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Originally Posted by Feinman
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The results from the ACCORD study were recently published in New England Journal of Medicine. Even to those of us used to the excesses of medical science, this is quite remarkable. The conclusions, as stated in the abstract, are
"As compared with standard therapy, the use of intensive therapy to target normal glycated hemoglobin levels for 3.5 years increased mortality and did not significantly reduce major cardiovascular events. These findings identify a previously unrecognized harm of intensive glucose lowering in high-risk patients with type 2 diabetes."
The intensive therapy is not described (certainly unlikely to include carbohydrate restriction) and, in fact, includes numerous different drugs in different combinations. Rather than identifying which of the treatments might cause the increased mortality, authors jump to the conclusion that lowering HbA1c is the culprit. This lack of scientific reasoning would not be accepted from an undergraduate student.
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For anybody interested in reading the entire article (it's only 15 pages), here is the
link. From here you can open the full text in html or pdf. For those that only want to click one link, click
here for the html version.
Would you please clarify something for me? I understand that 'intensive' generally means 'to the limit of safety'. So, when the authors discuss 'intensive therapy' v. 'standard therapy', to what does 'intensive' refer? The rapidity with which glycated hemoglobin levels were reduced? The method by which glycated hemoglobin levels were reduced? The amount the glycated hemoglobin levels were reduced?
Also, using 'standard therapy', is it possible to achieve a normal level of glycated hemoglobins (6% or lower if I read the article correctly)? Ignoring carbohydrate restriction methods.
I read the study - several times. The conclusion is not supported by the discussion. The authors state, in their discussion, that the higher rate of death could be attributed to any one or several of various factors, including the speed, amount and/or method of reduction; among other factors. Yet, on one hand, their conclusion does not match their discussion. On the other hand, the conclusion
may correlate to the discussion, depending on what 'intensive' means (speed, amount, method?).
I can see where, if 'intensive' refers to the speed or method of lowering the glycated hemoglobin levels -- but not the amount by which the levels were lowered, I could see how this study presents a jumping off point for further research. Although, given the numerous variables, this study appears to be useless.
From a lawyer's read of this article, it lacks logic and would be easily attacked and destroyed upon cross-examination. This article is a prime example of why I do not believe consumer-media reported health news.
P.S. - I signed the petition.