RE: Diabetes Study Partially Halted After Deaths

[Guest guest]

After reading study after study where the results of previous studies are

negated, it's hard to know what to think. I recently read that after years

of telling women to take calcium to lower the chances of osteoporosis, there

is now a study saying calcium supplementation can raise the chances of dying

of a heart attack. In the past it was found that calcium not only reduced

the risk of osteoporosis but lowered cholesterol, and now they are saying it

increases the chances of dying from a heart attack? All these reversals of

results from former studies have led me to come to one conclusion...

Living is hazardous to your health. The longer you live, the more chance

you have of dying. No matter what you eat or drink, no matter what

nutritional supplements you take, no matter whether you exercise or not, and

no matter whether your blood sugar is high or low, you are going to die.

So, I am not reading anymore health articles.

Becky

_____

From: blind-diabetics

[mailto:blind-diabetics ] On Behalf Of Larry Gassman

Sent: Thursday, February 07, 2008 11:17 PM

To: Blind Diabetics

Subject: Diabetes Study Partially Halted After Deaths

I saw a report about this topic on PBS this evening.

Larry Gassman

February 7, 2008

By

GINA KOLATA

For decades, researchers believed that if people with

diabetes

lowered their blood sugar to normal levels,

they would no longer be at high risk

of dying from heart disease. But a major federal

study of more than 10,000 middle-aged

and older people with

Type 2 diabetes

has found that lowering blood sugar actually

increased their risk of death, researchers

reported Wednesday.

The researchers announced that they were abruptly

halting that part of the study,

whose surprising results call into question how

the disease, which affects 21 million

Americans, should be managed.

The study's investigators emphasized that

patients should still consult with their

doctors before considering changing their medications.

Among the study participants who were randomly assigned to get their

blood sugar levels

to nearly normal, there were 54 more deaths

than in the group whose levels were

less rigidly controlled. The patients were in the

study for an average of four years

when investigators called a halt to the intensive

blood sugar lowering and put all

of them on the less intense regimen.

The results do not mean blood sugar is

meaningless. Lowered blood sugar can protect

against kidney disease,

blindness

and amputations, but the findings inject an

element of uncertainty into what has

been dogma - that the lower the blood sugar the

better and that lowering blood sugar

levels to normal saves lives.

Medical experts were stunned.

" It's confusing and disturbing that this

happened, " said Dr. Dove, president

of the American College of Cardiology. " For 50

years, we've talked about getting

blood sugar very low. Everything in the

literature would suggest this is the right

thing to do, " he added.

Dr. Irl Hirsch, a diabetes researcher at the

University of Washington

, said the study's results would be hard to

explain to some patients who have spent

years and made an enormous effort, through

diet

and medication, getting and keeping their blood

sugar down. They will not want to

relax their vigilance, he said.

" It will be similar to what many women felt when they heard the news about

estrogen

, " Dr. Hirsch said. " Telling these patients to

get their blood sugar up will be very

difficult. "

Dr. Hirsch added that organizations like the

American Diabetes Association would

be in a quandary. Its guidelines call for blood

sugar targets as close to normal

as possible.

And some insurance companies pay doctors extra if

their diabetic patients get their

levels very low.

The low-blood sugar hypothesis was so entrenched

that when the National Heart, Lung

and Blood Institute and the National Institute of

Diabetes and Digestive and Kidney

Diseases proposed the study in the 1990s, they

explained that it would be ethical.

Even though most people assumed that lower blood

sugar was better, no one had rigorously

tested the idea. So the study would ask if very

low blood sugar levels

in people with Type 2 diabetes - the form that

affects 95 percent of people with

the disease - would protect against heart disease and save lives.

Some said that the study, even if ethical, would

be impossible. They doubted that

participants - whose average age was 62, who had

had diabetes for about 10 years,

who had higher than average blood sugar levels,

and who also had heart disease or

had other conditions, like

high blood pressure

and high

cholesterol

, that placed them at additional risk of heart

disease - would ever achieve such

low blood sugar levels.

Study patients were randomly assigned to one of

three types of treatments: one comparing

intensity of blood sugar control; another

comparing intensity of cholesterol control;

and the third comparing intensity of

blood pressure

control. The cholesterol and blood pressure

parts of the study are continuing.

Dr. Buse, the vice-chairman of the study's

steering committee and the president

of medicine and science at the American Diabetes

Association, described what was

required to get blood sugar levels low, as measured by a protein,

hemoglobin

A1C

, which was supposed to be at 6 percent or less.

" Many were taking four or five shots of insulin a

day, " he said. " Some were using

insulin pumps. Some were monitoring their blood

sugar seven or eight times a day. "

They also took pills to lower their blood sugar,

in addition to the pills they took

for other medical conditions and to lower their

blood pressure and cholesterol. They

also came to a medical clinic every two months

and had frequent telephone conversations

with clinic staff.

Those assigned to the less stringent blood sugar

control, an A1C level of 7.0 to

7.9 percent, had an easier time of it. They

measured their blood sugar once or twice

a day, went to the clinic every four months and

took fewer drugs or lower doses.

So it was quite a surprise when the patients who

had worked so hard to get their

blood sugar low had a significantly higher death

rate, the study investigators said.

The researchers asked whether there were any

drugs or drug combinations that might

have been to blame. They found none, said Dr.

G. Simons-Morton, a project

officer for the study at the National Heart, Lung

and Blood Institute. Even the drug

Avandia

, suspected of increasing the risk of heart

attacks in diabetes, did not appear to

contribute to the increased death rate.

Nor was there an unusual cause of death in the

intensively treated group, Dr. Simons-Morton

said. Most of the deaths in both groups were from heart attacks, she added.

For now, the reasons for the higher death rate

are up for speculation. Clearly, people

without diabetes are different from people who

have diabetes and get their blood

sugar low.

It might be that patients suffered unintended

consequences from taking so many drugs,

which might interact in unexpected ways, said Dr.

E. Nissen, chairman of the

department of cardiovascular medicine at the Cleveland Clinic.

Or it may be that participants reduced their

blood sugar too fast, Dr. Hirsch said.

Years ago, researchers discovered that lowering

blood sugar very quickly in diabetes

could actually worsen blood vessel disease in the

eyes, he said. But reducing levels

more slowly protected those blood vessels.

And there are troubling questions about what the

study means for people who are younger

and who do not have cardiovascular disease.

Should they forgo the low blood sugar

targets?

No one knows.

Other medical experts say that they will be

discussing and debating the results for

some time.

" It is a great study and very well run, " Dr. Dove

said. " And it certainly had the

right principles behind it. "

But maybe, he said, " there may be some scientific

principles that don't hold water

in a diabetic population. "

[Guest guest]

I agree with this statement. Sounds good to me.

Diabetes Study Partially Halted After Deaths

I saw a report about this topic on PBS this evening.

Larry Gassman

February 7, 2008

By

GINA KOLATA

For decades, researchers believed that if people with

diabetes

lowered their blood sugar to normal levels,

they would no longer be at high risk

of dying from heart disease. But a major federal

study of more than 10,000 middle-aged

and older people with

Type 2 diabetes

has found that lowering blood sugar actually

increased their risk of death, researchers

reported Wednesday.

The researchers announced that they were abruptly

halting that part of the study,

whose surprising results call into question how

the disease, which affects 21 million

Americans, should be managed.

The study's investigators emphasized that

patients should still consult with their

doctors before considering changing their medications.

Among the study participants who were randomly assigned to get their

blood sugar levels

to nearly normal, there were 54 more deaths

than in the group whose levels were

less rigidly controlled. The patients were in the

study for an average of four years

when investigators called a halt to the intensive

blood sugar lowering and put all

of them on the less intense regimen.

The results do not mean blood sugar is

meaningless. Lowered blood sugar can protect

against kidney disease,

blindness

and amputations, but the findings inject an

element of uncertainty into what has

been dogma - that the lower the blood sugar the

better and that lowering blood sugar

levels to normal saves lives.

Medical experts were stunned.

" It's confusing and disturbing that this

happened, " said Dr. Dove, president

of the American College of Cardiology. " For 50

years, we've talked about getting

blood sugar very low. Everything in the

literature would suggest this is the right

thing to do, " he added.

Dr. Irl Hirsch, a diabetes researcher at the

University of Washington

, said the study's results would be hard to

explain to some patients who have spent

years and made an enormous effort, through

diet

and medication, getting and keeping their blood

sugar down. They will not want to

relax their vigilance, he said.

" It will be similar to what many women felt when they heard the news about

estrogen

, " Dr. Hirsch said. " Telling these patients to

get their blood sugar up will be very

difficult. "

Dr. Hirsch added that organizations like the

American Diabetes Association would

be in a quandary. Its guidelines call for blood

sugar targets as close to normal

as possible.

And some insurance companies pay doctors extra if

their diabetic patients get their

levels very low.

The low-blood sugar hypothesis was so entrenched

that when the National Heart, Lung

and Blood Institute and the National Institute of

Diabetes and Digestive and Kidney

Diseases proposed the study in the 1990s, they

explained that it would be ethical.

Even though most people assumed that lower blood

sugar was better, no one had rigorously

tested the idea. So the study would ask if very

low blood sugar levels

in people with Type 2 diabetes - the form that

affects 95 percent of people with

the disease - would protect against heart disease and save lives.

Some said that the study, even if ethical, would

be impossible. They doubted that

participants - whose average age was 62, who had

had diabetes for about 10 years,

who had higher than average blood sugar levels,

and who also had heart disease or

had other conditions, like

high blood pressure

and high

cholesterol

, that placed them at additional risk of heart

disease - would ever achieve such

low blood sugar levels.

Study patients were randomly assigned to one of

three types of treatments: one comparing

intensity of blood sugar control; another

comparing intensity of cholesterol control;

and the third comparing intensity of

blood pressure

control. The cholesterol and blood pressure

parts of the study are continuing.

Dr. Buse, the vice-chairman of the study's

steering committee and the president

of medicine and science at the American Diabetes

Association, described what was

required to get blood sugar levels low, as measured by a protein,

hemoglobin

A1C

, which was supposed to be at 6 percent or less.

" Many were taking four or five shots of insulin a

day, " he said. " Some were using

insulin pumps. Some were monitoring their blood

sugar seven or eight times a day. "

They also took pills to lower their blood sugar,

in addition to the pills they took

for other medical conditions and to lower their

blood pressure and cholesterol. They

also came to a medical clinic every two months

and had frequent telephone conversations

with clinic staff.

Those assigned to the less stringent blood sugar

control, an A1C level of 7.0 to

7.9 percent, had an easier time of it. They

measured their blood sugar once or twice

a day, went to the clinic every four months and

took fewer drugs or lower doses.

So it was quite a surprise when the patients who

had worked so hard to get their

blood sugar low had a significantly higher death

rate, the study investigators said.

The researchers asked whether there were any

drugs or drug combinations that might

have been to blame. They found none, said Dr.

G. Simons-Morton, a project

officer for the study at the National Heart, Lung

and Blood Institute. Even the drug

Avandia

, suspected of increasing the risk of heart

attacks in diabetes, did not appear to

contribute to the increased death rate.

Nor was there an unusual cause of death in the

intensively treated group, Dr. Simons-Morton

said. Most of the deaths in both groups were from heart attacks, she added.

For now, the reasons for the higher death rate

are up for speculation. Clearly, people

without diabetes are different from people who

have diabetes and get their blood

sugar low.

It might be that patients suffered unintended

consequences from taking so many drugs,

which might interact in unexpected ways, said Dr.

E. Nissen, chairman of the

department of cardiovascular medicine at the Cleveland Clinic.

Or it may be that participants reduced their

blood sugar too fast, Dr. Hirsch said.

Years ago, researchers discovered that lowering

blood sugar very quickly in diabetes

could actually worsen blood vessel disease in the

eyes, he said. But reducing levels

more slowly protected those blood vessels.

And there are troubling questions about what the

study means for people who are younger

and who do not have cardiovascular disease.

Should they forgo the low blood sugar

targets?

No one knows.

Other medical experts say that they will be

discussing and debating the results for

some time.

" It is a great study and very well run, " Dr. Dove

said. " And it certainly had the

right principles behind it. "

But maybe, he said, " there may be some scientific

principles that don't hold water

in a diabetic population. "

[Guest guest]

You are probably right, Becky! We are all born to die, I guess, but the

length of time living is what keeps us reading and following these

articles!

Diabetes Study Partially Halted After Deaths

I saw a report about this topic on PBS this evening.

Larry Gassman

February 7, 2008

By

GINA KOLATA

For decades, researchers believed that if people with

diabetes

lowered their blood sugar to normal levels,

they would no longer be at high risk

of dying from heart disease. But a major federal

study of more than 10,000 middle-aged

and older people with

Type 2 diabetes

has found that lowering blood sugar actually

increased their risk of death, researchers

reported Wednesday.

The researchers announced that they were abruptly

halting that part of the study,

whose surprising results call into question how

the disease, which affects 21 million

Americans, should be managed.

The study's investigators emphasized that

patients should still consult with their

doctors before considering changing their medications.

Among the study participants who were randomly assigned to get their

blood sugar levels

to nearly normal, there were 54 more deaths

than in the group whose levels were

less rigidly controlled. The patients were in the

study for an average of four years

when investigators called a halt to the intensive

blood sugar lowering and put all

of them on the less intense regimen.

The results do not mean blood sugar is

meaningless. Lowered blood sugar can protect

against kidney disease,

blindness

and amputations, but the findings inject an

element of uncertainty into what has

been dogma - that the lower the blood sugar the

better and that lowering blood sugar

levels to normal saves lives.

Medical experts were stunned.

" It's confusing and disturbing that this

happened, " said Dr. Dove, president

of the American College of Cardiology. " For 50

years, we've talked about getting

blood sugar very low. Everything in the

literature would suggest this is the right

thing to do, " he added.

Dr. Irl Hirsch, a diabetes researcher at the

University of Washington

, said the study's results would be hard to

explain to some patients who have spent

years and made an enormous effort, through

diet

and medication, getting and keeping their blood

sugar down. They will not want to

relax their vigilance, he said.

" It will be similar to what many women felt when they heard the news

about

estrogen

, " Dr. Hirsch said. " Telling these patients to

get their blood sugar up will be very

difficult. "

Dr. Hirsch added that organizations like the

American Diabetes Association would

be in a quandary. Its guidelines call for blood

sugar targets as close to normal

as possible.

And some insurance companies pay doctors extra if

their diabetic patients get their

levels very low.

The low-blood sugar hypothesis was so entrenched

that when the National Heart, Lung

and Blood Institute and the National Institute of

Diabetes and Digestive and Kidney

Diseases proposed the study in the 1990s, they

explained that it would be ethical.

Even though most people assumed that lower blood

sugar was better, no one had rigorously

tested the idea. So the study would ask if very

low blood sugar levels

in people with Type 2 diabetes - the form that

affects 95 percent of people with

the disease - would protect against heart disease and save lives.

Some said that the study, even if ethical, would

be impossible. They doubted that

participants - whose average age was 62, who had

had diabetes for about 10 years,

who had higher than average blood sugar levels,

and who also had heart disease or

had other conditions, like

high blood pressure

and high

cholesterol

, that placed them at additional risk of heart

disease - would ever achieve such

low blood sugar levels.

Study patients were randomly assigned to one of

three types of treatments: one comparing

intensity of blood sugar control; another

comparing intensity of cholesterol control;

and the third comparing intensity of

blood pressure

control. The cholesterol and blood pressure

parts of the study are continuing.

Dr. Buse, the vice-chairman of the study's

steering committee and the president

of medicine and science at the American Diabetes

Association, described what was

required to get blood sugar levels low, as measured by a protein,

hemoglobin

A1C

, which was supposed to be at 6 percent or less.

" Many were taking four or five shots of insulin a

day, " he said. " Some were using

insulin pumps. Some were monitoring their blood

sugar seven or eight times a day. "

They also took pills to lower their blood sugar,

in addition to the pills they took

for other medical conditions and to lower their

blood pressure and cholesterol. They

also came to a medical clinic every two months

and had frequent telephone conversations

with clinic staff.

Those assigned to the less stringent blood sugar

control, an A1C level of 7.0 to

7.9 percent, had an easier time of it. They

measured their blood sugar once or twice

a day, went to the clinic every four months and

took fewer drugs or lower doses.

So it was quite a surprise when the patients who

had worked so hard to get their

blood sugar low had a significantly higher death

rate, the study investigators said.

The researchers asked whether there were any

drugs or drug combinations that might

have been to blame. They found none, said Dr.

G. Simons-Morton, a project

officer for the study at the National Heart, Lung

and Blood Institute. Even the drug

Avandia

, suspected of increasing the risk of heart

attacks in diabetes, did not appear to

contribute to the increased death rate.

Nor was there an unusual cause of death in the

intensively treated group, Dr. Simons-Morton

said. Most of the deaths in both groups were from heart attacks, she

added.

For now, the reasons for the higher death rate

are up for speculation. Clearly, people

without diabetes are different from people who

have diabetes and get their blood

sugar low.

It might be that patients suffered unintended

consequences from taking so many drugs,

which might interact in unexpected ways, said Dr.

E. Nissen, chairman of the

department of cardiovascular medicine at the Cleveland Clinic.

Or it may be that participants reduced their

blood sugar too fast, Dr. Hirsch said.

Years ago, researchers discovered that lowering

blood sugar very quickly in diabetes

could actually worsen blood vessel disease in the

eyes, he said. But reducing levels

more slowly protected those blood vessels.

And there are troubling questions about what the

study means for people who are younger

and who do not have cardiovascular disease.

Should they forgo the low blood sugar

targets?

No one knows.

Other medical experts say that they will be

discussing and debating the results for

some time.

" It is a great study and very well run, " Dr. Dove

said. " And it certainly had the

right principles behind it. "

But maybe, he said, " there may be some scientific

principles that don't hold water

in a diabetic population. "

[Guest guest]

Yes, Becky, this whole thing is very unsettling. And our perceptin of health

has been going on for 40 years, a lot longer than most of us have been in the

diabetes game. I am not sure what to do, and I am not sure who to listen to as

folks come out with the new answers here. It is great to have this place

tolearn and to be accepted no matter our views.

Vicki

Rev 1:7

BEHOLD, HE IS COMING WITH THE CLOUDS, and every eye will see Him, even those who

pierced Him; and all the tribes of the earth will mourn over Him. So it

is to be. Amen.

Rev 1:8

" I am the Alpha and the Omega, " says the Lord God, " who is and who was and who

is to come, the Almighty. "

Diabetes Study Partially Halted After Deaths

I saw a report about this topic on PBS this evening.

Larry Gassman

February 7, 2008

By

GINA KOLATA

For decades, researchers believed that if people with

diabetes

lowered their blood sugar to normal levels,

they would no longer be at high risk

of dying from heart disease. But a major federal

study of more than 10,000 middle-aged

and older people with

Type 2 diabetes

has found that lowering blood sugar actually

increased their risk of death, researchers

reported Wednesday.

The researchers announced that they were abruptly

halting that part of the study,

whose surprising results call into question how

the disease, which affects 21 million

Americans, should be managed.

The study's investigators emphasized that

patients should still consult with their

doctors before considering changing their medications.

Among the study participants who were randomly assigned to get their

blood sugar levels

to nearly normal, there were 54 more deaths

than in the group whose levels were

less rigidly controlled. The patients were in the

study for an average of four years

when investigators called a halt to the intensive

blood sugar lowering and put all

of them on the less intense regimen.

The results do not mean blood sugar is

meaningless. Lowered blood sugar can protect

against kidney disease,

blindness

and amputations, but the findings inject an

element of uncertainty into what has

been dogma - that the lower the blood sugar the

better and that lowering blood sugar

levels to normal saves lives.

Medical experts were stunned.

" It's confusing and disturbing that this

happened, " said Dr. Dove, president

of the American College of Cardiology. " For 50

years, we've talked about getting

blood sugar very low. Everything in the

literature would suggest this is the right

thing to do, " he added.

Dr. Irl Hirsch, a diabetes researcher at the

University of Washington

, said the study's results would be hard to

explain to some patients who have spent

years and made an enormous effort, through

diet

and medication, getting and keeping their blood

sugar down. They will not want to

relax their vigilance, he said.

" It will be similar to what many women felt when they heard the news about

estrogen

, " Dr. Hirsch said. " Telling these patients to

get their blood sugar up will be very

difficult. "

Dr. Hirsch added that organizations like the

American Diabetes Association would

be in a quandary. Its guidelines call for blood

sugar targets as close to normal

as possible.

And some insurance companies pay doctors extra if

their diabetic patients get their

levels very low.

The low-blood sugar hypothesis was so entrenched

that when the National Heart, Lung

and Blood Institute and the National Institute of

Diabetes and Digestive and Kidney

Diseases proposed the study in the 1990s, they

explained that it would be ethical.

Even though most people assumed that lower blood

sugar was better, no one had rigorously

tested the idea. So the study would ask if very

low blood sugar levels

in people with Type 2 diabetes - the form that

affects 95 percent of people with

the disease - would protect against heart disease and save lives.

Some said that the study, even if ethical, would

be impossible. They doubted that

participants - whose average age was 62, who had

had diabetes for about 10 years,

who had higher than average blood sugar levels,

and who also had heart disease or

had other conditions, like

high blood pressure

and high

cholesterol

, that placed them at additional risk of heart

disease - would ever achieve such

low blood sugar levels.

Study patients were randomly assigned to one of

three types of treatments: one comparing

intensity of blood sugar control; another

comparing intensity of cholesterol control;

and the third comparing intensity of

blood pressure

control. The cholesterol and blood pressure

parts of the study are continuing.

Dr. Buse, the vice-chairman of the study's

steering committee and the president

of medicine and science at the American Diabetes

Association, described what was

required to get blood sugar levels low, as measured by a protein,

hemoglobin

A1C

, which was supposed to be at 6 percent or less.

" Many were taking four or five shots of insulin a

day, " he said. " Some were using

insulin pumps. Some were monitoring their blood

sugar seven or eight times a day. "

They also took pills to lower their blood sugar,

in addition to the pills they took

for other medical conditions and to lower their

blood pressure and cholesterol. They

also came to a medical clinic every two months

and had frequent telephone conversations

with clinic staff.

Those assigned to the less stringent blood sugar

control, an A1C level of 7.0 to

7.9 percent, had an easier time of it. They

measured their blood sugar once or twice

a day, went to the clinic every four months and

took fewer drugs or lower doses.

So it was quite a surprise when the patients who

had worked so hard to get their

blood sugar low had a significantly higher death

rate, the study investigators said.

The researchers asked whether there were any

drugs or drug combinations that might

have been to blame. They found none, said Dr.

G. Simons-Morton, a project

officer for the study at the National Heart, Lung

and Blood Institute. Even the drug

Avandia

, suspected of increasing the risk of heart

attacks in diabetes, did not appear to

contribute to the increased death rate.

Nor was there an unusual cause of death in the

intensively treated group, Dr. Simons-Morton

said. Most of the deaths in both groups were from heart attacks, she added.

For now, the reasons for the higher death rate

are up for speculation. Clearly, people

without diabetes are different from people who

have diabetes and get their blood

sugar low.

It might be that patients suffered unintended

consequences from taking so many drugs,

which might interact in unexpected ways, said Dr.

E. Nissen, chairman of the

department of cardiovascular medicine at the Cleveland Clinic.

Or it may be that participants reduced their

blood sugar too fast, Dr. Hirsch said.

Years ago, researchers discovered that lowering

blood sugar very quickly in diabetes

could actually worsen blood vessel disease in the

eyes, he said. But reducing levels

more slowly protected those blood vessels.

And there are troubling questions about what the

study means for people who are younger

and who do not have cardiovascular disease.

Should they forgo the low blood sugar

targets?

No one knows.

Other medical experts say that they will be

discussing and debating the results for

some time.

" It is a great study and very well run, " Dr. Dove

said. " And it certainly had the

right principles behind it. "

But maybe, he said, " there may be some scientific

principles that don't hold water

in a diabetic population. "

[Guest guest]

Since K. Bernstein, M. D. is a 72 year old type1 diabetic who practices

running normal A1C's, that is they typically run 4.5-4.7, do you think we ought

to tell him he is running a risk of a heart attack or stroke? I hear he run

such A1C's to avoid diabetic complications.

Diabetes Study Partially Halted After Deaths

I saw a report about this topic on PBS this evening.

Larry Gassman

February 7, 2008

By

GINA KOLATA

For decades, researchers believed that if people with

diabetes

lowered their blood sugar to normal levels,

they would no longer be at high risk

of dying from heart disease. But a major federal

study of more than 10,000 middle-aged

and older people with

Type 2 diabetes

has found that lowering blood sugar actually

increased their risk of death, researchers

reported Wednesday.

The researchers announced that they were abruptly

halting that part of the study,

whose surprising results call into question how

the disease, which affects 21 million

Americans, should be managed.

The study's investigators emphasized that

patients should still consult with their

doctors before considering changing their medications.

Among the study participants who were randomly assigned to get their

blood sugar levels

to nearly normal, there were 54 more deaths

than in the group whose levels were

less rigidly controlled. The patients were in the

study for an average of four years

when investigators called a halt to the intensive

blood sugar lowering and put all

of them on the less intense regimen.

The results do not mean blood sugar is

meaningless. Lowered blood sugar can protect

against kidney disease,

blindness

and amputations, but the findings inject an

element of uncertainty into what has

been dogma - that the lower the blood sugar the

better and that lowering blood sugar

levels to normal saves lives.

Medical experts were stunned.

" It's confusing and disturbing that this

happened, " said Dr. Dove, president

of the American College of Cardiology. " For 50

years, we've talked about getting

blood sugar very low. Everything in the

literature would suggest this is the right

thing to do, " he added.

Dr. Irl Hirsch, a diabetes researcher at the

University of Washington

, said the study's results would be hard to

explain to some patients who have spent

years and made an enormous effort, through

diet

and medication, getting and keeping their blood

sugar down. They will not want to

relax their vigilance, he said.

" It will be similar to what many women felt when they heard the news

about

estrogen

, " Dr. Hirsch said. " Telling these patients to

get their blood sugar up will be very

difficult. "

Dr. Hirsch added that organizations like the

American Diabetes Association would

be in a quandary. Its guidelines call for blood

sugar targets as close to normal

as possible.

And some insurance companies pay doctors extra if

their diabetic patients get their

levels very low.

The low-blood sugar hypothesis was so entrenched

that when the National Heart, Lung

and Blood Institute and the National Institute of

Diabetes and Digestive and Kidney

Diseases proposed the study in the 1990s, they

explained that it would be ethical.

Even though most people assumed that lower blood

sugar was better, no one had rigorously

tested the idea. So the study would ask if very

low blood sugar levels

in people with Type 2 diabetes - the form that

affects 95 percent of people with

the disease - would protect against heart disease and save lives.

Some said that the study, even if ethical, would

be impossible. They doubted that

participants - whose average age was 62, who had

had diabetes for about 10 years,

who had higher than average blood sugar levels,

and who also had heart disease or

had other conditions, like

high blood pressure

and high

cholesterol

, that placed them at additional risk of heart

disease - would ever achieve such

low blood sugar levels.

Study patients were randomly assigned to one of

three types of treatments: one comparing

intensity of blood sugar control; another

comparing intensity of cholesterol control;

and the third comparing intensity of

blood pressure

control. The cholesterol and blood pressure

parts of the study are continuing.

Dr. Buse, the vice-chairman of the study's

steering committee and the president

of medicine and science at the American Diabetes

Association, described what was

required to get blood sugar levels low, as measured by a protein,

hemoglobin

A1C

, which was supposed to be at 6 percent or less.

" Many were taking four or five shots of insulin a

day, " he said. " Some were using

insulin pumps. Some were monitoring their blood

sugar seven or eight times a day. "

They also took pills to lower their blood sugar,

in addition to the pills they took

for other medical conditions and to lower their

blood pressure and cholesterol. They

also came to a medical clinic every two months

and had frequent telephone conversations

with clinic staff.

Those assigned to the less stringent blood sugar

control, an A1C level of 7.0 to

7.9 percent, had an easier time of it. They

measured their blood sugar once or twice

a day, went to the clinic every four months and

took fewer drugs or lower doses.

So it was quite a surprise when the patients who

had worked so hard to get their

blood sugar low had a significantly higher death

rate, the study investigators said.

The researchers asked whether there were any

drugs or drug combinations that might

have been to blame. They found none, said Dr.

G. Simons-Morton, a project

officer for the study at the National Heart, Lung

and Blood Institute. Even the drug

Avandia

, suspected of increasing the risk of heart

attacks in diabetes, did not appear to

contribute to the increased death rate.

Nor was there an unusual cause of death in the

intensively treated group, Dr. Simons-Morton

said. Most of the deaths in both groups were from heart attacks, she

added.

For now, the reasons for the higher death rate

are up for speculation. Clearly, people

without diabetes are different from people who

have diabetes and get their blood

sugar low.

It might be that patients suffered unintended

consequences from taking so many drugs,

which might interact in unexpected ways, said Dr.

E. Nissen, chairman of the

department of cardiovascular medicine at the Cleveland Clinic.

Or it may be that participants reduced their

blood sugar too fast, Dr. Hirsch said.

Years ago, researchers discovered that lowering

blood sugar very quickly in diabetes

could actually worsen blood vessel disease in the

eyes, he said. But reducing levels

more slowly protected those blood vessels.

And there are troubling questions about what the

study means for people who are younger

and who do not have cardiovascular disease.

Should they forgo the low blood sugar

targets?

No one knows.

Other medical experts say that they will be

discussing and debating the results for

some time.

" It is a great study and very well run, " Dr. Dove

said. " And it certainly had the

right principles behind it. "

But maybe, he said, " there may be some scientific

principles that don't hold water

in a diabetic population. "

[Guest guest]

before u attack the doctor i think u should read his books. as u know he himself

is a diabetic and his wife and he are doctors. he has clinics to help care for

diabetics and i know i owe my good blood sugars to his research and information

reading his books. karen from canada

Diabetes Study Partially Halted After Deaths

I saw a report about this topic on PBS this evening.

Larry Gassman

February 7, 2008

By

GINA KOLATA

For decades, researchers believed that if people with

diabetes

lowered their blood sugar to normal levels,

they would no longer be at high risk

of dying from heart disease. But a major federal

study of more than 10,000 middle-aged

and older people with

Type 2 diabetes

has found that lowering blood sugar actually

increased their risk of death, researchers

reported Wednesday.

The researchers announced that they were abruptly

halting that part of the study,

whose surprising results call into question how

the disease, which affects 21 million

Americans, should be managed.

The study's investigators emphasized that

patients should still consult with their

doctors before considering changing their medications.

Among the study participants who were randomly assigned to get their

blood sugar levels

to nearly normal, there were 54 more deaths

than in the group whose levels were

less rigidly controlled. The patients were in the

study for an average of four years

when investigators called a halt to the intensive

blood sugar lowering and put all

of them on the less intense regimen.

The results do not mean blood sugar is

meaningless. Lowered blood sugar can protect

against kidney disease,

blindness

and amputations, but the findings inject an

element of uncertainty into what has

been dogma - that the lower the blood sugar the

better and that lowering blood sugar

levels to normal saves lives.

Medical experts were stunned.

" It's confusing and disturbing that this

happened, " said Dr. Dove, president

of the American College of Cardiology. " For 50

years, we've talked about getting

blood sugar very low. Everything in the

literature would suggest this is the right

thing to do, " he added.

Dr. Irl Hirsch, a diabetes researcher at the

University of Washington

, said the study's results would be hard to

explain to some patients who have spent

years and made an enormous effort, through

diet

and medication, getting and keeping their blood

sugar down. They will not want to

relax their vigilance, he said.

" It will be similar to what many women felt when they heard the news

about

estrogen

, " Dr. Hirsch said. " Telling these patients to

get their blood sugar up will be very

difficult. "

Dr. Hirsch added that organizations like the

American Diabetes Association would

be in a quandary. Its guidelines call for blood

sugar targets as close to normal

as possible.

And some insurance companies pay doctors extra if

their diabetic patients get their

levels very low.

The low-blood sugar hypothesis was so entrenched

that when the National Heart, Lung

and Blood Institute and the National Institute of

Diabetes and Digestive and Kidney

Diseases proposed the study in the 1990s, they

explained that it would be ethical.

Even though most people assumed that lower blood

sugar was better, no one had rigorously

tested the idea. So the study would ask if very

low blood sugar levels

in people with Type 2 diabetes - the form that

affects 95 percent of people with

the disease - would protect against heart disease and save lives.

Some said that the study, even if ethical, would

be impossible. They doubted that

participants - whose average age was 62, who had

had diabetes for about 10 years,

who had higher than average blood sugar levels,

and who also had heart disease or

had other conditions, like

high blood pressure

and high

cholesterol

, that placed them at additional risk of heart

disease - would ever achieve such

low blood sugar levels.

Study patients were randomly assigned to one of

three types of treatments: one comparing

intensity of blood sugar control; another

comparing intensity of cholesterol control;

and the third comparing intensity of

blood pressure

control. The cholesterol and blood pressure

parts of the study are continuing.

Dr. Buse, the vice-chairman of the study's

steering committee and the president

of medicine and science at the American Diabetes

Association, described what was

required to get blood sugar levels low, as measured by a protein,

hemoglobin

A1C

, which was supposed to be at 6 percent or less.

" Many were taking four or five shots of insulin a

day, " he said. " Some were using

insulin pumps. Some were monitoring their blood

sugar seven or eight times a day. "

They also took pills to lower their blood sugar,

in addition to the pills they took

for other medical conditions and to lower their

blood pressure and cholesterol. They

also came to a medical clinic every two months

and had frequent telephone conversations

with clinic staff.

Those assigned to the less stringent blood sugar

control, an A1C level of 7.0 to

7.9 percent, had an easier time of it. They

measured their blood sugar once or twice

a day, went to the clinic every four months and

took fewer drugs or lower doses.

So it was quite a surprise when the patients who

had worked so hard to get their

blood sugar low had a significantly higher death

rate, the study investigators said.

The researchers asked whether there were any

drugs or drug combinations that might

have been to blame. They found none, said Dr.

G. Simons-Morton, a project

officer for the study at the National Heart, Lung

and Blood Institute. Even the drug

Avandia

, suspected of increasing the risk of heart

attacks in diabetes, did not appear to

contribute to the increased death rate.

Nor was there an unusual cause of death in the

intensively treated group, Dr. Simons-Morton

said. Most of the deaths in both groups were from heart attacks, she

added.

For now, the reasons for the higher death rate

are up for speculation. Clearly, people

without diabetes are different from people who

have diabetes and get their blood

sugar low.

It might be that patients suffered unintended

consequences from taking so many drugs,

which might interact in unexpected ways, said Dr.

E. Nissen, chairman of the

department of cardiovascular medicine at the Cleveland Clinic.

Or it may be that participants reduced their

blood sugar too fast, Dr. Hirsch said.

Years ago, researchers discovered that lowering

blood sugar very quickly in diabetes

could actually worsen blood vessel disease in the

eyes, he said. But reducing levels

more slowly protected those blood vessels.

And there are troubling questions about what the

study means for people who are younger

and who do not have cardiovascular disease.

Should they forgo the low blood sugar

targets?

No one knows.

Other medical experts say that they will be

discussing and debating the results for

some time.

" It is a great study and very well run, " Dr. Dove

said. " And it certainly had the

right principles behind it. "

But maybe, he said, " there may be some scientific

principles that don't hold water

in a diabetic population. "

[Guest guest]

, dear, there was only one mention of Dr. Bernstein in this entire

thread, as attached to your note. And that mention was quite favorable to

the good doctor.

I have brought this up before and I really should look up the source, but

maybe Harry knows of it. People will believe things they intellectually

know not to be true when those things affect them. Generally, the more dyre

a person's situation, the more outrageous propositions will be accepted.

I always try to keep that in mind when I assess whether or not something

might be true or maybe is just a false life rope I am clutching for.

The mind that is closed to possibility is a mind that is wasted. So to is

the mind that is locked onto an idea to the exclusion of all others.

Re: Diabetes Study Partially Halted After Deaths

before u attack the doctor i think u should read his books. as u know he

himself is a diabetic and his wife and he are doctors. he has clinics to

help care for diabetics and i know i owe my good blood sugars to his

research and information reading his books. karen from canada

Diabetes Study Partially Halted After Deaths

I saw a report about this topic on PBS this evening.

Larry Gassman

February 7, 2008

By

GINA KOLATA

For decades, researchers believed that if people with

diabetes

lowered their blood sugar to normal levels,

they would no longer be at high risk

of dying from heart disease. But a major federal

study of more than 10,000 middle-aged

and older people with

Type 2 diabetes

has found that lowering blood sugar actually

increased their risk of death, researchers

reported Wednesday.

The researchers announced that they were abruptly

halting that part of the study,

whose surprising results call into question how

the disease, which affects 21 million

Americans, should be managed.

The study's investigators emphasized that

patients should still consult with their

doctors before considering changing their medications.

Among the study participants who were randomly assigned to get their

blood sugar levels

to nearly normal, there were 54 more deaths

than in the group whose levels were

less rigidly controlled. The patients were in the

study for an average of four years

when investigators called a halt to the intensive

blood sugar lowering and put all

of them on the less intense regimen.

The results do not mean blood sugar is

meaningless. Lowered blood sugar can protect

against kidney disease,

blindness

and amputations, but the findings inject an

element of uncertainty into what has

been dogma - that the lower the blood sugar the

better and that lowering blood sugar

levels to normal saves lives.

Medical experts were stunned.

" It's confusing and disturbing that this

happened, " said Dr. Dove, president

of the American College of Cardiology. " For 50

years, we've talked about getting

blood sugar very low. Everything in the

literature would suggest this is the right

thing to do, " he added.

Dr. Irl Hirsch, a diabetes researcher at the

University of Washington

, said the study's results would be hard to

explain to some patients who have spent

years and made an enormous effort, through

diet

and medication, getting and keeping their blood

sugar down. They will not want to

relax their vigilance, he said.

" It will be similar to what many women felt when they heard the news

about

estrogen

, " Dr. Hirsch said. " Telling these patients to

get their blood sugar up will be very

difficult. "

Dr. Hirsch added that organizations like the

American Diabetes Association would

be in a quandary. Its guidelines call for blood

sugar targets as close to normal

as possible.

And some insurance companies pay doctors extra if

their diabetic patients get their

levels very low.

The low-blood sugar hypothesis was so entrenched

that when the National Heart, Lung

and Blood Institute and the National Institute of

Diabetes and Digestive and Kidney

Diseases proposed the study in the 1990s, they

explained that it would be ethical.

Even though most people assumed that lower blood

sugar was better, no one had rigorously

tested the idea. So the study would ask if very

low blood sugar levels

in people with Type 2 diabetes - the form that

affects 95 percent of people with

the disease - would protect against heart disease and save lives.

Some said that the study, even if ethical, would

be impossible. They doubted that

participants - whose average age was 62, who had

had diabetes for about 10 years,

who had higher than average blood sugar levels,

and who also had heart disease or

had other conditions, like

high blood pressure

and high

cholesterol

, that placed them at additional risk of heart

disease - would ever achieve such

low blood sugar levels.

Study patients were randomly assigned to one of

three types of treatments: one comparing

intensity of blood sugar control; another

comparing intensity of cholesterol control;

and the third comparing intensity of

blood pressure

control. The cholesterol and blood pressure

parts of the study are continuing.

Dr. Buse, the vice-chairman of the study's

steering committee and the president

of medicine and science at the American Diabetes

Association, described what was

required to get blood sugar levels low, as measured by a protein,

hemoglobin

A1C

, which was supposed to be at 6 percent or less.

" Many were taking four or five shots of insulin a

day, " he said. " Some were using

insulin pumps. Some were monitoring their blood

sugar seven or eight times a day. "

They also took pills to lower their blood sugar,

in addition to the pills they took

for other medical conditions and to lower their

blood pressure and cholesterol. They

also came to a medical clinic every two months

and had frequent telephone conversations

with clinic staff.

Those assigned to the less stringent blood sugar

control, an A1C level of 7.0 to

7.9 percent, had an easier time of it. They

measured their blood sugar once or twice

a day, went to the clinic every four months and

took fewer drugs or lower doses.

So it was quite a surprise when the patients who

had worked so hard to get their

blood sugar low had a significantly higher death

rate, the study investigators said.

The researchers asked whether there were any

drugs or drug combinations that might

have been to blame. They found none, said Dr.

G. Simons-Morton, a project

officer for the study at the National Heart, Lung

and Blood Institute. Even the drug

Avandia

, suspected of increasing the risk of heart

attacks in diabetes, did not appear to

contribute to the increased death rate.

Nor was there an unusual cause of death in the

intensively treated group, Dr. Simons-Morton

said. Most of the deaths in both groups were from heart attacks, she

added.

For now, the reasons for the higher death rate

are up for speculation. Clearly, people

without diabetes are different from people who

have diabetes and get their blood

sugar low.

It might be that patients suffered unintended

consequences from taking so many drugs,

which might interact in unexpected ways, said Dr.

E. Nissen, chairman of the

department of cardiovascular medicine at the Cleveland Clinic.

Or it may be that participants reduced their

blood sugar too fast, Dr. Hirsch said.

Years ago, researchers discovered that lowering

blood sugar very quickly in diabetes

could actually worsen blood vessel disease in the

eyes, he said. But reducing levels

more slowly protected those blood vessels.

And there are troubling questions about what the

study means for people who are younger

and who do not have cardiovascular disease.

Should they forgo the low blood sugar

targets?

No one knows.

Other medical experts say that they will be

discussing and debating the results for

some time.

" It is a great study and very well run, " Dr. Dove

said. " And it certainly had the

right principles behind it. "

But maybe, he said, " there may be some scientific

principles that don't hold water

in a diabetic population. "

[Guest guest]

I am quite sure if you show Dr. Bernstein a better way he would adopt it He is

a strong believer in the scientific method. To be a scientist one must first be

skeptical of all findings, methods and results. A true scientist is even

skeptical of his own findings, because he knows if there is one slight speck of

contradictory evidence, his theory has to be reworked.

Diabetes Study Partially Halted After Deaths

I saw a report about this topic on PBS this evening.

Larry Gassman

February 7, 2008

By

GINA KOLATA

For decades, researchers believed that if people with

diabetes

lowered their blood sugar to normal levels,

they would no longer be at high risk

of dying from heart disease. But a major federal

study of more than 10,000 middle-aged

and older people with

Type 2 diabetes

has found that lowering blood sugar actually

increased their risk of death, researchers

reported Wednesday.

The researchers announced that they were abruptly

halting that part of the study,

whose surprising results call into question how

the disease, which affects 21 million

Americans, should be managed.

The study's investigators emphasized that

patients should still consult with their

doctors before considering changing their medications.

Among the study participants who were randomly assigned to get their

blood sugar levels

to nearly normal, there were 54 more deaths

than in the group whose levels were

less rigidly controlled. The patients were in the

study for an average of four years

when investigators called a halt to the intensive

blood sugar lowering and put all

of them on the less intense regimen.

The results do not mean blood sugar is

meaningless. Lowered blood sugar can protect

against kidney disease,

blindness

and amputations, but the findings inject an

element of uncertainty into what has

been dogma - that the lower the blood sugar the

better and that lowering blood sugar

levels to normal saves lives.

Medical experts were stunned.

" It's confusing and disturbing that this

happened, " said Dr. Dove, president

of the American College of Cardiology. " For 50

years, we've talked about getting

blood sugar very low. Everything in the

literature would suggest this is the right

thing to do, " he added.

Dr. Irl Hirsch, a diabetes researcher at the

University of Washington

, said the study's results would be hard to

explain to some patients who have spent

years and made an enormous effort, through

diet

and medication, getting and keeping their blood

sugar down. They will not want to

relax their vigilance, he said.

" It will be similar to what many women felt when they heard the news

about

estrogen

, " Dr. Hirsch said. " Telling these patients to

get their blood sugar up will be very

difficult. "

Dr. Hirsch added that organizations like the

American Diabetes Association would

be in a quandary. Its guidelines call for blood

sugar targets as close to normal

as possible.

And some insurance companies pay doctors extra if

their diabetic patients get their

levels very low.

The low-blood sugar hypothesis was so entrenched

that when the National Heart, Lung

and Blood Institute and the National Institute of

Diabetes and Digestive and Kidney

Diseases proposed the study in the 1990s, they

explained that it would be ethical.

Even though most people assumed that lower blood

sugar was better, no one had rigorously

tested the idea. So the study would ask if very

low blood sugar levels

in people with Type 2 diabetes - the form that

affects 95 percent of people with

the disease - would protect against heart disease and save lives.

Some said that the study, even if ethical, would

be impossible. They doubted that

participants - whose average age was 62, who had

had diabetes for about 10 years,

who had higher than average blood sugar levels,

and who also had heart disease or

had other conditions, like

high blood pressure

and high

cholesterol

, that placed them at additional risk of heart

disease - would ever achieve such

low blood sugar levels.

Study patients were randomly assigned to one of

three types of treatments: one comparing

intensity of blood sugar control; another

comparing intensity of cholesterol control;

and the third comparing intensity of

blood pressure

control. The cholesterol and blood pressure

parts of the study are continuing.

Dr. Buse, the vice-chairman of the study's

steering committee and the president

of medicine and science at the American Diabetes

Association, described what was

required to get blood sugar levels low, as measured by a protein,

hemoglobin

A1C

, which was supposed to be at 6 percent or less.

" Many were taking four or five shots of insulin a

day, " he said. " Some were using

insulin pumps. Some were monitoring their blood

sugar seven or eight times a day. "

They also took pills to lower their blood sugar,

in addition to the pills they took

for other medical conditions and to lower their

blood pressure and cholesterol. They

also came to a medical clinic every two months

and had frequent telephone conversations

with clinic staff.

Those assigned to the less stringent blood sugar

control, an A1C level of 7.0 to

7.9 percent, had an easier time of it. They

measured their blood sugar once or twice

a day, went to the clinic every four months and

took fewer drugs or lower doses.

So it was quite a surprise when the patients who

had worked so hard to get their

blood sugar low had a significantly higher death

rate, the study investigators said.

The researchers asked whether there were any

drugs or drug combinations that might

have been to blame. They found none, said Dr.

G. Simons-Morton, a project

officer for the study at the National Heart, Lung

and Blood Institute. Even the drug

Avandia

, suspected of increasing the risk of heart

attacks in diabetes, did not appear to

contribute to the increased death rate.

Nor was there an unusual cause of death in the

intensively treated group, Dr. Simons-Morton

said. Most of the deaths in both groups were from heart attacks, she

added.

For now, the reasons for the higher death rate

are up for speculation. Clearly, people

without diabetes are different from people who

have diabetes and get their blood

sugar low.

It might be that patients suffered unintended

consequences from taking so many drugs,

which might interact in unexpected ways, said Dr.

E. Nissen, chairman of the

department of cardiovascular medicine at the Cleveland Clinic.

Or it may be that participants reduced their

blood sugar too fast, Dr. Hirsch said.

Years ago, researchers discovered that lowering

blood sugar very quickly in diabetes

could actually worsen blood vessel disease in the

eyes, he said. But reducing levels

more slowly protected those blood vessels.

And there are troubling questions about what the

study means for people who are younger

and who do not have cardiovascular disease.

Should they forgo the low blood sugar

targets?

No one knows.

Other medical experts say that they will be

discussing and debating the results for

some time.

" It is a great study and very well run, " Dr. Dove

said. " And it certainly had the

right principles behind it. "

But maybe, he said, " there may be some scientific

principles that don't hold water

in a diabetic population. "