Good point. Nobody ever reads the study.

This is a moderated forum so I can't say what I really feel about reading about advice that is so...stupid. Perhaps this doctor got his/her degree out of a cracker jack box, or for three easy payments of $39.95? :help:

The petition will make a difference -- have your voice heard
 

We already have 400 signers but, more important, we have effectively come up with an impressive testament on what real people do. Remember, in this case, the people will lead the experts. Please tell your story in the petition.
http://www.thepetitionsite.com/1/ge...xperts-who-have

There are now a lot of people working for you.
RF

loved that, Angeline!
 

That was a perfect analogy, Angeline! And it is exactly what I had thought about concerning diabetes / low carb when I wrote the petition. May I have your permission to use this analogy on the Nutrition & Metabolism Society website?
Thanks to all who signed - We're confident that we will be able to use this petition to get the benefits of lcd better recognized by the powers that be. . .
If you haven't yet signed it, please do - and spread the word!
Link:
http://www.thepetitionsite.com/1/ge...xperts-who-have

go for it lauricags :)

I'm not signing unless I understand what I'm signing, and right now all of this is just confusing my brain. Maybe tomorrow I'll take another look at this and try to make sense of the study and what's being said- I understand what blood glucose is but the rest of these tests are like Greek to me right now.

That's fair enough, Ruth. I admire that you want to understand the petition before signing. Here is the link to the study which was published in New England Journal of Medicine:
http://content.nejm.org/cgi/content/full/358/24/2545
Please note the following points which led to my petition:
In the study, aggressive drug therapy was used to lower blood glucose. (A low carb diet was not considered).

A large number of people in the group using aggressive drug therapy died and that part of the study had to be stopped.

From this the NIH concluded & stated that lowering blood sugars to near normal levels puts people with diabetes at increased risk of death! They never considered the aggressive drug therapy was the problem & most importantly, they never considered using a natural diet to lower the blood sugar!

Finally, I ask that you take a look at the lead authors disclosure agreements . The NMS site has a great commentary on it home page that helps to explain the study (far better than I).
Here's the link to "What the MD's have to say" http://nmsociety.org/index.php

I hope to see your name up on trhe petition site soon, Ruth!
Link:

http://www.thepetitionsite.com/1/ge...xperts-who-have
Thanks in advance!
Laurie

I signed and left this comment: "Normally, I do not use the term "douchebag" in polite discourse, believing that personal insults detract from rational debate. In this case, however, I'm very tempted. What on God's green earth could cause you to accept reasoning a college undergrad would reject? Are you truly feeble-minded, or just in thrall to those who have some hidden agenda?"

I minored in firebombing in college.

I'm aghast
 

I realize that I am seeing this thread several months after the fact, but I felt the need to comment. Speaking as someone who is trained in epidemiology and biostatistics, this study's leaps of logic are very upsetting. Unfortunately, many medical doctors who conduct research have little to no training in research methodology and therefore tend to assume causation when there is no evidence to support this conclusion. Just because intensive therapy is associated with increased mortality does not mean that it caused this increase in mortality.

No real conclusions can be drawn from this study due to severe confounding by treatment, notably that the variability of medications received and their dosing was not controlled for in the analysis. Without accounting for this, it is quite possible that the increased mortality is completely caused by the intensive therapy medications and not the lowering of the A1c. This assumption that an association of a lower A1c with increased mortality automatically means that the lower A1c caused the increase in mortality is extremely dangerous--this type of thinking is how the medical establishment got wrapped up in the low-fat hypothesis.

The fact that NEJM published this piece of rubbish in this form is disheartening. They should require that a statistician and an epidemiologist review manuscripts from clinical trials to prevent physicians from making these kinds of logic leaps.

As an aside, the "disclosures" statements in general are useless. They require the authors to disclose their financial interest, but they don't restrict them from publishing at all. This system obviously doesn't work and should be scraped for something more effective.

Ok now I am going to fume somewhere else.

--Melissa
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A couple additional thoughts on this as I've mused over the last couple hours.

First, this study really encapsulates the inherent tradeoffs of stopping a trial early. Most clinical trials have very detailed rules on when the study must be stopped--usually if there is an established risk to some or all of the participants or if the results are so unequivocal that continuing to withhold the treatment from the other groups would be unethical. This means that the Data Safety Monitoring Board (every study has one) has to review the data from the study periodically.

Statistically, this involves tradeoffs--the more you look at the data, the harder it becomes to find significant results from the study. Also, when the study is stopped early, the resulting data does not look the way it was planned--in terms of the length of follow up, the number of datapoints for each participant, etc. Most of the calculations for the study design are based on completion of the full study as it was originally envisioned. Since you did not complete the study as planned, you often do not have enough data to be able to definitively answer the questions that you set out to understand.

Last year I gave a presentation on Institutional Review Boards, which are present at each institution that conducts human research, to my Intervention Trial Design class at Berkeley. If anyone is interested in reading more about how these studies are evaluated, I can upload it.

Not too late
 

It's not too late to sign the petition & help us to do something about this!
Here is the link:
http://www.thepetitionsite.com/1/ge...xperts-who-have

Please be sure to forward the link to all in your circle & thank you!
:)

I signed today, and added the following comment:

In my university days, had I presented a conclusion based on such shoddy reasoning I would not only have received a failing mark but would also have been subject to a caustic commentary concerning my inability to use logic and reason. Over the years, when examining studies on Medline, I have been distressed to see many studies - providing recommendations on the health of millions of people - demonstrating the same lack of basic logic and reason in support of the conclusions. Taxpayers in both the US and Canada are not well served by such rubbish - certainly, I am not amused by the waste of my hard-earned money on slip-shod pseudo-science.

I just signed it. Very important that everyone do this !!!

Valtor

Accord Study
 

Thank you - We need less than 300 more signatures before taking this petition to congress. If everyone would forward this lik to their contacts, we can have it by the end of the day today!
Thanks to all who have signed.
http://www.thepetitionsite.com/1/ge...xperts-who-have

Only 264 votes still needed! We can do this by the end of the day if everyone reading forwards this link to their contacts and asks for signatures.
This is so important and can help make positive changes especially but not limited to those with diabetes.
Thanks!

If Richard is reading this, there is an answer for you from someone in the zero-carb forums.

Here is the link

http://forum.zeroinginonhealth.com/...=56881#pid56881

Valtor