December 17, 2006
Question from India:
As a follow-up to my previous question, I agree that it may not be ethical or practical to conduct placebo controlled studies on humans to evaluate the complete cycle of diabetes with and without medication. But, aren't there clinical/personal observations of type 2 diabetics who have not taken any medications or remained on a minimum of medications? Such data can be very important in understanding diabetic complications with and without medication. Is such data systematically recorded and made available to the public? Do you have any references to it? On looking at the outcome of few of my close near and dear ones with type 2 diabetes, some who have followed their medication program seriously and others have not, I am bit uncomfortable.
Part of the ethics of not doing such a study is not actively participating in the collection of data for a condition that is known to be against good clinical care. I do not know any serious researcher who would actively collect data on those who have withheld care. There are previous studies that clearly show that those with the worst control have the most complications. Examples of individuals who are seen in clinical care who do not have good glucose control are also more frequent than would be desired. I would suggest that part of that is the economics of medical care and many cannot afford it.