Earlier this year I posted about the ACCORD study that was discontinued because more subjects in the intensive-glucose-control arm of the study were dying than were those whose glucose was less strictly controlled. In this post I made the case that one of the reasons this might be happening is that the strict-glucose-control was brought about by various drug regimens, none of which address the underlying problem of too much insulin. If insulin resistance and hyperinsulinemia are the real problems here (and my bet is that they are), drug combinations deal only with one of the symptoms – the elevated glucose of type II diabetes – and not the underlying problem. The underlying problems continue to chug along causing more disease, disability and death. (Another possibility is that the drugs themselves are causing the increase in death.) All of which doesn’t really make the outcome all that surprising.
And even less surprising is the horde of diabetes ‘experts’ who are stampeding over the cliff with the idea that careful glucose control isn’t the panacea they had hoped it would be. Unfortunately, it isn’t they who will be splattered on the rocks below; it will be their patients instead.
Last week’s New England Journal of Medicine published the ACCORD study (full text here), and the authors concluded:
As compared with standard therapy, the use of intensive therapy to target normal glycated hemoglobin levels for 3.5 years increased mortality and did not significantly reduce major cardiovascular events. These findings identify a previously unrecognized harm of intensive glucose lowering in high-risk patients with type 2 diabetes.
The implication of these conclusions is that focusing on blood sugar control is a fool’s errand irrespective of how the blood sugar is controlled.
The low-carb diet is probably the single most effective method known of reducing insulin resistance, hyperinsulinemia and elevated blood sugar, yet it was ignored in the ACCORD study. And, unfortunately, is pretty much ignored throughout the mainstream medical community. Dr. Richard Feinman and the Nutrition & Metabolism society (of which yours truly is a member in good standing) would like to see that rectified. You can help by signing the petition below that will be presented to the NIH and/or other organizations (ADA, for example) and governmental bodies.
Here is the full text of the petition.
NIH must acknowledge existing science!
National Institute of Health re: the ACCORD Diabetes Study: “Intensively targeting blood sugar to near-normal levels … increases risk of death. ”
This statement is untrue. This study lowered blood glucose levels only by aggressive drug treatment.
Preventative measures and proven non-drug treatments are being ignored by the NIH, ADA and many other governing agencies.
There is abundant scientific evidence proving a carbohydrate restricted diet can be as effective as drugs in lowering blood glucose levels safely. Many times diet is more effective than medication in controlling diabetes – all without side effects or increased risk of death.
I ask that the NIH publically retract the above statement. It is misleading the public.
I also request that the NIH acknowledge the existing science and fund more research by the experts who have experience with carbohydrate restriction as a means of treatment for diabetes.
For more info, or to help people with diabetes, please e-mail info@nmsociety.org .
Thank you.
Click here for petition
As always, these things carry much more weight if they are personalized, so take a minute and add a brief comment about your own experience with low-carb diets.
Thanks from all of us at the Nutrition and Metabolism Society in helping us reach our goal of 15,000 signatures.
This reminded me of an article by Dr. Malcolm Kendrick:
http://www.thincs.org/Malcolm3.htm#July%2029
(please forgive me if the link doesn’t come across).
If research has been ‘discredited,’ how can it be rectified? Once one bogus (or just plain incorrect) study has been published, and later studies reference it, are those later studies tracked and re-evaluated also?
Just wondering how the ‘system’ works. Dr. Kendrick also has several other articles that cast a critical eye on medical research and publications (He’s also a very engaging writer, too!)
Sadly, once such discredited research makes it into print, it’s pretty much there forever.
A few months ago I read a quote used to substantiate a position an author took in an exchange of views in a prestigious medical journal. The quote was referenced as coming from an obscure, difficult to find government publication. I tracked down the publication and combed it for the quote, but was never able to find it. I contacted the author of the letter in which the quote appeared. He was kind enough to answer my query and honest enough to tell me that he had put the quote together mistakenly – it didn’t actually exist in any form even near the way it was quoted in the journal (with quotation marks and all).
When I Googled the quote, I found it picked up by a number of other authors and referenced the same way. How much of this goes on? Who knows? I’m sure a lot more than we expect.
Reminds me of one of my most recent visits to the hospital. I am a non-diabetic on metformin for issues pertaining to insulin resistance and hyperinsulinemia. I am a low carb eater. In the hospital I was greeted 3 meals a day with a plate of sugar and starch–potatoes, bread, corn, cheerios, muffins, bananas, etc. The protein: (not kidding) sweet & sour chicken or similar (no matter what the meat, it had to be breaded or otherwise dipped in sugar/cornstarch). There was a can of regular pepsi. There was a cup of coffee. I was offered a choice of desserts. This was all supposedly on a diabetic meal plan. (I had to con a cup of cottage cheese or something green out of the nurses from time to time. Apparently I am not supposed to have such fatty things on a diabetic meal plan.)
Needless to say, because I was alternately fasting (read: looking at this junk and suddenly not feeling hungry) and having to eat the stuff they were giving me so as not to starve, my blood sugar (which they insisted on checking daily because they could not believe I was not diabetic “at my weight”) was all over the map. One time the nurse came in after testing me and explained in a calm and cheerful voice that she was ready to give me my insulin shot (“just a teeny bit, you aren’t that high”). My jaw hit the floor. Then I refused to take any such thing until someone could show in my most recent bloodwork that my insulin levels were low.
So, in a nutshell, if this is what they refer to as “intensively targeting blood sugar to near-normal levels,” I can see why it kills. *Facepalm*
Unbelievable. But, unfortunately, what passes for standard medical care in a whole lot of places. Really, really tragic. And they wonder why were in the midst of a diabetes epidemic.
Mike,
“Blog of the Month” no less! Congrats!
I am now (belatedly) a member … not sure about the “good standing” bit though …
One sentence leapt out at me from the ACCORD paper;
“All patients provided written informed consent.”
I doubt many of us would use “informed” in the same way.
Oh yes and;
“This study was not designed to test the components of the intervention strategy.”
Hard to disagree with that one … but they still got it funded anyway!
Cheers,
Malcolm