Page 1 of 2 12 LastLast
Results 1 to 15 of 23

Thread: Diabetes Study Partially Halted After Deaths

  1. #1
    Join Date
    May 2002
    Location
    Adelaide
    Posts
    38,791
    Post Thanks / Like
    Blog Entries
    20

    Question Diabetes Study Partially Halted After Deaths

    I wonder if it was the drugs?


    Diabetes Study Partially Halted After Deaths

    By GINA KOLATA
    Published: February 7, 2008

    For decades, researchers believed that if people with diabetes lowered their blood sugar to normal levels, they would no longer be at high risk of dying from heart disease. But a major federal study of more than 10,000 middle-aged and older people with Type 2 diabetes has found that lowering blood sugar actually increased their risk of death, researchers reported Wednesday.

    The researchers announced that they were abruptly halting that part of the study, whose surprising results call into question how the disease, which affects 21 million Americans, should be managed.

    The study’s investigators emphasized that patients should still consult with their doctors before considering changing their medications.

    Among the study participants who were randomly assigned to get their blood sugar levels to nearly normal, there were 54 more deaths than in the group whose levels were less rigidly controlled. The patients were in the study for an average of four years when investigators called a halt to the intensive blood sugar lowering and put all of them on the less intense regimen.

    The results do not mean blood sugar is meaningless. Lowered blood sugar can protect against kidney disease, blindness and amputations, but the findings inject an element of uncertainty into what has been dogma — that the lower the blood sugar the better and that lowering blood sugar levels to normal saves lives.

    Medical experts were stunned.

    “It’s confusing and disturbing that this happened,” said Dr. James Dove, president of the American College of Cardiology. “For 50 years, we’ve talked about getting blood sugar very low. Everything in the literature would suggest this is the right thing to do,” he added.

    Dr. Irl Hirsch, a diabetes researcher at the University of Washington, said the study’s results would be hard to explain to some patients who have spent years and made an enormous effort, through diet and medication, getting and keeping their blood sugar down. They will not want to relax their vigilance, he said.

    “It will be similar to what many women felt when they heard the news about estrogen,” Dr. Hirsch said. “Telling these patients to get their blood sugar up will be very difficult.”

    Dr. Hirsch added that organizations like the American Diabetes Association would be in a quandary. Its guidelines call for blood sugar targets as close to normal as possible.

    And some insurance companies pay doctors extra if their diabetic patients get their levels very low.

    The low-blood sugar hypothesis was so entrenched that when the National Heart, Lung and Blood Institute and the National Institute of Diabetes and Digestive and Kidney Diseases proposed the study in the 1990s, they explained that it would be ethical. Even though most people assumed that lower blood sugar was better, no one had rigorously tested the idea. So the study would ask if very low blood sugar levels in people with Type 2 diabetes — the form that affects 95 percent of people with the disease — would protect against heart disease and save lives.

    Some said that the study, even if ethical, would be impossible. They doubted that participants — whose average age was 62, who had had diabetes for about 10 years, who had higher than average blood sugar levels, and who also had heart disease or had other conditions, like high blood pressure and high cholesterol, that placed them at additional risk of heart disease — would ever achieve such low blood sugar levels.

    Study patients were randomly assigned to one of three types of treatments: one comparing intensity of blood sugar control; another comparing intensity of cholesterol control; and the third comparing intensity of blood pressure control. The cholesterol and blood pressure parts of the study are continuing.

    Dr. John Buse, the vice-chairman of the study’s steering committee and the president of medicine and science at the American Diabetes Association, described what was required to get blood sugar levels low, as measured by a protein, hemoglobin A1C, which was supposed to be at 6 percent or less.

    “Many were taking four or five shots of insulin a day,” he said. “Some were using insulin pumps. Some were monitoring their blood sugar seven or eight times a day.”

    They also took pills to lower their blood sugar, in addition to the pills they took for other medical conditions and to lower their blood pressure and cholesterol. They also came to a medical clinic every two months and had frequent telephone conversations with clinic staff.

    Those assigned to the less stringent blood sugar control, an A1C level of 7.0 to 7.9 percent, had an easier time of it. They measured their blood sugar once or twice a day, went to the clinic every four months and took fewer drugs or lower doses.

    So it was quite a surprise when the patients who had worked so hard to get their blood sugar low had a significantly higher death rate, the study investigators said.

    The researchers asked whether there were any drugs or drug combinations that might have been to blame. They found none, said Dr. Denise G. Simons-Morton, a project officer for the study at the National Heart, Lung and Blood Institute. Even the drug Avandia, suspected of increasing the risk of heart attacks in diabetes, did not appear to contribute to the increased death rate.

    Nor was there an unusual cause of death in the intensively treated group, Dr. Simons-Morton said. Most of the deaths in both groups were from heart attacks, she added.

    For now, the reasons for the higher death rate are up for speculation. Clearly, people without diabetes are different from people who have diabetes and get their blood sugar low.

    It might be that patients suffered unintended consequences from taking so many drugs, which might interact in unexpected ways, said Dr. Steven E. Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic.

    Or it may be that participants reduced their blood sugar too fast, Dr. Hirsch said. Years ago, researchers discovered that lowering blood sugar very quickly in diabetes could actually worsen blood vessel disease in the eyes, he said. But reducing levels more slowly protected those blood vessels.

    And there are troubling questions about what the study means for people who are younger and who do not have cardiovascular disease. Should they forgo the low blood sugar targets?

    No one knows.

    Other medical experts say that they will be discussing and debating the results for some time.

    “It is a great study and very well run,” Dr. Dove said. “And it certainly had the right principles behind it.”

    But maybe, he said, “there may be some scientific principles that don’t hold water in a diabetic population.”

    http://www.nytimes.com/2008/02/07/he...in&oref=slogin

  2. #2
    Join Date
    Feb 2008
    Location
    Canada, east coast
    Posts
    67
    Post Thanks / Like

    Re: Diabetes Study Partially Halted After Deaths

    Epidemiological studies. They show connections - not causality. The example they give of the HRT 'experiments' is a prime example; HRT does work, but when you start it determines how well it works..

    A few shots in the dark; you lower blood sugar with insulin. Insulin is highly inflammatory. Inflammatory markers are far more important when discussing CVD risk.

    Fixing blood sugar is going after a symptom, not the problem. If diabetics aren't adhering to dietary changes (or if they haven't been given any to begin with) then they're still filling their bodies with the crap that helped make them sick in the first place. And it's not just a question of carbs being bad because they're carbs - they're also highly inflammatory. The more refined they are, the more inflammatory they are.

    This is so frustrating, isn't it?

  3. #3
    Join Date
    May 2002
    Location
    Adelaide
    Posts
    38,791
    Post Thanks / Like
    Blog Entries
    20

    Re: Diabetes Study Partially Halted After Deaths

    Insulin is highly inflammatory. Inflammatory markers are far more important when discussing CVD risk.
    Sounds to me like you just hit the nail on the head perhaps. What about people with diabetes 1, they obviously take lots of insulin, do they have the same problems?

  4. #4
    Join Date
    Nov 2003
    Location
    Western Australia
    Posts
    5,259
    Post Thanks / Like

    Re: Diabetes Study Partially Halted After Deaths

    It must be the low sugar aspect that's doing it - can't be anything to do with the drugs - morons!

  5. #5
    Join Date
    Feb 2003
    Location
    ballarat
    Posts
    1,424
    Post Thanks / Like

    Re: Diabetes Study Partially Halted After Deaths

    I bet they had them on low fat or low GI diets.
    Whoever said 'people get fat because they're going to get diabetes' has my respect.

  6. #6
    Join Date
    May 2004
    Posts
    301
    Post Thanks / Like

    Re: Diabetes Study Partially Halted After Deaths

    Yes, as I said when I posted it they claim to have eliminated the drugs as a cause and they are not clear on the role of insulin therapy (and also the drugs that 'help' the body produce even more insulin). I hope Mike gets around to it soon, the slacker!
    Started LC (PP) Dec 2003
    114/86.5/85
    BF 30+/17/15

  7. #7
    Join Date
    May 2002
    Location
    Adelaide
    Posts
    38,791
    Post Thanks / Like
    Blog Entries
    20

    Re: Diabetes Study Partially Halted After Deaths

    Is Mike going to post about it? I heard Regina is going to, haven't checked her blog yet to see if its up.

  8. #8
    Join Date
    May 2002
    Location
    Adelaide
    Posts
    38,791
    Post Thanks / Like
    Blog Entries
    20

    Re: Diabetes Study Partially Halted After Deaths

    Looks like the actual data is yet to be published rolleyes: http://weightoftheevidence.blogspot....rial-mess.html

  9. #9
    Join Date
    May 2004
    Posts
    301
    Post Thanks / Like

    Re: Diabetes Study Partially Halted After Deaths

    Yes, and sorry, I thought you got it from me in the first place!
    Started LC (PP) Dec 2003
    114/86.5/85
    BF 30+/17/15

  10. #10
    Join Date
    May 2002
    Location
    Adelaide
    Posts
    38,791
    Post Thanks / Like
    Blog Entries
    20

    Re: Diabetes Study Partially Halted After Deaths

    Well I will be looking forward to it! Does he have access to the data?

  11. #11
    Join Date
    May 2004
    Posts
    301
    Post Thanks / Like

    Re: Diabetes Study Partially Halted After Deaths

    Not as of a couple of days ago;

    "As of yet, I haven’t been able to find the real data on this study. I don’t want to comment on it until I’ve read something more substantial than a report in the New York Times."

    Fair enough too, and, as usual, this or anything else of real interest in health, won't make the papers here at all.
    Started LC (PP) Dec 2003
    114/86.5/85
    BF 30+/17/15

  12. #12
    Join Date
    May 2002
    Location
    Adelaide
    Posts
    38,791
    Post Thanks / Like
    Blog Entries
    20

    Re: Diabetes Study Partially Halted After Deaths

    Well I think we all come to the same conclusion

    I hope this forces some to take interest in diet and lifestyle more seriously particularly before throwing all these drugs at their patients!

  13. #13
    Join Date
    Feb 2008
    Posts
    27
    Post Thanks / Like

    Re: Diabetes Study Partially Halted After Deaths

    Duh.. elevated insulin is not only inflammatory, it also damages blood vessels and is associated with cardio and other circulation risks. Anecdotally I recently screened diabetic amputee admissions for 6 months. They were all on insulin to manage their diabetes and most were considered to be managing their diabetes well with reasonable BG levels.....

  14. #14
    Join Date
    May 2004
    Posts
    301
    Post Thanks / Like

    Re: Diabetes Study Partially Halted After Deaths

    He still doesn't have the data but from his and the other comments he quotes, it appears that the assertion that the drugs in isolation or in combination not being a factor is nonsense (and very dangerous nonsense at a that). I don't think the original piece defined what the researchers thought the role of massive insulin doeses might be, but as we all have said ... why on earth wasn't this the first question asked?

    http://www.proteinpower.com/drmike/c...udy/#more-1174

    Cheers,


    Malcolm
    Started LC (PP) Dec 2003
    114/86.5/85
    BF 30+/17/15

  15. #15
    Join Date
    Feb 2008
    Location
    Canada, east coast
    Posts
    67
    Post Thanks / Like

    Re: Diabetes Study Partially Halted After Deaths

    Quote Originally Posted by Sherrie View Post
    Is Mike going to post about it? I heard Regina is going to, haven't checked her blog yet to see if its up.
    Might be old news but Mike posted about it; I read today. He was leaning toward insulin being having an impact. Makes sense, Type I diabetics have a much shorter life span than non diabetics.

Page 1 of 2 12 LastLast

Similar Threads

  1. Millions of needless deaths
    By Sherrie in forum Health
    Replies: 4
    Last Post: 20-12-2009, 06:26 PM
  2. Binge Eating Study
    By ishenka in forum Introduce Yourself
    Replies: 3
    Last Post: 20-08-2009, 05:51 PM
  3. Replies: 0
    Last Post: 29-08-2008, 03:32 PM
  4. Another pointless study ...
    By Malcolm in forum Real Research and Media
    Replies: 1
    Last Post: 23-02-2008, 02:05 PM
  5. Replies: 13
    Last Post: 31-01-2008, 09:48 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •