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  #1   ^
Old Wed, Sep-10-08, 21:47
KarenJ's Avatar
KarenJ KarenJ is offline
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Default Study sees longterm benefit of blood-sugar control

Study sees longterm benefit of blood-sugar control

Quote:
Study sees longterm benefit of blood-sugar control

By ALICIA CHANG, AP Science WriterWed Sep 10, 6:13 AM ET

Diabetics who tightly control their blood sugar — even if only for the first decade after they are diagnosed — have lower risks of heart attack, death and other complications 10 or more years later, a large follow-up study has found.

The discovery of this "legacy effect" may put new emphasis on rigorous treatment when people first learn they have Type 2 diabetes, the most common form and the type linked to obesity.

Doctors warn that people should not let their blood sugar spin out of control — that could have serious health consequences.

"What you don't want is for people to think that they had a period of good glucose control and then they allow their blood glucose to go high — that would be disadvantageous," said Dr. Stephen Davis, head of Vanderbilt University's diabetes and endocrinology division, who had no role in the study.

Results were published online Wednesday by the New England Journal of Medicine and were being presented at the European Association for the Study of Diabetes meeting in Rome.

Diabetes affects more than 18 million Americans. Most have Type 2, which occurs when the body makes too little insulin or cannot use what it does produce. Being overweight raises this risk.

Researchers led by Dr. Rury Holman at the University of Oxford in England originally studied 4,209 newly diagnosed diabetes patients assigned to manage their blood sugar either through standard diet restrictions or medicines. In the drug group, most took sulfonylurea, which prompts the pancreas to release more natural insulin into the bloodstream. Overweight diabetics took metformin, sold in the United States as Glucophage. Treatment lasted on average 10 years.

That study showed intensive blood sugar control lowered the risks of eye disease and kidney damage, but did not find any significant difference in heart attack risk except in the overweight group taking metformin. Those results led to guidelines recommending tight blood sugar control still in wide use today.

The follow-up study was on 3,277 participants who were tracked for an average of 10 more years — first in clinics, where blood sugar could be measured, and through questionnaires in the later years.

Within one year of the original study ending, differences in blood sugar control between the groups disappeared.

Despite that, the sulfonylurea group had a 15 percent lower risk of heart attack and a 13 percent lower risk of death compared with the diet group.

The benefits were even greater among overweight diabetics on metformin, who had a 33 percent lower risk of heart attack and a 27 percent reduced risk of death.

"It really stresses the importance of taking the long term-view of a chronic disease," said Dr. Judith Fradkin, who heads the diabetes division at the National Institute of Diabetes and Digestive and Kidney Diseases.

"This really gives information on steps that people can take that's going to improve their health," said Fradkin, who had no role in the latest research.

In a related study, Oxford researchers failed to find the same benefit among nearly 1,000 diabetics who maintained strict control of their blood pressure early on and then lapsed. There was no significant reduction in stroke, death or diabetes-related complications among those who initially had tight blood pressure control compared with those who did not.

Both studies were funded by various British government health organizations and advocacy groups. Six major drug companies, including the makers of diabetes drugs, also supported the research.

Dr. Alvin C. Powers, director of Vanderbilt's diabetes center, said the studies underscore the need to treat diabetes in a holistic manner — managing blood sugar, blood pressure and cholesterol levels.

"The important message is that it re-emphasizes that glucose control is important," said Powers, who is not connected with the research.

Recent attention on the impact of tight blood sugar rose after the U.S. government stopped a diabetes trial earlier this year after a surprising number of deaths among patients who pushed down their blood sugar. However, that study was done in high-risk patients who had taken diabetes medications for many years — not newly diagnosed patients.

___

On the Net:

New England Journal: http://www.nejm.org

NIDDK: http://www2.niddk.nih.gov

Copyright © 2008 The Associated Press. All rights reserved. The information contained in the AP News report may not be published, broadcast, rewritten or redistributed without the prior written authority of The Associated Press.
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  #2   ^
Old Thu, Sep-11-08, 08:53
Mrs. Skip's Avatar
Mrs. Skip Mrs. Skip is offline
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Hmmm, an interesting study....but a bit more ambiguous than I expected after reading the title they gave it. The last sentence, about the increase in deaths among the diabetics who were "pushing" down their blood sugar, seemed quite discouraging. I've got a long-time-diabetic friend and I was trying to convince her to follow low-carb...not I'm not so sure...
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  #3   ^
Old Thu, Sep-11-08, 08:56
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lowcarbUgh lowcarbUgh is offline
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The study that increased deaths also involved a lot of drugs and was conducted on people who were in very bad shape, many with heart disease. Poorly controlled diabetes is just a death sentence. The best treatment for diabetes is a low carb diet. There are no risks involved.
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  #4   ^
Old Thu, Sep-11-08, 09:11
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JLx JLx is offline
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Quote:
Originally Posted by lowcarbUgh
The best treatment for diabetes is a low carb diet.


Do you mean "low carb" according to the ADA: 130 gm/26%?
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  #5   ^
Old Thu, Sep-11-08, 09:20
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lowcarbUgh lowcarbUgh is offline
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Quote:
Originally Posted by JLx
Do you mean "low carb" according to the ADA: 130 gm/26%?


Most diabetics can't eat that many carbs and remain in control. The low carb diet should be tailored to the individual to achieve "normal" blood sugars. Many type 2s initially need to lose weight to decrease their insulin resistance and that can mean very low carb for a while. The diabetic's glucose meter will give him or her all the information needed to make good decisions about how many carbs and what foods they can tolerate. Eat to your meter is the name of the game.
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  #6   ^
Old Thu, Sep-11-08, 09:39
M Levac M Levac is offline
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What is the cause of diabetes type 2?

Carbohydrates drive insulin drive fat accumulation. But why do carbs drive insulin? Because carbs drive blood glucose. What is diabetes type 2? Not producing enough insulin and/or not being able to process insulin properly and/or combined with hyperinsulinemia and hyperglycemia. So, the cause of diabetes type 2 is carbohydrates. Cut that out and the disorder disappears. Bring back the carbs and the disorder comes back as well.

There is no risk involved in cutting out carbs. All the risks belong to carbs.
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  #7   ^
Old Thu, Sep-11-08, 09:46
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Nancy LC Nancy LC is offline
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I think that might work for prevention and sometimes it works as a treatment. But some Type 2's even on low carb can't get the blood sugar working like normal again.

I've been seeing my blood sugar inching up and I'm staying quite low carb. It is bizarre.
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  #8   ^
Old Thu, Sep-11-08, 09:49
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lowcarbUgh lowcarbUgh is offline
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People who are DXed with type 2 rarely have it disappear even with low carb. Most of them have already suffered beta cell loss. Type 2 is also highly genetic (100% identical twin concordance). It is not just carbs, but also a sedentary lifestyle and eating processed food that contributes to type 2. If it were just carbs, then you would find type 2 in hunter/gatherer societies that eat more than 130 grams of carbs. But it doesn't happen as long as people eat unprocessed foods and move their bodies.
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  #9   ^
Old Thu, Sep-11-08, 11:35
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MizKitty MizKitty is offline
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Mrs Skip, the sticky thread 2nd from the top in this forum, Sticky: ACCORD and petition to the NIH.
is all about the flawed study referred to here as causing deaths by pushing dowm A1c through "aggresive means". The victi.. I mean patients, were put on insulin and heavy doses of dangerous drugs, old and new, in untested combinations. Low carb diet was not used.
Low carb dieting is always the safest and healthiest approach for a diabetic.
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  #10   ^
Old Fri, Sep-12-08, 12:22
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Angeline Angeline is offline
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The conclusions derived from it are almost criminal if you ask me. There is NO possible way that keeping tight control of your blood sugar for a diabetic can be anything but helpful. All the problems associated with diabetes are CAUSED DIRECTLY by lack of good control. Anyone that says otherwise should have their license removed. The means by which you try to achieve this control might be flawed, which is what we suspect in this case. Or the study badly designed.

This is like designing a study to discover a better way to stop smoking and using 3 different patches simultaneously. When your subjects get heart palpitations from so many patches you conclude that stopping smoking is bad for you.

Or testing a new medication on anorexics that makes them hungry and then concluding, after some of them die, that eating is dangerous. ( I know it's got nothing to do with hunger just a silly example)

Or devising a new regime of cortisone for asthmatics and then concluding, after some bad results, that breathing is a bad idea.

it's THAT STUPID.

Last edited by Angeline : Fri, Sep-12-08 at 12:27.
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  #11   ^
Old Fri, Sep-12-08, 21:32
Mrs. Skip's Avatar
Mrs. Skip Mrs. Skip is offline
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After all these posts clarifying everything, I'm feeling a little better. My friend (Type 2) told me she is afraid to do low-carb because she did Atkins a long, long time ago (before I knew her) and it caused problems with her diabetes, so she had to go off it. That had always confused me...so when I read this study, I was thinking there must be something to it. I'm sure glad you are all around to set me straight! (Now I'm wondering if she was just eating alot of frankenfoods and other unhealthy stuff?)

BTW, although I have not yet convinced her to go low-carb, I convinced her DH. If he does well, maybe she'll join him yet!
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  #12   ^
Old Fri, Sep-12-08, 21:37
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lowcarbUgh lowcarbUgh is offline
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Mrs. Skip,

If your friend is on medication, she could have problems with hypoglycemia. She needs to read Dr. Bernstein's Diabetes Solution:

http://www.amazon.com/Dr-Bernsteins...21276939&sr=8-1

to learn how it would affect her medication and how to adjust it.
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