5 Whys of Diabetes

My first published piece in Asimov Press!

Excerpt:

"But Why?"

Taiichi Ohno, a Japanese engineer who helped to create the Toyota Production System, once described a five-step system to identify the root cause of a problem. It’s called the Five Whys, and it works like this:

A car doesn’t start. A mechanic begins their diagnosis by asking “Why does the car not start?” and finds the culprit: a dead battery. A good mechanic continues the interrogation and probes deeper, asking, “Why is the battery dead?”  It’s because the alternator is broken. The mechanic evaluates each issue as it comes up, one-by-one, and asks “why?” each time. Eventually, several whys down, it becomes clear that the alternator was not maintained on a proper service schedule. This is the root cause. 

The trickiest problems that we face in life are often multifactorial, yet we tend to address only the most proximate causes. But when it comes to solving complex problems, diagnosing and addressing them from the onset is usually more effective than firefighting after a spark has grown into an inferno. This is especially true in medicine, where the temporal gap between the initiation of the disease (a random genetic mutation, say) and the appearance of symptoms makes finding the root cause difficult.

This is where a technique like the Five Whys can be applied to great effect. 

A recent study in Nature shows the utility of Toyota’s approach. For the study, the authors, led by scientists from Vanderbilt University in Tennessee, investigated type 2 diabetes, a disease most often treated based on proximate causes, such as high blood sugar, and tried to find the root cause. In doing so, they not only illuminated the molecular pathways that lead to type 2 diabetes, but also provided a template for other scientists to follow.

Continued in full on the Asimov Press substack!