Gastrointestinal conditions interact with a mechanism that slows gastric emptying in ways that are plausible and largely unstudied. Marking that as an opinion rather than a finding.
Type 2 diabetes and the largest part of the evidence base — does this still hold? I have a specific reason for asking rather than idle curiosity, and the context is below.
Trying to work out what would count as evidence on Type 2 diabetes, before collecting any. This is the part I usually skip and it is the part that makes the rest useful.
If two explanations predict the same observation, observing it does not help. So: what observation would separate them?
Taking the opening post at face value and following it one step further.
Reading back through the Type 2 diabetes threads from last year, the same three questions come up every time and only one of them has ever been answered properly. That seems like a documentation gap rather than a knowledge gap.
Noted, and thank you for writing it out rather than summarising it.
A condition that affects nutrition or absorption changes the calculus around a treatment that reduces intake, and that interaction is mostly unstudied.
I checked the source rather than the summary, and they differ.
Marking my uncertainty on Type 2 diabetes explicitly. I am confident about the direction, much less confident about the size, and not confident at all that it generalises past the case in the first post.
Coming back to post #5, because the follow-up matters more than the original answer.
A methods point on Type 2 diabetes rather than a substantive one: if the comparison is not like for like, the difference you are measuring is the difference in method.
On post #5 — agreed on the reasoning, with one qualification.
The question underneath Type 2 diabetes is usually "how would I tell?" rather than "what is true?", and that one has a method attached to it.
Write down what you would expect to see under each hypothesis before you collect anything. If they predict the same observation, collecting it will not help.
Multiple comorbidities: a person with diabetes, kidney disease, and cardiovascular disease is outside the studied populations in most trials. Extrapolating to that person requires reasoning from the individual component trials and mechanisms.
That is one dataset and I would not build a rule on it.
Since Type 2 diabetes keeps coming up, it should probably be a maintained page rather than a recurring thread. I am happy to draft it if someone with more direct experience will review it.
Second this, and I would have said it less carefully.
Where two conditions pull in opposite directions, that is a clinical judgement rather than a lookup, and it is the kind of question a forum answers worst.
I would be glad to be shown a cleaner way of putting this.
Interactions between comorbidities: diabetes and kidney disease together change the risk calculation for hypoglycemia and for medication clearance. They are not independent variables.
Post #13 put the caveat in the right place and I want to underline it.
Checked the Type 2 diabetes claim against the primary source this morning. It survives, with a narrower scope than the version quoted here. Posting the narrower scope.
Picking up post #18: that is the part I would want checked first.
Genuine question rather than a rhetorical one: has anyone here actually observed Type 2 diabetes, as opposed to read about it? The thread is long and I cannot tell.
On post #16 — agreed on the reasoning, with one qualification.
Bariatric surgery history: altered anatomy after surgery affects absorption. That matters for oral medications and for reconstituted solutions. Discussing specific medications and doses with a clinician familiar with bariatric surgery is prudent.
Where I would look next, rather than where I would stop.
Practical answer on Type 2 diabetes, since the theoretical one is upthread: do the simplest check first, write down the result, and only then decide whether the complicated explanation is needed. It usually is not.
Confirming post #21 from a second method, which matters more than confirming it from a second person.
I have no financial interest in anything named in this thread and I want to say so before I comment on Type 2 diabetes, because it is the sort of subject where it matters.
Post #21 describes the usual case. This is about the unusual one.
Cardiovascular disease: several compounds have cardiovascular outcome trials. SELECT was in people without diabetes; SUSTAIN 6 was in high-risk diabetes. Absolute benefit is largest in high-risk people.
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