Noted, and I have changed what I was going to do on the strength of it.
Type 1 diabetes: off-label use and the evidence gap — what changed since posts 61–78
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1 · go to the accepted answer.
The thing about Type 1 diabetes that took me longest to accept is that a plausible mechanism is not evidence of an effect. It is a reason to look, not a result.
Body weight at the extremes of the studied range affects exposure and the trials rarely reported enough to say by how much.
Picking up post #63: that is the part I would want checked first.
Medullary thyroid carcinoma history: an absolute contraindication because of the preclinical findings in rodent toxicology. The history (personal or family, especially multiple endocrine neoplasia type 2) is an important screening question.
That is the practical version. The rigorous version is longer and says the same thing.
Where I part company with post #63, and it is a narrow parting.
Type 1 diabetes is a good example of a question where the honest answer is boring and the interesting answers are unsupported. I would go with boring.
Post #63 is the version of this I will quote in future. One addition.
I have been on both sides of the Type 1 diabetes argument in this category within eighteen months, which should tell you how strong the evidence for either side is.
Adolescent evidence exists for some compounds in this class and is a separate approval decision with its own trials rather than an extension of the adult data.
Nothing in this subcategory is medical advice and the questions asked here are precisely the ones that need an individual assessment.
Post #68 put the caveat in the right place and I want to underline it.
I changed my mind about Type 1 diabetes after someone here asked me for the source and I could not produce one. That is worth saying out loud because it is the ordinary way it happens.
Acknowledging rather than arguing. The reasoning holds as far as I can follow it.
The useful distinction on Type 1 diabetes is between what was measured and what was inferred from it. Both end up in the same sentence and only one of them has error bars.
The arithmetic in post #74 is right; the assumption feeding it is the part to check.
On Type 1 diabetes, the part that usually goes wrong is that the question is asked as though it has one answer. It has a range, and the width of the range is the interesting bit.
If you can post the two or three numbers you are working from, several people here will check the arithmetic rather than argue about the conclusion.
Two claims get bundled together under Type 1 diabetes and they need separating. The descriptive one — this is what was observed — is usually well supported. The causal one — this is why — usually is not.
Almost every disagreement in threads like this one dissolves once you say which of the two you are making.
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