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  #16   ^
Old Mon, Jun-23-08, 16:37
mermaiden9's Avatar
mermaiden9 mermaiden9 is offline
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Posts: 356
 
Plan: Atkins
Stats: 163/129.4/133 Female 160cm
BF:28%
Progress: 112%
Location: Australia
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Signed and commented but cynical they'll take any notice
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  #17   ^
Old Mon, Jun-23-08, 18:17
catfishghj's Avatar
catfishghj catfishghj is offline
Senior Member
Posts: 428
 
Plan: atkins
Stats: 330/217/190 Male 70 in
BF:?/30/less than 20
Progress: 81%
Location: Tucson, AZ
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I signed and said:
I have completly controlled my type II diabetes by following a low carb diet and am in excellent health. Do you guys only research treatments that can make drug companies money?
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  #18   ^
Old Mon, Jun-23-08, 20:38
Kisal's Avatar
Kisal Kisal is offline
Posts: 14,482
 
Plan: It's anybody's guess!
Stats: 350/250/160 Female 70 inches
BF:
Progress: 53%
Location: Oregon
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I just signed and added a personal comment about my own positive health improvements from lc.
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  #19   ^
Old Mon, Jun-23-08, 20:52
M Levac M Levac is offline
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Posts: 6,468
 
Plan: VLC, mostly meat
Stats: 202/200/165 Male 5' 7"
BF:
Progress: 5%
Location: Montreal, Quebec, Canada
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Foolish me, I forgot to un-check the "yes, send me crap about stuff" in the signature so now I'm looking for a way to undo this mistake. Does anybody know how I can go about doing that? Thanks.
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  #20   ^
Old Mon, Jun-23-08, 21:22
mermaiden9's Avatar
mermaiden9 mermaiden9 is offline
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Posts: 356
 
Plan: Atkins
Stats: 163/129.4/133 Female 160cm
BF:28%
Progress: 112%
Location: Australia
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When you recieve a crap about stuff email, there should be a link to unsubscribe off the mailing list or instructions on how to do so.
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  #21   ^
Old Mon, Jun-23-08, 23:35
Gypsybyrd's Avatar
Gypsybyrd Gypsybyrd is offline
Posts: 5,995
 
Plan: Atkins '72 It works best!
Stats: 281/281/180 Female 5'3"
BF:mini goal 250
Progress: 0%
Location: St. Pete, Florida
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Quote:
Originally Posted by Feinman
...

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.

...



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.

Last edited by Gypsybyrd : Tue, Jun-24-08 at 00:05.
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  #22   ^
Old Mon, Jun-23-08, 23:39
Kisal's Avatar
Kisal Kisal is offline
Posts: 14,482
 
Plan: It's anybody's guess!
Stats: 350/250/160 Female 70 inches
BF:
Progress: 53%
Location: Oregon
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Quote:
Originally Posted by M Levac
Foolish me, I forgot to un-check the "yes, send me crap about stuff" in the signature so now I'm looking for a way to undo this mistake. Does anybody know how I can go about doing that? Thanks.
There is an "unsubscribe" link in the stuff they send you. I checked the box on the ACCORD petition, but while I was there, I also signed the petition about the polar bears/arctic drilling, and I forgot to check the box on that petition!
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  #23   ^
Old Tue, Jun-24-08, 08:36
lowcarbUgh's Avatar
lowcarbUgh lowcarbUgh is offline
Dazed and Confused
Posts: 2,927
 
Plan: South Beach
Stats: 170/132/135 Female 5'10
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Location: Flip-flop, FL
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Quote:
Originally Posted by Gypsybyrd

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?


I take it to mean an objective of an A1c of 6, which is not even normal, and doesn't reflect excellent control at all. So the objective was really the number in and of itself. The means they used I'm sure varied with each patient and included glucose lowering drugs known to exacerbate heart disease. The A1c number is important because it reflects average BG levels over time. There is a strong correlation between a higher A1c and increased diabetic complications of all kinds. Intensive therapy is almost a joke because diabetics who are low carbing are posting MUCH better A1cs than their "intensive" group. "Standard" therapy is not much of any therapy and they expect you to die of diabetic complications. The study didn't even look at carbohydrate restriction as a means to achieve a good A1c, and in that sense, it was a complete travesty of science. The NIH funded it and I'm highly doubtful they will admit their made an error in judgment and no doubt they will promulgate it as a "best" practice.

The life of a diabetic who depends on doctors to dictate their lifestyle is generally a poor one which results in blindness, amputations, kidney failure and heart disease.

Last edited by lowcarbUgh : Tue, Jun-24-08 at 08:52.
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  #24   ^
Old Tue, Jun-24-08, 11:20
MizKitty's Avatar
MizKitty MizKitty is offline
95% Sugar Free!
Posts: 7,010
 
Plan: Very high fat LC/HCG
Stats: 310/155.4/159 Female 67 inches
BF:
Progress: 102%
Location: Missouri
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Quote:
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?


It is my understanding that 'intensive therapy' included putting these patients on many and strong doses of drugs, including statins and hypertension drugs, insulin, new diabetes drugs like Byetta, known dangerous ones like Avandia and Actos, etc, in untested combinations. No dietary interventions were included, and it is assumed they were all on (or recommended to be on) the ADA high carb low fat diet.

Here is a great blog from our member Lottadata with analysis and commentary on ACCORD:
http://diabetesupdate.blogspot.com/search?q=accord
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  #25   ^
Old Tue, Jun-24-08, 11:50
lowcarbUgh's Avatar
lowcarbUgh lowcarbUgh is offline
Dazed and Confused
Posts: 2,927
 
Plan: South Beach
Stats: 170/132/135 Female 5'10
BF:
Progress: 109%
Location: Flip-flop, FL
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The NIH itself did another, earlier study on type 1 diabetes and reached the opposite conclusion of the ACCORD study.

The DCCT and EDIC studies showed that:

What is the EDIC?

When the DCCT ended in 1993, researchers continued to study more than 90 percent of participants. The follow-up study, called Epidemiology of Diabetes Interventions and Complications (EDIC), is assessing the incidence and predictors of cardiovascular disease events such as heart attack, stroke, or needed heart surgery, as well as diabetic complications related to the eye, kidney, and nerves. The EDIC study is also examining the impact of intensive control versus standard control on quality of life. Another objective is to look at the cost-effectiveness of intensive control.

DCCT Study Findings

Intensive blood glucose control reduces risk of

* eye disease
76% reduced risk
* kidney disease
50% reduced risk
* nerve disease
60% reduced risk

EDIC Study Findings

Intensive blood glucose control reduces risk of

* any cardiovascular disease event
42% reduced risk
* nonfatal heart attack, stroke, or death from cardiovascular causes
57% reduced risk

http://diabetes.niddk.nih.gov/dm/pubs/control/

The blood glucose lowering agent was simply insulin instead of the cocktails prescribed to Type 2s. IMO, insulin is the safest glucose lowering agent because Human insulin is the same as the insulin in your body.
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  #26   ^
Old Tue, Jun-24-08, 12:03
LessLiz's Avatar
LessLiz LessLiz is offline
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Posts: 6,938
 
Plan: who knows
Stats: 337/204/180 Female 67 inches
BF:100% pure
Progress: 85%
Location: Pacific NW
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Quote:
Originally Posted by Gypsybyrd
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.
....

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.
Thanks for the link -- I was going to hunt it up. I don't sign petitions without knowing what I'm signing about.

The disturbing thing to me is this is not a consumer health report -- the basic failing is in the supposedly scientifically valid study.
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  #27   ^
Old Tue, Jun-24-08, 13:26
Gypsybyrd's Avatar
Gypsybyrd Gypsybyrd is offline
Posts: 5,995
 
Plan: Atkins '72 It works best!
Stats: 281/281/180 Female 5'3"
BF:mini goal 250
Progress: 0%
Location: St. Pete, Florida
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Quote:
Originally Posted by LessLiz
Thanks for the link -- I was going to hunt it up. I don't sign petitions without knowing what I'm signing about.

The disturbing thing to me is this is not a consumer health report -- the basic failing is in the supposedly scientifically valid study.


I was glad to see it's a free article from NEJM ...

'Supposedly' is the correct term - once a person reads, they realize how flawed the study was.
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  #28   ^
Old Tue, Jun-24-08, 13:31
Nancy LC's Avatar
Nancy LC Nancy LC is offline
Experimenter
Posts: 45,318
 
Plan: Paleo 99.5%
Stats: 210/170/160 Female 67.5"
BF:
Progress: 80%
Location: San Diego, CA
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Dr. Davis posted about the petition on his blog: http://heartscanblog.blogspot.com/2...titutes-of.html
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  #29   ^
Old Tue, Jun-24-08, 19:13
LC FP LC FP is offline
Senior Member
Posts: 1,150
 
Plan: Atkins
Stats: 228/195/188 Male 72 inches
BF:
Progress: 83%
Location: Erie PA
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Intensive therapy-- target <6.0 HBA1c
Standard therapy-- target 7-8 HBA1c. Quite a difference.

Main difference betweek groups (in meds) was twice as many in intensive group took Avandia and 77% vs 55% took insulin.

The Avandia maker was out immediately with a press release that the differences in Avandia use weren't the cause of increased mortality...
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  #30   ^
Old Tue, Jun-24-08, 21:51
Gypsybyrd's Avatar
Gypsybyrd Gypsybyrd is offline
Posts: 5,995
 
Plan: Atkins '72 It works best!
Stats: 281/281/180 Female 5'3"
BF:mini goal 250
Progress: 0%
Location: St. Pete, Florida
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Ok, so that's 2 that read 'intensive' in 'intensive therapy' refers to level the A1c is lowered to. And 1 for that read 'intensive' to refer to the method (drug combos) by which A1c was lowered.

Because the study is clearly unclear about what 'intensive' refers to, the study is fundamentally flawed. And the authors discussed this in the report yet concluded something that isn't supported by the research. Interesting, huh?
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