Snake and Kidney... the bad news.. avoid if feeling down

[Cowboyjim]

http://www.medpagetoday.com/Nephrology/Diabetes/32954
don't read if you are feeling some burnout...
this kind of info is really NOT what I want to know thanks Dox! 8)

THE GOOD NEWS....

Tighter control in clinical trials with hemoglobin A1c (HbA1c) targets ranging from 7.1% to less than 6% significantly cut down on micro- and macroalbuminuria compared with conventional glucose control, Steven G. Coca, DO, MS, of Yale and the VA Medical Center in West Haven, Conn., and colleagues found.

BUT.....

.... the intensive strategy had no impact on doubling of serum creatinine level, risk of end-stage renal disease, or death from renal disease, they reported in the May 28 issue of the Archives of Internal Medicine.

 

[alaska]

However, there's a very good point made by Dr Tracy Breen, (director of diabetes care at North Shore-LIJ Health System in New Hyde Park, N.Y.)

"I feel this [finding] is misleading since most of the studies included in the analysis had relatively short durations of 'intensive' treatment and also fairly short durations of follow-up,"

"microvascular complications often take many years to develop - any analysis that includes trials with less than 10 years of follow-up may not have the statistical power to show difference in clinical events."

Source:
http://health.msn.com/health-topics...ows-mixed-results-for-health-of-kidneys-study

 

[Dillinger]

Thanks Jim,

The article says:-

"However, the intensive strategy had no impact on doubling of serum creatinine level, risk of end-stage renal disease, or death from renal disease, they reported in the May 28 issue of the Archives of Internal Medicine.

Given the risks of severe hypoglycemia, minimal cardiovascular benefit, and potential increased risk of death seen with tight glucose control, the renal findings don't do much to justify it, Coca's group argued." (my bold).

But what they mean when the say 'tight glucose control' (as per ACCORD and ADVANCE) is intense medication to lower blood sugars; they are not talking about reducing blood sugars by reducing carbohydrates.

What evidence is there to say that low HbA1c is bad for you - or increases your risk of dying? None - after all - every single non diabetic has a low HbA1c ranging from about 3.5% to 5.5% and how does this effect them? Well they tend not to have retinopathy, neuropathy or nephropathy resulting from elevated blood sugars, nor do they have elevated risks of CVD from the same.

So, what the ACCORD and ADVANCE studies show is that taking lots of medication will damage you (ACCORD included Actos and Avandia - drugs shown to increase your risk of having a heart attack that have been withdrawn!).

So, what to do? Reduce your carbs of course; if you have kidney problems take Lisinopril which will reduce serum creatinine levels and keep as close to non-diabetic levels as you can. Our glucose homeostasis didn't evolve by accident; it's important that's why it is tightly regulated by the body.

Please don't take this kind of thing as a reason to not bother tightening up your control - it is a reason to do that with as little medication as possible.

My analogy of ACCORD is it's like saying we are going to investigate weight loss to see if that helps increase your life expectancy. We are going to do that by chainsawing off the participants legs; they will therefore benefit from swift BMI improvements. But oh look they've all bled to death; therefore we can conclude that losing weight is VERY BAD FOR YOU. Do you know what I mean?

Best

Dillinger