“Social networks gave voice to a legion of imbeciles.” – Umberto Eco
His observation is particularly relevant today, as the digital landscape is flooded with information and misinformation. The ease of sharing content by online charlatans, conspiracists, manufacturers, and “brands” has created a breeding ground for falsehoods that can seriously affect public health.
In response to this misinformation, scientific communicators often create videos or posts to expose errors, hoping to encourage critical thinking among their followers. While these efforts frequently lead only to heated debates in comments, social media disputes rarely enter the judicial realm. Here is such a case that nearly set a troubling precedent in Brazil.
It began when an "integrative" nutritionist claimed in an Instagram story that type 1 diabetes was caused by parasites. In response, Ana Bonassa and Laura Marise, from the channel "Não Vi 1 Cientista," refuted this claim, clarifying that diabetes is related to insulin and cautioning against misinformation.
Upset by their response, the nutritionist sued the content creators for moral damages - it's not uncommon for purveyors of misinformation to use the courts in attempts to silence those who expose their errors. However, unlike most cases, the judge ruled in favor of the nutritionist, alleging that the duo caused moral harm by bringing shame and distress to the plaintiff by publishing his publicly available data without permission on a widely viewed video. The judge also ordered the removal of the video and set compensation at R$1,000 (approximately US$184). Yet, after widespread media coverage and significant support for the researchers, Brazil’s Supreme Federal Court (STF) overturned the ruling.
But where did this idea come from?
Intestinal parasites do exist, often spreading through contaminated food, water, poor sanitation, and hygiene. Common symptoms, such as diarrhea, stomach pain, gas, and fatigue, are non-specific. Infections are rare in industrialized countries, and when they do occur, they are usually linked to international travel. For example, according to the CDC Yellow Book, which offers guidance for safe and healthy travel abroad, 10% of the cases involving Cryptosporidium spp., which infects around 823,000 people annually, are associated with travel abroad.
Despite the facts, internet gurus often cherry-pick information to create a “deworming” market fueled by sensationalist marketing, which includes:
- False or vague claims like, “We all have parasites,” or, “Headaches, fatigue, gas, diarrhea, constipation, and skin issues could mean parasites!”
- Surgery videos showing “thousands of parasites” being removed, implying this occurs if people skip parasite cleanses.
- Promoting unnecessary natural products and consultations with self-proclaimed “experts,” profiting from misinformation.
During my search, I encountered several videos promoting this absurd notion. One claimed that worms, specifically the Eurytrema pancreaticum parasite, can cause diabetes. Other platforms echoed similar claims, including the idea that the parasite originates from cow's milk.
Diabetes mellitus is a metabolic disease
The hallmark, of course, is high blood sugar due to insulin’s absence or resistance.
- Type 1 diabetes is an autoimmune disease that typically appears in childhood or adolescence, targeting the beta cells and destroying their ability to produce insulin. These individuals require insulin from external sources.
- Type 2 diabetes, which accounts for over 90% of cases, is influenced by genetic and lifestyle factors. This type of diabetes is characterized by insulin resistance and pancreatic beta-cell dysfunction [1]. In addition to lifestyle modification, treatment includes medications that inhibit glucose absorption and enhance insulin sensitivity, among others.
Notice that I have not mentioned that parasites cause diabetes anywhere. This omission isn't because researchers, medical associations, or health organizations are hiding information from the public. Rather, it's because the claims about “parasitic diabetes” are nothing more than a blend of “free-style” physiology based on untested clinical cases or hypotheses and supported by a very selective and peculiar interpretation of the evidence.
Down the Rabbit Hole
One of the first studies to propose that parasites could be a cause of diabetes was “Tapeworms as a Possible Cause of Diabetes,” which was published in The Lancet in 1902. The author described the cases of two patients who exhibited tapeworm infections associated with glycosuria (the excretion of glucose in the urine).
In the first case, a 50-year-old man presented with a solitary tapeworm and weight loss. The examination revealed early signs of tuberculosis, an enlarged liver, and a high amount of sugar in his urine. He was treated with filix, a homeopathic remedy derived from ferns and diet. The patient returned to the doctor in June and September with new segments of the worm, and on October 7, he passed away. The autopsy revealed an enlarged liver with signs of cirrhosis, lungs affected by tuberculosis, and an apparently normal pancreas.
The second case involved a 40-year-old man hospitalized due to gangrene in his big toe. Despite his generally good health, he had been suffering from a tapeworm infection for three years. He presented glycosuria and experienced increased thirst. The treatment involved amputating the leg, and the patient was discharged.
Based on these cases, the physician-author hypothesized that tapeworm infestation could trigger diabetes-like symptoms - ultimately, his hypothesis was not substantiated.
Parasites in the Pancreas
The parasite mentioned in the current controversy, Eurytrema pancreaticum, primarily attacks the pancreas of ruminant animals, with very few cases recorded in humans. No studies have observed a relationship between this parasite and the development of diabetes mellitus in humans.
The closest evidence comes from a theoretical model that employs a different parasite in cows. The experiment evaluated 12 parasitically infected bovine pancreases and a control group of 3 uninfected specimens. In addition to the presence of parasites, the researchers found
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Greater firmness, thickening, and dilation of the pancreatic duct
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Fibrosis, replacement of tissue with scarring connective tissue
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Enhanced antioxidant defenses, such as elevated levels of vitamin C
Based on these observations, the authors suggested that bovine pancreas infected with E. coelomaticum exhibit changes similar to those found in human pancreas affected by certain diseases, including type 1 diabetes. However, they emphasize that more studies are needed to assess the extent of these similarities.
A 2019 article published in Abdominal Radiology presented a case of Eurytrema infection (eurythrematosis) in humans. Japan has recorded nine cases. In Japan, human eurythrematosis typically occurs through ingesting grasshoppers, which serve as the second intermediate host for the parasite. Clinical symptoms include abdominal discomfort, diarrhea, and occasionally jaundice and enlarged liver.
In this case report, a 43-year-old man was admitted to a local hospital due to nausea and itching. After several imaging tests, he was diagnosed with cancer and underwent surgery to remove the head of the pancreas and duodenum. During a microscopic examination of the removed tissue, numerous parasite eggs, but no adult worms were observed – a diagnosis of eurythrematosis was established.
To understand the rarity of this infection, note that of the four references used in the article, three are case reports that occurred 33 years earlier.
Given all this, I can confidently assert that anyone attempting to establish a link between diabetes and possible worms is spreading misinformation—whether due to ignorance of scientific studies, bad faith, or a desire to profit from selling parasite cleanse protocols.
What did we learn?
That parasites are not secretly causing type 1 diabetes, and that the promotion of pseudoscience for profit thrives in the age of Instagram. While laughing off these absurd claims may be tempting, they can have serious consequences when they spread unchecked. Misinformation can cause harm, but the pushback from credible science is crucial, as evidenced by this case—loudly debunking nonsense, one absurdity at a time.
[1] Beta-cell dysfunction occurs as these cells work harder to create more insulin due to the body’s decreased sensitivity. Over time, this increased workload can lead to insulin deficiency.
Sources: Tapeworms as a Possible Cause of Diabetes. Lancet. DOI: 10.1016/S0140-6736(01)45141-5
Eurytrematose as a developmental model of the Diabetes Mellitus Type 1 pathological condition: pathophysiological parameters and oxidative stress. Brazilian Journal of Development. DOI: 10.34117/bjdv7n12-328
A case of human pancreatic eurytremiasis. Abdom Radiol (NY). DOI: 10.1007/s00261-019-01925-4.
