I don’t know what to do with an anecdote. Sorry.

A lot of people are sending me this article from the WSJ:

A 3-year-old girl with Type 2 diabetes, one of the youngest people to have developed the disease, recovered after six months of treatment, offering hope that the rising numbers of children suffering from the condition can be reversed.

More about the girl:

The unidentified girl, who is now five, was seen by doctors at the University of Texas two years ago and presented a number of symptoms corresponding with diabetes, including excessive urination and thirst. She weighed a little over 77 pounds (35 kilogram), placing her in the heaviest 5% of children in her age group. She scored high in diabetic blood sugar tests but tested negative for Type 1 diabetes, the most common form of the condition in children.

Dr. Yafi, who works at the university’s pediatric endocrinology clinic, said the girl’s diet consisted mainly of fast food, candy and sugary drinks, and she hardly ever played outdoors. The parents were also obese but had no previous family history of diabetes, he said.

There are no details in the article about the girl’s case, but I think we can agree that this is an anomaly. As the lede states, this would have to be one of the youngest cases of type 2 diabetes ever. Almost by definition, something else would have to be involved. Kids, even super obese ones (and she wasn’t there), just don’t develop diabetes by age 3. Plus, there’s this:

After the 3-year-old girl had been diagnosed with Type 2 diabetes, she was put on a liquid diabetes drug called metformin, Dr. Yafi said. The parents began to gradually replace the sugary drinks with water and fast foods with home-cooked meals. They also started playing in the garden, taking walks in the neighborhood and placed their daughter in a swimming class.

I mean… gah. A three year old child on metformin has to be beyond any studied use of the drug. She also made dietary and lifestyle changes, lost weight, became active, and six months later no longer has type 2 diabetes.

This is an anecdote. And it’s absolutely not like usual diabetes. She’s not a typical case, she wasn’t treated in a typical manner, and she was “cured” in an insanely short period of time. Are we even sure she had type 2 diabetes? Did they repeat the screening labs? Given that we don’t noramally test kids at this age, we don’t even know the sensitivity and specificity of the diagnostic tests in this population. I’m not sure think there’s anything to be learned here at all. The presenter disagrees with me (emphasis mine):

Dr. Michael Yafi, who presented the case study at the annual European Association for the Study of Diabetes conference in Stockholm on Thursday, said it shows the importance of testing for Type 2 diabetes regardless of age as early detection and lifestyle modifications are key to reversing the disease.

So now we should start screening toddlers because of this one child? This is why I don’t use anecdotes.


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