Rapid Sugar Reduction = The Bad Guy?

Christopher's Commentary:

So, how do we know that the causative agent of these excessive deaths was the 'aggressive' lowering of blood sugar as opposed to the fact that synthetic drugs (and their copious side effects) were used to aggressively lower the participants' blood sugar?  Not to mention that it appears the subjects were also being treated with anti-hypertensive and cholesterol lowering medications. . .

Wouldn't it be a better solution to simply teach people how to consistently eat better?

Diabetes Health Goes Beyond Blood Sugar
By TARA PARKER-POPE
Published: February 8, 2008

(New York Times)  The startling findings of a major federal study on the effects of lowering blood sugar are unlikely to change the way most people with Type 2 diabetes manage their illness, doctors said Thursday.
The study, announced Wednesday, showed that an intensive program to lower blood sugar actually increased risk of death. The findings were so surprising that the study was stopped early, and they seemed to undercut the accepted wisdom that people with diabetes should do everything possible to get their blood sugar down to normal.
But the methods used in the study, called Accord (for Action to Control Cardiovascular Risk in Diabetes), bear little resemblance to the techniques most doctors and patients use to manage blood sugar levels. And the patients in the study were typically far sicker than many people with diabetes today.  Read more. . .

 

For more detail, here's The Science Daily article:

Diabetes And Cardiovascular Disease Trial Involving Intensively Lower Blood Glucose Stopped For Risk Of Death

ScienceDaily (Feb. 7, 2008) — The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health has stopped one treatment within a large, ongoing North American clinical trial of diabetes and cardiovascular disease 18 months early due to safety concerns after review of available data, although the study will continue.  Read more. . .

Comments

[Eugene Thong]

Well, if you believe that fat and cholesterol will kill you, there's not much left to eat once you take away foods that cause an appreciable rise in blood sugar.

Since they haven't released the data yet, who knows what really happened, but here's what I gleaned from the news reports and press releases:

1) As you correctly pointed out, they were taking statins. Big red flag for me.

2) Doctors were left to their own "accord" as far as drug prescription was concerned, so there's tons of potential interaction effect that might have been overlooked.

3) I'm no metabolic clinician, but from the reports it seems like they were shooting for an unusually low blood sugar goal (A1C 6 or below). I can't help but think that enducing what's akin to reactive hypoglycemia in diabetics to be a bad thing, but what do I know?

Thanks for the posts, Dr. Warden!

[Eugene Thong]

Now here's the thing: If doctors merely focused on making sure their charges ate minimal starches, grains, and sugars, virtually all of their patients' A1c numbers would come in at 6% - no drug interventions needed; no unnecessary death.

It's too bad (as you pointed out) that the conception of "eating better" from a traditional medical POV is to eat more of the stuff that raises blood sugar (as well as TG and other nasty little fellows) and less of the stuff that avoids those elevations. Sad, ne?

[Christopher Warden]

It is always a wonder to me why it seems the research/medical community is so quick to use synthetic intervention as a means to treat pathologies.

When I was pre-med, professors often discussed that many of the required courses (physics, calculus, etc.) were beneficial because they taught/reinforced critical thinking -- a skill that is obviously vitally important in any healthcare-related profession.

I have a tendency to feel that this skill has been lost -- whether it's because we're quick to rely on technology, we're looking for a quick-fix or (sadly) we're more concerned about making money.

A little reflection and intuition, I'd think, would lead to use of more "natural" intervention methods and stop what has become and out-of-control reliance on pharmaceuticals to fix every malady that effects humankind.