My curious interest in type 2 diabetes was triggered by some discussions in Katta by mid 2000 if I remember correctly. I looked at it as an evolutionary biologist and tried to interpret it afresh. Over the years my own entirely novel interpretation developed which I published in a series of over 25 research papers and two books. This journey changed my life, my science as well as my perspective and relationship with academia. But did it change the mainstream research in the field? The answer is a big no. It remains equally confused, laden with serious anomalies in the underlying theories, unscientific beliefs, data manipulations and purposeful misleading of doctors and patients. The entire field is pseudoscience and nobody cares.
As soon as I started browsing through literature, I was struck by the horrendous anomalies in the field, reproducible experiments having proved beyond doubt that the foundational beliefs were wrong, simple mathematical models showing the impossibility of the prevalent theory and on top of it the complete failure to cure diabetes and/or prevent diabetic complications effectively and consistently.
The anomalies that were already there were the following. Inducing insulin resistance by gene knock outs does not result into consequences that the theory expects. Neither insulin nor glucose levels go out of range by the induced insulin resistance. Suppressing insulin production or release in an insulin resistance state does not increase fasting glucose in rodent as well as human experiments. During development of T2D, hyperinsulinemia does not seem to be a response to insulin resistance as the theory says. Hyperinsulinemia precedes insulin resistance and experimentally suppressing hyperinsulinemia brings down insulin resistance and glucose remains normal. All these experiments have been reproducible and are more than sufficient to conclusively show that the prevalent theory is absolutely wrong. All this has been very much there is mainstream literature, high impact journals.
Then there are anomalies that I pointed out. The clinical definition of insulin resistance is circular and non-falsifiable. The compensatory fasting hyperinsulinemia with normoglycemia is illogical and mathematically impossible. If you put together all experimentally demonstrated links to and from glucose and insulin, a network of known causal links can be constructed. Neither glucose nor insulin are central to this network and normalizing these two are unable to cure diabetes even in a theoretical model. The older evolutionary thinking that a “thrifty” tendency developed as an evolutionary adaptation to feast and famine is neither ecologically nor physiologically sound. Humans do not show any physiological characteristics of being thrifty. Fat cells do not induce insulin resistance. In fact the most abundant signal molecule secreted by fat cells is actually insulin sensitizing by the popular definition. The diet theories including high fat, high carb, intermittent fasting, time of eating and all are full of mutually contradicting data.
On top of it no clinical trial has conclusively shown that normalizing glucose can arrest diabetic complications. Clinical trials are full of bad experimental designs and all signs of data twisting, conclusion spinning, unscientific data handling and purposeful misleading. Glucose is not central to T2D and therefore normalizing glucose is not even theoretically expected to avoid diabetic complications and reduce mortality. But this rhetoric is repeated as a religious text and all treatment focuses on reducing glucose which is not going to help anyway.
Showing all this with reproducible experiments, rigorous data analysis and sound theory and mathematical models, publishing this in any form has absolutely no effect on the religion of type 2 diabetes. There was no counterargument on what we showed and published. I gave talks in places like Joslin Diabetes Centre and OCDEM arguing that the prevalent theory has been proved wrong with multiple lines of evidence. The Joslin talk was well attended by everyone including the Director. There was no cross questioning or counterargument after my talk. More than one personal responses later were that the argument is not new. We all know the theory is wrong. Just that you openly said it, others don’t.
Not only my group pointed out the glaring anomalies, we also proposed an alternative theory which goes like this. We evolved as hunter gatherers and our physiology evolved to support the necessary behaviours of that lifestyle. Now many of the behaviours are simply missing in the modern lifestyle. These behaviours have been experimentally demonstrated to be linked with many growth factors, angiogenic factors, neurotransmitters and other signal molecules. The deficiency of these behaviours has multiple well demonstrated physiological effects. For example, altered expression of angiogenic factors because of altered behaviours leads to reduced capillary density and endothelial dysfunction. This reduced the glucose supply to the brain (again experimentally demonstrated). When the brain receives subnormal glucose it instructs the liver to synthesize more of it. That is why there is fasting hyperglycemia. This has nothing to do with insulin resistance. Vascular dysfunction is primary and glucose change is only consequential. Therefore bringing blood glucose to normal doesn’t do any good. Getting the growth factor and other signals back to normal is the solution. This is easy to do through sports because all sports is an attempt to get back the hunting fighting behaviours. Exercise is useful not because it burns calories but because it brings back some critical missing behaviours and their neuroendocrine correlated. This theory logically and mathematically explains 19 major anomalies which the classical theory was muddled with. Getting funded for a new idea that too from a person away from the power centers of the field is impossible. We did try and failed to get funded to work further on the hypotheses. But there already existed substantial support to these ideas in literature.
I would have welcomed any criticism of my arguments. I would have taken back my statements if they were shown to be wrong. But nobody did this. They knew any counterarguments would put them in deeper trouble. It is better to pretend that they are just not aware of any such arguments. The multiple serious anomalies just don’t exist and everyone is happy with the ongoing pseudoscience. And the field continues with the theory disproven decades ago, creating new waves by beating drums of a new drug, whose clinical trials actually show no effect. Currently with volunteer researchers I am examining the raw data of clinical trials and feel astonished at how commonly they trample all well known principles of statistics to claim support to their already decided conclusions.
In short, the entire field of type 2 diabetes is pseudoscience and all people supporting it call themselves scientists and enjoy the fat salaries, perks, prestige and positions. With this my perspective of academia changed completely. I no more look at people in academia with respect. They have sold out their souls to funders. Publication metric and funding prospects have completely overtaken basic curiosity and research integrity. I personally gained a lot from the experience so I am grateful to everyone. Understanding of science is complete only when you learn how not to do it as well. These people helped me expanding my understanding of science. I realized that just the principles of science are not enough, human behaviour is an intrinsic part of it and this behaviour is not at all different than that in wars, politics, power and business. Power is more important than fairness and truth even in the field of science. But once in a while, someone follows truth, it may be ignored for a long time. May be at times someone rediscovers it later. The history of science is full of such examples and nothing has changed.
My science, My way 