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Home » Uncategorized » Today’s British Medical Journal: Are Wellness Programs Killing (some) Diabetics?

Today’s British Medical Journal: Are Wellness Programs Killing (some) Diabetics?

Do you know whether heartburn pills are safe for long-term use?

Today’s STATNews (a must-read if you don’t already) highlighted a meta-analysis in the February 25 British Medical Journal showing that diabetics should not try to control their hypertension if the systolic blood pressure isn’t over 140.  Otherwise they are raising their risk of death. Literally, if wellness vendors had their way and diabetic employees did what they are told to do, some diabetics would die.

Not to overstate this: the effect is subtle and on an absolute basis (as opposed to “relative risk”) very few diabetics in wellness programs would die due to the program’s advice. But the correct figure for a wellness program is that zero employees should die as a result of it.

This hypertension-diabetes link is news to everyone, which is why it is in STATNews.  Many protocols for patients need to be readjusted.  Quizzify, for example, will have this information made into a question today, reviewed by Harvard Medical School tomorrow, and in our quiz on Monday, assuming HMS doesn’t notice a nuance we missed.  The information will also be properly sourced and linked. And the action will be to read the information and discuss with one’s physician. It won’t be a simplistic “do this” or “don’t do that.”

Once again, wellness vendors have been presenting as facts (“diabetics need to lower their blood pressure”) information that in some cases just ain’t so.  Plenty of doctors do that too.  The difference is that doctors can’t fine patients for not submitting.  Bad medicine is one thing. Bad medicine that employees are forced to participate in by vendors who have no training, no oversight and no licenses  — but who have a direct line to their employers — is something else altogether.

We have addressed this in a previous posting.  Employees and people in general should only be penalized for not doing things — like buckling their seat belts and vaccinating their kids — where the science is both totally settled and totally overwhelming.

Unlike Quizzify, the amount of time that will elapse before wellness vendors fix this will be measured in months or even years, not days or weeks.  Their whole “risk factor” model, in which they get graded by finding risk factors and then reducing them, has to be re-thought with respect to diabetics.  Systolic hypertension at 140 or below needs to be treated as good, not as  a risk.

It would be one thing if this were an isolated incident, but wellness vendors do this type of thing all the time, harming employees because they either don’t understand what they are doing or know that what they are doing is wrong, but is profitable. And of course being demonstrably wrong and harming employees isn’t going to cost them their licenses because wellness vendors don’t need licenses.

mark twain what you know


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