google research into diabetic research

[jopar]

While the forum was down I decide to do a google search on diabetic research, the aim was not only to see what research that has been carried out, but also on which types of diabetes..

It came up with loads of Type 2 research, some new drugs that should becoming out soon, aimed to be marketed in 2010-2012ish…. One in Phase 3 trial stage and 2 that were in Phase 2 stages.

So what did I find?

Well in the main interesting information, but with saying that you read one bit and thought yep that makes sense, then you read another research piece that really said the complete opposite but it also made sense….

Then you got a article that was released in the Washington post yesterday (17/12/08) concerning titled ‘strict blood sugar lowering wont ease diabetes heart risk’ which made for one mind boggling confusing read to say the least…

Study was based on a group of 1,800 T2 diabetics average age of 60; one group maintained a good tight control and the other maintaining a reasonable/not considered good control…. They followed these two groups of almost 6 years to see how they fared! The conclusion was that yes both groups had suffered complications and that the tightly controlled blood glucose group only did slightly better a difference 25 less patients from this group suffered a complication against the standard controlled group!! The figures were out of the 1,800 a total of 495 had a complication 235 of these belonged to the tight controlled group…..

What on earth is one supposed to make of that study? Apart from hoping for the best?

I think it is the case of look, listen to everything whether or not they seem to go against the grain and attempt to make a decision that you think as a individual that suits you, keep you blood glucose as well controlled as possible with methods that you are happy with…

It's no surprise that with so much conflicting information it does feel that we are treading through a mine field...

 

[sugarless sue]

I'd be really surprised if a group of 60-66 year olds of whatever health or disease did not have a significant proportion with some sort of heart trouble!!By the law of averages we are all going to get past our sell by date eventually and have some sort of age related illnesses.
They say statistics can prove anything.What else did you find Jo?

 

[jopar]

Sue

Can't agree with you more... Take a different group the same size and a different story might be told!

I think it stuck out as it sort of in my minds eye, showed how and why there is so much conflicting advise and thoughts over living with diabetes... It just goes to show that there is a much bigger picture to be concidered and a hell of a lot more research required...


this was interesing
http://www.irishtimes.com/newspaper/hea ... 84126.html

But I didn't find any research on low carbs and diabetes, but with saying that I really was only having a flick through and not in depth...

 

[phoenix]

The full study http://content.nejm.org/cgi/content/full/NEJMoa0808431



The subjects, mean age 60.4, were selected from men (ex military)with poor control ie an inadequate response to either oral medicaments or insulin therapy. Subjects were excluded if they had an HbA1c of less than 7.5%, recent cardiovascular event,(but 40% had already had one) had a BMi over 40 or had a life expectancy less than 7 years. There were 2 conditions one standard therapy, the other intensive control.
At a mean follow up time of 5.6 years, normal control group had an average HbA1c of 8.4%, intensive of 6.9%. Outcomes were defined as 'major cardiovascular event, a composite of myocardial infarction, stroke, death from cardiovascular causes, congestive heart failure, surgery for vascular disease, inoperable coronary disease, and amputation for ischemic gangrene'
There was no significant difference in outcomes between groups.

They state that the study was limited to men so not necessarily applicable to women. and that newer drugs have become available and they might have different effects.
They note similar results in the ACCORD and ADVANCE studies
They note that other factors ' levels of HDL cholesterol, weight gain, systolic blood pressure, and pharmacologic agents could play a role in the observed lack of benefit of intensive glucose control and need to be examined in detail.'
In conclusion they say 'the results of this and other studies do not indicate that intensive glucose control in this population decreased the rate of cardiovascular events. In addition, it appears that intensive glucose control had minimal effects on microvascular complications during a period of 5 to 6 years. Intensive glycemic control earlier in the disease course may produce benefit, especially if severe hypoglycemia is avoided. For now, appropriate management of hypertension, dyslipidemia, and other cardiovascular risk factors appears to be the most effective approach to preventing cardiovascular morbidity and mortality.'(my underlinings)


To me it is sad that the people in the intensive condition were in fact able to reduce their BG levels, however they had already had damaging BG levels for an average of 11 years.

 

[tubolard]

To be fair to Jo, the press release does not mention that those with an HbA1c of < 7.5% were excluded.

 

[Trinkwasser]

Haven't read it yet but this looks similar to ACCORD, using intensive or less intensive medication to reduce the effects of a high carb diet, and succeeding in reducing very high A1cs to just dangerously high.

Much research is along these lines

http://jama.ama-assn.org/cgi/content/full/300/23/2742

this one showed that a low GI diet improved A1c but nowhere near as much as suitably low carb diets achieve both here and in all forums and newsgroups where improvements of 5 - 8% are common and improvements of 10 - 16% are achieved, OK not purely due to diet but it is a major factor

 

[phoenix]

The Washington Post article did not make it clear, they rarely do.Thats why I now never accept a newspapers interpretation of a scientific paper.
(ditto to Tubs)

 

[jopar]

I think you missed my point slightly....

I used it as it shows not only how a very high percentage of people will get information concerning diabetic control, but also to show the limitations of a lot of research that is carried out on our behalf and what sort of mine field there is out there concerning research and how do we interprtate it all for our own benefit!

I do know where I stand, I would hedge my bets and take the tighter control side, must admit 25 less people might be a small figure but hey it's 25 less changes of not being fallen by your diabeties!!

It's a point of discussion, that hopefully will be expanded into, have you looked at this research data? As it say this that and the other....

It is not by any means intended that anyone should make a dission from this one research report, but encouragement to take a look to see what researchers are doing and how different these can be

 

[phoenix]

I started writing this before the last two posts but I'll post anyway

I'm going to plunge in here,. I try extremely hard to be objective. On this occasion I felt the research was not applicable to many of the members on here. It was not aimed at attempting to ammeliorate the outcomes of very well motivated and fairly recently diagnosed people but to see if more intesive control could be effective at a later date. It was not well reported in the newspaper. My inclination is to find the original research where possible but I have had some experience in reading scientific papers.

However,I have found on lots of occassions ridicule has been made of research studies, ( not really looking at what has been investigated or quite frequently by using anecdotal evidence in an attempt to prove a point. I sat on my hands , with your recent posting and others responses to the recent cognitive research thread . basiI felt it really wasn't worth getting into an argument. On other forums I would be quite willing to discuss what the research appears ( to me) to be really about. I didn't because frankly I would be quite scared of trying to do that on here. ( yet cognitive psychology is my area of expertise).

All of us have different experiences and knowledge. Sometimes, we will be right, sometimes not so, often we will learn. I learnt nearly all I know about my control, which is good, from the internet and from people on forums. I have found almost all posters are wanting support in some way, and at the same time, when they can, to offer assistance, their motivations are benevolent .I know you didn't write it but I was stunned when one poster implied some form of conspiracy theory by people they didn't agree with. If you feel that posters are wrong in fact, rather than opinion, by all means point that out. If you differ in opinion, then again point it out (whilst recognising that your opinions and experience are no more valid than anyone elses) but unless there is evidence to the contrary please don't denigrate peoples motivations.

 

[seabill]

Hi Jopar

Thanks for some really good information.

The Richard M. Schulze Family Foundation
have pledged $40 million to the University of
Minnesota.

Goal is to find a cure for type 1 in 5 years.

Seabill

 

[fergus]

Looking for consensus here......

Perhaps what we should take from the seminar is this:

That it takes a skilled eye and resolute objectivity to see beyond a prima facie case in any scientific discipline.

That with depressing regularity many research studies appear to begin in the knowledge that certain hypotheses are true and thereafter seek to prove them.

That there is little more dangerous to proper science than the certainty that one's opinions are right.

These are failings in all of us of course but also in much published research I have read. In our own little area of expertise, we would do well to concentrate on asking intelligent questions of both ourselves and those who offer us advice.

All the best,

fergus

 

[Trinkwasser]

Eddie, I'm going to plunge in here,. I try extremely hard to be objective. On this occasion I felt the research was not applicable to many of the members on here. It was not aimed at attempting to ammeliorate the outcomes of very well motivated and fairly recently diagnosed people but to see if more intesive control could be effective at a later date. It was not well reported in the newspaper. My inclination is to find the original research where possible but I have had some experience in reading scientific papers.

Yes the results of many studies are spun to "prove" the thesis that was expected by those who financed the study, if you actually read the paper rather than the abstract you may easily reach different conclusions (which the writers intend)

Then the "result" is further spun by the media who also have a thesis, ie. to prove that Type 2 is a "lifestyle disease" brought about by being fat and lazy, and in this case that there's no point wasting money trying to treat it.

I know you didn't write it but I was stunned when one poster implied some form of conspiracy theory by people they didn't agree with.

You should get out more, it's common on certain newsgroups and other forums also. It's got nothing to do with agreeing or disagreeing, it has to do with Type 1s giving dangerous advice to Type 2s just because it works for them, who have a totally different disease.

Good ways to do your own research

[1] pay staff to do it for you <G> actually I have friends in other places who dig out interesting papers

[2] good search engines and sources

http://www.medscape.com/medscapetoday

http://medlineplus.gov/

http://www.ncbi.nlm.nih.gov/PubMed/medline.html

http://highwire.stanford.edu/

http://scholar.google.com/advanced_scholar_search

An excellent plan, find a reputable site which lists the source papers like

http://www.bloodsugar101.com/

http://www.dsolve.com/

read the papers they reference

each paper will have references to other papers

read them too

Most reputable papers looking at low or reduced carbing will say "this works but you shouldn't do it as there are no long term studies"

They've been saying that for over ten years now. Why are there no long term studies? Who will finance them? Not the drug companies who may lose sales and not the diabetic charities who will lose money from their sponsors like Kelloggs and Cadburys and Novo Nordisk.