Thursday, February 21, 2008

More ACCORD

Laura Dolson, at About.com, recently posted about the ACCORD Trial mess in a Tale of Two Diabetes Studies. To get you started:

Many people who follow low-carb diets do it to achieve greater blood glucose control. Therefore, it was disconcerting when ten days ago the news was full of a large study of diabetics ("ACCORD") which was halted when it was found that patients in the more aggressive treatment group, who had lower blood glucose as a result, had more deaths than the patients with higher levels of blood glucose.

Note that none of the researchers said that the lower blood sugar itself caused the result -- it could have been the more agressive drug therapy that these patients were on, or some other factor. Nor are they clear on what caused the extra deaths at this point. And no one was recommending that treatment programs or goals be changed based on this preliminary data. In fact, the American Diabetes Association recommended not changing anything. However, this did not stop the media from producing headlines such as, "Diabetes Study Shows Lowering Blood Sugar Increases Death Risk" and "Diabetes Study Upends Another Long-held Belief". In my opinion, these kinds of headlines are blatantly irresponsible, and I also wonder what is to be gained by blasting this story everywhere before we have a decent analysis of what was going on in the study.

The findings in the ACCCORD study prompted researchers in Austalia to peek into a similar study in progress there called ADVANCE. Were the results the same? No, not at all! Their data did not show increased deaths in the lower blood glucose group, despite the fact that twice as much data has been collected so far in the ADVANCE study. So the interim advice is to wait until the results of both studies, plus one additional similar one, are available.

What are we to think?

Continue reading full article...

5 comments:

  1. We are to think that the protocol of ACCORD that included having dietitians nag participants about eating high carb low fat diets on a regular basis, and then put them on several blood sugar drugs including sulfonylureas which have been associated with causing heart attacks and Actos and Avandia which both cause heart failure in people who didn't have it, and then put them on several blood pressure drugs including beta blockers which worsen blood sugar, and then top that off with two different kinds of cholesterol drugs was a tad flawed.

    The coverage of this story is sickening. It is as if the media wants to believe that all people with diabetes are doomed.

    And it is part of the whole media attitude of "They did it to themselves those lazy gluttons who gave themselves diabetes."

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  2. calianna8:39 AM

    Laura concludes her article this way:

    "So the next time you see a scary medical headline in the news, take a deep breath, and get some facts."

    Unfortunately, the full facts are not forthcoming, as of yet.

    We know that they were on a veritable chemical stew of drugs, which leads us to believe that all blood sugar control was to be achieved exclusively through drug treatment, and that they were still expected to eat the ridiculous amount of carbs the ADA insists on... but do we know that? Not yet, they haven't admitted how much carb these diabetics were eating.

    There's a huge difference between achieving normal blood glucose through a diet of significantly lowered carb consumption, with minimal drug use, and achieving it purely through drugs designed to increase insulin levels to cope with whatever level of carbs they're consuming.

    Do you think they'll ever admit that it's the high insulin levels and constant blood sugar ups and downs that are the real problem?

    Or is that something we can't expect to see until this generation of researchers, scientists and nutritionists are replaced by a more renegade generation that refuses to blindly accept the low fat dogma?

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  3. Do you think they'll ever admit that it's the high insulin levels and constant blood sugar ups and downs that are the real problem?

    Given the mountain of evidence pointing to elevated insulin (hyperinsulinemia) associated with so many health issues, I'm left wondering why it remains such an elusive line of inquiry - maybe I'm jaded, but I doubt we'll see much in the way to shift the focus to insulin any time soon...to do that would mean abandonment of the idea we need most of our energy each day from carbohydrate since it is the primary force driving up insulin.

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  4. "maybe I'm jaded, but I doubt we'll see much in the way to shift the focus to insulin any time soon"

    Me too Regina! I was starting to think it was just a matter of time, but I'm not so sure now!

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  5. Irresponsible reporting. This is why I've stopped reading the newspaper or watching news on TV - and if I do, I take it with a very large grain of salt.

    The goal of a headline is to hook people (who, it is assumed, are generally fairly dim and have ADD) into reading the whole article. Then the piece itself must be designed to encourage a readthrough. Accuracy seems to have taken a backseat. Makes me sick. (and it's certainly helped make the rest of us sick too)

    Whatever happened to Occam's Razor? Simplest explaination - drugging the hell outta already health-compromised people while stuffing them full of food that further exacorbates their condition kills them. Like, hello.

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