Posted on 12/17/2008 11:47:25 PM PST by FocusNexus
(HealthDay News) -- Intensive lowering of blood sugar in people with poorly controlled type 2 diabetes does not have a significant effect on reducing cardiovascular events, such as heart attack and stroke, a new study finds.
"You can decrease cardiovascular events in patients with type 2 diabetes by good treatment of lipids [cholesterol], blood pressure and other cardiovascular risk factors," noted lead researcher Dr. William Duckworth, from the Phoenix Veterans Affairs Health Care Center in Arizona. "But among older patients whose risk factors are controlled, intensive glucose control does not add any significant benefit," he said.
The report was published in the Dec. 17 online edition of the New England Journal of Medicine.
The value of intensive blood sugar control has become a highly debated topic, especially since two recent studies looking at the benefits of aggressively lowering blood sugar in people with type 2 diabetes came to different conclusions.
One study, the ADVANCE (Action in Diabetes and Vascular Disease) trial found a 21 percent reduced risk for kidney disease in patients on tight glucose control. On the other hand, the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial found a 22 percent increased risk of death for those on the stricter regimen.
(Excerpt) Read more at washingtonpost.com ...
Ping — I think you have a health and/or diabetes ping list.
Related article:
Intensive Glycemic Control Fails to Prevent Most Microvascular Complications
http://www.medpagetoday.com/Endocrinology/Diabetes/12210
Keeping a tight rein on blood glucose in type 2 diabetes patients did nothing to prevent retinopathy, nephropathy, or neuropathy in the closely watched VA Diabetes Trial, researchers here said.
With a median of 5.6 years of follow-up, rates of microvascular complications did not differ significantly between diabetic veterans who received standard care and those randomized to a regimen of tight glycemic control, reported William Duckworth, M.D., of the Phoenix VA Health Care Center and colleagues online in the New England Journal of Medicine.
Median levels of glycated hemoglobin reached in the trial were 8.4% with standard therapy and 6.9% in the intensive treatment group.
As Dr. Duckworth had reported at the American Diabetes Association meeting earlier this year, cardiovascular outcomes also did not differ between the groups. (See: ADA: VA Diabetes Trial Appears to Vindicate Rosiglitazone (Avandia) Safety)
“Overall, the benefit of decreasing the glycated hemoglobin level from 8.4% to 6.9% appeared to be minimal,” the researchers said in their NEJM report.
“.....intensive glucose control does not add any significant benefit,” he said.”
So as I understand this, I have been denying myself apple pie for nothing.
It's a FReebie that you may have to register - not subscribe - to read the whole article. I only read the abstract so far, but it looks like one more feather in the cap of carbohydrate restriction and exercise as opposed to medical therapy/medicine.
FReepmail me if you want on or off the diabetes ping list.
“So as I understand this, I have been denying myself apple pie for nothing”
Me too!
After this she began to scream horribly. She cursed the poison, railed at it, and implored it to be quick, and thrust away with her stiffened arms everything that Charles, in more agony than herself, tried to make her drink. He stood up, his handkerchief to his lips, with a rattling sound in his throat, weeping, and choked by sobs that shook his whole body. Félicité was running hither and thither in the room. Homais, motionless, uttered great sighs; and Monsieur Canivet, always retaining his self-command, nevertheless began to feel uneasy.
"The devil! yet she has been purged, and from the moment that the cause ceases -- "
"The effect must cease," said Homais, "that is evident."
But what about kidney failure?
I’m about to go on both high blood pressure and T2 diabetes medication.I loath taking pills,even aspirin.
So this sounds good to me.
Oh boy! Now I can have donuts!
/sarc
One huge benefit to glycemic control and lipid control is weight loss. Maybe statisticly there is little benefit but there seems to be individually...at least for me.
My husband has had Type 2 for over 10 years now, and when he was diagnosed, we all went on the Atkins type diet. Hubby has never had to increase his meds, and consistently keeps his blood sugar between 85-110 no matter what he eats. His doctor is sometimes incredulous that after all these years, he has developed no complications from the disease. His comment to my hubby is always, "Whatever you're doing, keep doing it!"
ping
IOW, Atkins was right all along.
That is correct.
Nice testimony, thanks!
Medicine is just a way station along the route to the hereditary inevitability.
Intensive glucose control does not add any significant benefit,
There was recently a study which had to be halted because some of diabetics participating in it were dying. It turns out that tight control may not be the best thing for diabetics. See: http://www.sciencedaily.com/releases/2008/02/080206105440.htm.
Things were basically ok for me until menopause. Since then, I have been battling. I did the low carb thing for almost a year. I thought I was going to go crazy with the restrictions and after 9 months or so, I wasn’t seeing the benefits that I had at first. On top of that, I ended up taking all kinds of other meds for my ‘protection.’
I’ve been doing low fat vegan for almost a year now and am very pleased. No cholesterol meds, no BP meds. My endo took me off of insulin while keeping the metformin. Based on the negative experiences (like death) of some diabetic family and friends this past year, I decided to forgo the metformin w/its liver issues, and stay w/the insulin as needed. At one point a few years ago I was taking 190 units a day. Now I take about 10 units, and don’t have to do that everyday. I also take Byetta, which is a hormone, not insulin, and seems to help me quite a bit. I’m hoping that in another 6 months or so, I will have lost enough weight where I won’t have to take that, either. Oh yeah, no matter what I did previously, I didn’t lose weight. After going vegan, I’m losing weight easily.
This is such an individual disease. I don’t knock Atkins, tho I do think you have to watch your fats. Dr. Bernstein has a similar carb-restricted program that isn’t so fat loaded.
So many of the diabetic treatments seem to do harm - either the meds make you fat or cause liver damage or cause heart attacks. It’s hard for people to make dietary changes, whether it’s vegan or Atkins, but in the end, it seems so much better to care for diabetes w/food choices than meds. Just my 2 cents.
Thank you for taking the time to put that together.
I am new to this diabetic junk. I have already had heart surgery and a stroke (MRSA and a few other things) during the surgery.
A few months ago I learn that I am type 2. My BG was at 400. It’s now down to around 100 =or- at fasting. I do feel better and thanks to my new dog, I have lost over 30 pounds. My feet are still troublesome, but they have also improved.
I have, for the most part, managed to stay within the diet guidance that the diabetic nurses taught during a several week class. I will look at what you have mentioned and discuss it with my doctor. It would be very tough for me to give up meat though.... I am not sure it would even be possible. I recently turned 60, so it seems that there won’t be all that many more years to even worry about this.
Again, thank you.
<I recently turned 60, so it seems that there won’t be all that many more years to even worry about this.
Nonsense. My mother is 78, diabetic for probably 20+ years and doing well. My uncle died several years ago after amputations, severe infections, etc. He never took his diabetes seriously. My father died from a heart attack brought about my uncontrolled diabetes. Most diabetics die from heart-related issues, not the blood sugar levels.
I’m 55. I’d like to hit 100. I can’t do it if my diabetes isn’t in control. I thought I couldn’t give up meat and cheese as well. I looked at the research on veganism & diabetes for years and thought I just couldn’t do it. Well, one day I said, ok, this is it and I haven’t looked back. The lack of cholesterol and the increased fiber in a vegan diet helps tremendously with the heart issues, so that they become a non-issue for vegan diabetics. This is important to me, tho maybe not so much to others. I way more aware of this at 55 than I might be if I were a 30 yr old diabetic.
Keep reading and learning on your own. Learn from other diabetics as well as your health care providers. I’ll send you some Freepermail with more info.
<I recently turned 60, so it seems that there won’t be all that many more years to even worry about this.
Nonsense. My mother is 78, diabetic for probably 20+ years and doing well. My uncle died several years ago after amputations, severe infections, etc. He never took his diabetes seriously. My father died from a heart attack brought about my uncontrolled diabetes. Most diabetics die from heart-related issues, not the blood sugar levels.
I’m 55. I’d like to hit 100. I can’t do it if my diabetes isn’t in control. I thought I couldn’t give up meat and cheese as well. I looked at the research on veganism & diabetes for years and thought I just couldn’t do it. Well, one day I said, ok, this is it and I haven’t looked back. The lack of cholesterol and the increased fiber in a vegan diet helps tremendously with the heart issues, so that they become a non-issue for vegan diabetics. This is important to me, tho maybe not so much to others. I way more aware of this at 55 than I might be if I were a 30 yr old diabetic.
Keep reading and learning on your own. Learn from other diabetics as well as your health care providers. I’ll send you some Freepermail with more info.
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