I will keep having to explain this.

  8. RCon 16 Dec 2016 at 9:40 am

    @Haggard

    “Anyone who is not completely off their nut will instantly realize that just about anything “published” on a site like this is absolute crap. ”

    The problem is that the vast majority of people make their opinions, and then look for confirming evidence instead of looking at the evidence and coming to a conclusion.

    As SN said, people pass worse stuff than this around on Facebook all the time. I’ve seen everything down to blog posts on cooking sites posted as anti-gmo ‘evidence’. There’s pretty much no floor for what ideologists will use to defend their ideology.

  9. chikoppion 16 Dec 2016 at 10:13 am

    @Haggard

    When the ‘Event’ happens Steve will be among the many swept up in the arrests. He’s just trying to forestall the inevitable. The ‘Event’ will be triggered when articles like this one, articles that demonstrate we know the truth about the worldwide criminal cabal, have received enough shares and likes on Facebook, so do your part today!

  10. Haggardon 16 Dec 2016 at 12:36 pm

    I’m depressed just thinking of someone reading this nonsense and believing it.

    Steve – I can see your point about having something show up in a search result that highlights what shouldn’t need to be said about this stuff. And that perhaps it’s a useful tool for explaining critical thinking. However, that adds to the depressing nature of it all. That this needs to be done at all, in relation to an article like this with its pedigree, is a sorry mess to be in. Truly.
    I generally hold people in high regard. I am sincere in the thinking that most people I meet are pretty reasonable and that they are at least as intelligent, and are often more intelligent than I am. I’ve met very few cranks (in ratio to most reasonable people) in my time, that I know of. I’m going to keep on believing that, thank you.

    RC – I’ve not really considered the idea that this can get passed around in social media, detached from where it came from, as Steve has pointed out. I’ve not been a part of social media (for no particular reason other than I simply haven’t got sucked in yet), so I guess I am now in a bubble and don’t see what is going on. I suppose I am still relying on “mainstream” journals and newspapers for news and generally have a trust that they wouldn’t possibly publish something like this. I suppose I ought to re-evaluate that stance as well, just to be safe. I don’t know what the hell people should do if they use something like facebook to get informed and are exposed to stuff like this as if it were presented as real. That’s really something. And it’s not funny. That’s some serious business. In the past, didn’t we know that if we picked up the World News that it was a joke or a tool to be used by embedded agents in the field to receive coded messages? There used to be a distinction, I think.

    Chikoppi- I briefly thought of joining up to see what they had to offer, perhaps passing a few names of targets along to curry favour, but I remembered that I actually have work to do. And that maybe it’s also not such a good idea to engage with people who genuinely believe this stuff. It’s a shame, really, because they do seem like a group of interesting folks.

    Anyway, interesting stuff. I feel a little bit sad now, to be honest, but still have hope that this stuff is a long way off from reaching a large audience. If this ever becomes normal, I think I’ll crap my pants and stay inside.

  11. BillyJoe7on 20 Dec 2016 at 1:25 pm

    Haggard,

    “I am sincere in the thinking that most people I meet…are at least as intelligent, and are often more intelligent than I am”

    I know you say some pretty dumb things sometimes, but this can’t possibly be true.

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