I agree. It must be hypo comas causing death if good control on meds and insulin reduce inflammation and infections etc.
@Oldvatr you can link to the full article from the abstract, or via the following link:Thanks for posting the abstract here.
Yes, I would agree with you! Unfortunately, most studies are funded by the pharmaceutical industry, so most of the research looks at outcomes associated with medications, not outcomes associated with dietary interventions. For information on the sponsor of this study, see the acknowledgements on page 20 of the article.So the obvious conclusion I would draw is that if normal HbA1c is achieved by lifestyle changes only (i.e. as if we were normals) then thats the best remedy, Doctor.
Agreed @ringi, Dr. Jason Fung explains the failure of the ‘glucotoxicity paradigm’ to address the real issue which is insulin toxicity in the following October 2017 article:But remember that for a drug to cause hypos it must increase insulin levels....
There must be other drugs which lower BG without a hypo risk as well.
One confusing thing is that it seems to imply that if you are on insulin et. al. then running high HbA1c averages doesn't reduce your life expectancy but if you are just on Metformin then it does.
More research (or at least more detail) needed.
That's just it a little higher causes me problems with numb feet and constant thrush. Exercise cannot help. I also have atherosclerosis which can get worse with uncontrolled diabetes. Then there's my hormone imbalances PCOS which is great on lower bgs. Weight loss too.@ickihun I think you have missed the main point of the study, that "length of life" is not improved by moving from "OK" BG control to "great" BG control when using most drugs/insulin. Hence trying to push BG down to "normal" levels in Type2 with insulin is not a good option, better to accept a level that is a little higher. (The ACCORD study showed the same.)
I guess me losing weight on excellent bgs on insulin if I wasn't over-weight could threaten my life. If only! (Me not being heavily over-weight).There were none in common usage at the time the data was collected. I think they only included people who were on the same drugs for the complete time. Hence SGLT2 inhibitors were not included in the study.
Firstly that is not what they found, they found that on insulin et. al. that high HbA1c and low HbA1c both reduce your life expectancy, with mid-range being best.
I think we already know the answer to this, that high insulin levels in our bodies are not good, and all the drugs in the study apart from Metformin work by increasing Insulin levels. Very high BG is worse than increased insulin levels, but mid-range BG is a good tradeoff in exchange for a lower blood insulin level.
As the study was just looking at the data, the only included in the paper what they could see from the data they were working with. It is assumed that everyone will be reading all papers about Type2. After all, this is a research paper not a chapter from a textbook.
If you watch the video from Jason a Fung on The Two Big Lies of Type 2 Diabetes he describes how he treated many people with long term type 2 diabetes who were being treated with insulin and who were dramatically overweight. He was successful in about 90% of cases using a low carb regime and intermittent fasting. One of his patients was about to have bariatric surgery, but managed to achieve the desired weight loss using fasting instead. Typically it took about 10 weeks to bring down the level of medication and in many cases he managed to get his patients off all medication including insulin.But what happens to people where low carb and all type2 drugs don't work or intolerant?
I'm such person. Low carb helps but not solves high bgs totally. I am highly insulin resistant. Only insulin stops me rotting away. I cannot do heavy exercise, walking is in pain. Many others have other health problems too.
My GP wants me to average a higher bgl level (7.0 mmol/l) than I had shown I was capable of achieving (5,4). I am currenntly running at 6.6 mmol/l. It is true that in my case, I was having frequent excursions in the hypoland territory when I was trying to go lower, and now I rarely get such problems. Feels like a good compromise that I am happy with.@ickihun You are being very sensible choosing a BG level based on how it affects your body.
This study stops doctor's thinking that a lower AC1 is always better when these drugs in a use.
That's just it a little higher causes me problems with numb feet and constant thrush. Exercise cannot help. I also have atherosclerosis which can get worse with uncontrolled diabetes. Then there's my hormone imbalances PCOS which is great on lower bgs. Weight loss too.
You cannot tell me that I don't benefit from not getting these things in good control and far less worry. Too much anxiety and mood swings aren't good for lasting relationships and career prospects.
The whole picture for me is what's important.
So
Weight loss til on as little insulin has been my on-going plan for a few yrs now. Progress is being made....which will continue.
I won't be panicking with this finding but I must express the whole health picture should be considered not snippets, like this seems to cover.
I won't be risking high bgs after these findings, no one should be expected too either.
Extract from the full report:There were none in common usage at the time the data was collected. I think they only included people who were on the same drugs for the complete time. Hence SGLT2 inhibitors were not included in the study.
Firstly that is not what they found, they found that on insulin et. al. that high HbA1c and low HbA1c both reduce your life expectancy, with mid-range being best.
I think we already know the answer to this, that high insulin levels in our bodies are not good, and all the drugs in the study apart from Metformin work by increasing Insulin levels. Very high BG is worse than increased insulin levels, but mid-range BG is a good tradeoff in exchange for a lower blood insulin level.
As the study was just looking at the data, the only included in the paper what they could see from the data they were working with. It is assumed that everyone will be reading all papers about Type2. After all, this is a research paper not a chapter from a textbook.
Yes page 20 is interesting. One pharma company supplied both the funding, and most of the co-authors, so this raises the usual query about independence and conflicts of interests. This is a problem where an external interest supplies not just funding, but also employees involved in the conduction of the study and/or the writing of the report or conclusions. I did not see any list of peer reviewers either.@Oldvatr you can link to the full article from the abstract, or via the following link:
http://onlinelibrary.wiley.com/doi/10.1111/dom.13155/pdf
Yes, I would agree with you! Unfortunately, most studies are funded by the pharmaceutical industry, so most of the research looks at outcomes associated with medications, not outcomes associated with dietary interventions. For information on the sponsor of this study, see the acknowledgements on page 20 of the article.
I remember telling my older gp that endocrologist wanted me inbetween 51-xx and he was surprised since I'm on insulin. GP thought it should be lower. Seeing dn at hospital this week. Last hba1c was 48 but this next one will be higher. I think back to my common 53-56 result.My GP wants me to average a higher bgl level (7.0 mmol/l) than I had shown I was capable of achieving (5,4). I am currenntly running at 6.6 mmol/l. It is true that in my case, I was having frequent excursions in the hypoland territory when I was trying to go lower, and now I rarely get such problems. Feels like a good compromise that I am happy with.
My GP wants me to average a higher bgl level (7.0 mmol/l) than I had shown I was capable of achieving (5,4). I am currenntly running at 6.6 mmol/l. It is true that in my case, I was having frequent excursions in the hypoland territory when I was trying to go lower, and now I rarely get such problems. Feels like a good compromise that I am happy with.
Not necessarily. Someone in a hypo state could be more at risk of losing concentration or losing control, so it could contribute a skew factor.Again, are diabetics necessarily more prone to depression that could lead to suicide? The report does not consider or even identify these endgames so we are blaming the meds soley, and not the co-morbidities that may exist. The other study I saw did, and seperated these effects out as not being relevant to their analysis. My heart medications also have co-morbidity that could lead to a fatal endpoint, in their own right, and again, would my death be put down to a heart medication issue, or a diabetes treatment regime issue? Or would I just be put down?As they are comparing people with different AC1 and on different diabetes drugs, "RTA deaths, suicides and accidental deaths" should have been the same in all the groups of people. Hence the differences in death rate between the groups give us useful information.
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?