Re: Lower A1c's Increase Death Risk?
Andrew B. Chung, MD/PhD
diabetic.
Lowering HgbA1c with medications invariably increase frequency and
severity of hypoglycemic attacks in our collective clinical experience
among those of us who are practicing physicians.
ACCORD is simply mirroring the reality of clinical experience with
managing type-2 diabetics.
Smarter to lower HgbA1c by eating less, down to the optimal amount
with concomitant downward titration of diabetic medications to avoid
hypoglycemia:
Be hungry... be healthy... be hungrier... be blessed:
http://TheWellnessFoundation.com/BeHealthy
Prayerfully in the infinite power and might of the Holy Spirit,
Andrew <><
--
Andrew B. Chung, MD/PhD
Lawful steward of http://EmoryCardiology.com
Bondservant to the KING of kings and LORD of lords.
morris wrote:
> Is that what the cessation of the ACCORD Study, announced today is
> really saying? Or just in high risk patients? or...?
> Morris
> *********************************************************
> MSNBC.com
> Major diabetes trial halted after deaths
> 257 patients died after intense therapy to lower blood sugar, NIH
> reports
> The Associated Press
> updated 7:34 a.m. PT, Wed., Feb. 6, 2008
>
> WASHINGTON - An unexpected number of deaths among patients receiving
> intense therapy to lower their blood sugar forced the National
> Institutes of Health to abruptly cut short part of a major study on
> diabetes and heart disease.
>
> The therapy was aimed at reducing to normal levels the blood sugar of
> type 2 diabetics at especially high risk of heart attack and stroke.
> There were 257 deaths among people receiving intense diabetes
> treatment, compared with 203 in the standard treatment group, NIH's
> National Heart Lung and Blood Institute said.
>
> More than 18 million Americans have diabetes, with type 2 the most
> common form.
>
> Last fall the Food and Drug Administration added new warnings to the
> label of the popular diabetes drug Avandia, listing concerns about
> heart ailments. However, in Wednesday's announcement NHLBI officials
> stressed that they have been unable to link the increased deaths in
> the study to any drug, including Avandia.
>
> Some 10,251 people were enrolled in the Action to Control
> Cardiovascular Risk in Diabetes study, with an average participation
> time of four years.
>
> The participants were in groups receiving three types of treatment,
> intensive lowering of blood sugar, lowering blood pressure or reducing
> cholesterol.
>
> "A thorough review of the data shows that the medical treatment
> strategy of intensively reducing blood sugar below current clinical
> guidelines causes harm in these especially high-risk patients with
> type 2 diabetes," said Dr. Elizabeth G. Nabel, director of the
> institute.
>
> "Though we have stopped this part of the trial, we will continue to
> care for these participants, who now will receive the less-intensive
> standard treatment. In addition, we will continue to monitor the
> health of all participants, seek the underlying causes for this
> finding, and carry on with other important research within ACCORD,"
> she said in a statement.
>
> Multiple risk factors
> The study focuses on treatments for adults with type 2 diabetes, the
> most common form, who are at especially high risk for heart disease,
> meaning they had at least two risk factors, which include high blood
> pressure, high cholesterol, obesity and smoking.
>
> Dr. William Friedewald, professor of Public Health and Medicine at
> Columbia University, and chairman of the ACCORD Steering Committee,
> said that there were "about 10 percent fewer nonfatal cardiovascular
> events such as heart attacks in the intensive treatment group compared
> to the standard treatment group. However, it appeared that, if a heart
> attack did occur, it was more likely to be fatal. In addition, the
> intensive treatment group had more unexpected sudden deaths, even
> without a clear heart attack."
>
> The action was recommended by an independent advisory group of experts
> in diabetes, heart disease, epidemiology, patient care, biostatistics,
> medical ethics and clinical trial design that has been monitoring
> ACCORD since it began.
>
> Participants will continue to receive blood sugar treatment from their
> study clinicians until the planned trial conclusion in June 2009.
>
> Nabel stressed that diabetes patients should not change their
> treatment without consulting their doctor. The American Diabetes
> Association agreed and said it continues to encourage control of blood
> sugar in treatment of diabetes.
>
> NHLBI said the intensive treatment group had a target blood sugar goal
> of less than 6 percent, which is similar to blood sugar levels in
> adults without diabetes. The standard treatment group aimed for a
> target similar to what is achieved, on average, by those with diabetes
> in the United States, of 7 to 7.9 percent.
>
> (c) 2008 The Associated Press. All rights reserved. This material may
> not be published, broadcast, rewritten or redistributed.
Andrew B. Chung, MD/PhD
> morris <morri...@comcast.net> wrote:
>
> >WASHINGTON - An unexpected number of deaths among patients receiving
> >intense therapy to lower their blood sugar forced the National
> >Institutes of Health to abruptly cut short part of a major study on
> >diabetes and heart disease.
>
>
> I find it fascinating how a results lead to conclusions.
Results are supposed to lead folks to concluding.
> The patients receiving intensive therapy were more likely to die.
Because patients were randomly assigned to the various levels of
intensity of therapies to lower their blood sugar, the patients were
not different from those assigned to less intense therapy.
Bottom line:
The patients assigned to receive intensive medical therapy were not
more likely to die so that the discovery that they were more likely to
die upon receiving intensive medical therapy leads those of us trained
in the scientific method to conclude that intensive medical therapy to
lower blood glucose places patients at higher risk for death.
Andrew B. Chung, MD/PhD
> "morris" <morri...@comcast.net> wrote in message
> news:3b1bdf96-6870-4661...@1g2000hsl.googlegroups.com...
> > Is that what the cessation of the ACCORD Study, announced today is
> > really saying? Or just in high risk patients? or...?
> > Morris
> > *********************************************************
>
> thanks for the link
>
> This is not for speed readers ; I managed to find the whole study and the
> protocol > 100 pages :(
>
> Here are my 2 cents :
> 1) In the ACCORD study there were ONLY patients that had MORE THAN 1 problem
> : obesity , smoking , heart , T2D
>
> 2) The patients in the intensive treatment group had to lower their A1c with
> medication and medical nutrition therapy.See below for the enormous amount
> of medication.The medical nutrition theraphy followed the ADA diet
> recommandations for a healthy diet
>
> 3) So they started with lots of whole grains and carbohydrates in their
> diets
>
> 4) Thus they were put on insulin , raising their insulin resistance ,
> icreasing their BMI
>
> 5) The carbohydrates in their diet raised their LDL levels and thus their
> symvastin and other drugs medication were increased
>
> 5) Within 3 months most of the patients used : a cholesterol drug , insulin
> and 1 or 2 other T2D drugs !!!!
>
> This study clearly demonstrates the failure of the current treatment
> paradigma's for T2D : eat "healthy" and use all necessary drugs to
> compensate for the complications.
>
> I would like to see another group that were given the skills , education
> etc to lower their A1c by diet & exercise while minimizing (instead of
> maximizing) their drug intake
>
> Maybe Gary Taubes has an opinion on this
>
> I'm not making this up read the original statements by the authors here :
> ============================================
> The news release :
> http://www.eurekalert.org/pub_releases/2008-02/nhla-ibs020608.php
>
> They were also enrolled in one of two other ACCORD randomized clinical
> trials examining effects of treatments for blood pressure or blood lipids;
> those study components will continue. Participants had been followed for 2
> years to 7 years at the time the intensive blood sugar control treatment was
> stopped.
>
> For both the intensive and standard treatment groups, study clinicians could
> use all major classes of diabetes medications available: metformin,
> thiazolidinediones (TZDs, primarily rosiglitazone), insulins, sulfonylureas,
> exanatide, and acarbose.
>
> "Because of the recent concerns with rosiglitazone, our extensive analysis
> included a specific review to determine whether there was any link between
> this particular medication and the increased deaths. We found no link," said
> William T. Friedewald, M.D., ACCORD Steering Committee Chair and Clinical
> Professor of Medicine and Public Health at Columbia University.
>
> The Accord website:
> http://www.accordtrial.org/public/index.cfm
>
> The Accord Protocol:
> http://www.accordtrial.org/public/protocol_2005-05-11.pdf
> Page 54 :
> For example, within 6 months of randomization, most intensive group
> participants will likely be on 3 or more injections of insulin per day in
> addition to 2 or 3 oral agents.
>
> Page 59 :
> Self-titration of Anti-hyperglycemic Therapy
> Standard therapy participants will be provided with simple algorithms to
> allow them to self-titrate their oral therapy or insulin to avoid
> hypoglycemia. They will also be instructed to call the clinic if they are
> recording frequent low SMBG values (see Table 3.2); if they have any episode
> of severe hypoglycemia; if they are experiencing frequent episodes of
> symptomatic hypoglycemia (>1/week); or if they have any symptoms of
> hyperglycemia. In these instances, therapy can be adjusted.
>
> Page 61 :
> Glycemia Medications Available Within ACCORD
> The following classes of antihyperglycemic drugs are available within
> ACCORD:
> a) biguanides (e.g., metformin)
> b) secretagogues (e.g., sulfonylureas such as glimepiride and meglitinides
> such as repaglinide)
> c) thiazolidinediones (e.g., rosiglitazone)
> d) alpha-glucosidase inhibitors (e.g., acarbose)
> e) insulins (e.g., NPH, ultralente, glargine, aspart, regular).
>
> Page 78 :
> Medical Nutrition Therapy
> Medical Nutrition Therapy (MNT) consists of weight control and dietary
> modification. The American Diabetes Association (ADA) position statement on
> "Nutrition Recommendations and Principles for People with Diabetes Mellitus"
> reports that "medical nutrition therapy is integral to total diabetes care
> and an essential component of successful diabetes management" (ADA 2000a).
Clearly the focus on lowering blood glucose in type-2 diabetics to
improve health is wrong:
http://groups.google.com/group/alt.support.diabetes/msg/eb22e6e360a743cf?
It is time to direct the focus on removing the harmful black fat
(visceral adipose tissue aka VAT) that is the source of the
proinflammatory adipocytokines (PIACs) that are fueling the
inflammatory cascade which is the proximate cause of the insulin
resistance (IR/MetS) that caused the type-2 diabetes from the outset:
tr...@is-best.com
"The patients assigned to receive intensive medical therapy were not
more likely to die so that the discovery that they were more likely to
die upon receiving intensive medical therapy leads those of us trained
in the scientific method to conclude that intensive medical therapy to
lower blood glucose places patients at higher risk for death."
Were you to really rely on science you would with great shame of face
beg our pardon for such trash thinking.
Whatever benefit a training in science might have once given you has
long since been submerged into service to a non-scientific agenda of
confusion and lateral cognative lurches far removed from reality.
God bless.
Andrew B. Chung, MD/PhD
tr...@is-best.com
Andrew B. Chung, MD/PhD
Nicky wrote:
> On Thu, 07 Feb 2008 12:50:13 GMT, "Peter C" <pet...@hotmail.co.uk>
> wrote:
> >A bit of a poke in the eye for the six per cent club though ;-)
> >
>
> You volunteering to go higher and see how well you feel on it?!
>
> Nicky.
> T2 dx 05/04 + underactive thyroid
> D&E, 100ug thyroxine
> Last A1c 5.6% BMI 25
feli...@gmail.com
<heartdo...@emorycardiology.com> wrote:
> friend GysdeJongh wrote:
.
.
.
> > Page 78 :
> > Medical Nutrition Therapy
> > Medical Nutrition Therapy (MNT) consists of weight control and dietary
> > modification. The American Diabetes Association (ADA) position statement on
> > "Nutrition Recommendations and Principles for People with Diabetes Mellitus"
> > reports that "medical nutrition therapy is integral to total diabetes care
> > and an essential component of successful diabetes management" (ADA 2000a).
>
> Clearly the focus on lowering blood glucose in type-2 diabetics to
> improve health is wrong:
>
>
> It is time to direct the focus on removing the harmful black fat
> (visceral adipose tissue aka VAT) that is the source of the
> proinflammatory adipocytokines (PIACs) that are fueling the
> inflammatory cascade which is the proximate cause of the insulin
> resistance (IR/MetS) that caused the type-2 diabetes from the outset:
And visceral adipose tissue is "black fat"....why, exactly?
Procyonophile
Andrew B. Chung, MD/PhD
The same reason that subcutaneous adipose tissue is white fat.
Truth is simple.
May you and other dear neighbors, friends, and brethren have a
blessedly wonderful 2008th year since the birth of our LORD Jesus
Christ as the Son of Man ...
... by being hungrier:
http://TruthRUS.org/KnowingGOD
Hunger is wonderful :-)
It's how we know what GOD wants, which is what is good.
Yes, hunger is our knowledge of good versus evil that Adam and Eve
paid for with their and our immortal lives.
Those who suffer from the powerful delusion predicted by the prophecy
of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! )
forever ...
http://HeartMDPhD.com/Convicts/CrazyOne
http://HeartMDPhD.com/Convicts/CrazyTwo
http://HeartMDPhD.com/Convicts/CrazyThree
http://HeartMDPhD.com/Convicts/CrazyFour
http://HeartMDPhD.com/Convicts/Bob
... gone:
http://YouTube.com/watch?v=Qb6d_z5C35E
Such will be the demise of all those who refuse to know **and** love
the truth, Who is LORD Jesus Christ:
http://HeartMDPhD.com/Love/TheTruth
Be hungry... be healthy... be hungrier... be blessed:
http://HeartMDPhD.com/HolySpirit/BeBlessed
"Blessed are you who hunger NOW...
... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21)
Amen.
feli...@gmail.com
<heartdo...@emorycardiology.com> wrote:
> feliph...@gmail.com wrote:
> > Andrew, in the Holy Spirit, boldly wrote:
> > > friend GysdeJongh wrote:
> > .
> > .
> > .
> > > > Page 78 :
> > > > Medical Nutrition Therapy
> > > > Medical Nutrition Therapy (MNT) consists of weight control and dietary
> > > > modification. The American Diabetes Association (ADA) position statement on
> > > > "Nutrition Recommendations and Principles for People with Diabetes Mellitus"
> > > > reports that "medical nutrition therapy is integral to total diabetes care
> > > > and an essential component of successful diabetes management" (ADA 2000a).
>
> > > Clearly the focus on lowering blood glucose in type-2 diabetics to
> > > improve health is wrong:
>
> > >http://groups.google.com/group/alt.support.diabetes/msg/eb22e6e360a74...
>
> > > It is time to direct the focus on removing the harmful black fat
> > > (visceral adipose tissue aka VAT) that is the source of the
> > > proinflammatory adipocytokines (PIACs) that are fueling the
> > > inflammatory cascade which is the proximate cause of the insulin
> > > resistance (IR/MetS) that caused the type-2 diabetes from the outset:
>
> > And visceral adipose tissue is "black fat"....why, exactly?
>
> The same reason that subcutaneous adipose tissue is white fat.
I am unable to unearth a single reference wihch describes VAT a
being "black".
Perhaps you will provide one or more?
Procyonophile
Andrew B. Chung, MD/PhD
GOD has provided those who work at slaughterhouses to testify to this.
They call the VAT of slaughtered animals...
B L A C K F A T
May dear neighbors, friends, and brethren have a blessedly wonderful
feli...@gmail.com
Actually, I'd rather talk about human adipose tissue,
and I'd rather take the word of medical researchers over
hearsay alleged to have come from unspecified
slaughterhouse workers.
And what medical researchers say about human VAT
is that it is primarily white in color, with a minor component
which is brown, due to the presence of mitochondria.
The fraction of brown VAT to white VAT drops sharply
in adulthood, with some workers unable to identify
any at all.
www.jlr.org/cgi/reprint/24/4/381.pdf
http://www.vivo.colostate.edu/hbooks/pathphys/misc_topics/brownfat.html
Procyonophile
Andrew B. Chung, MD/PhD
> Andrew, in the Holy Spirit, boldly wrote:
> > feliph...@gmail.com wrote:
> > > Andrew, in the Holy Spirit, boldly wrote:
> > > > feliph...@gmail.com wrote:
> > > > > Andrew, in the Holy Spirit, boldly wrote:
> > > > > > friend GysdeJongh wrote:
> > > > > .
> > > > > > > Medical Nutrition Therapy
> > > > > > > Medical Nutrition Therapy (MNT) consists of weight control and dietary
> > > > > > > modification. The American Diabetes Association (ADA) position statement on
> > > > > > > "Nutrition Recommendations and Principles for People with Diabetes Mellitus"
> > > > > > > reports that "medical nutrition therapy is integral to total diabetes care
> > > > > > > and an essential component of successful diabetes management" (ADA 2000a).
> >
> > > > > > Clearly the focus on lowering blood glucose in type-2 diabetics to
> > > > > > improve health is wrong:
> >
> > > > > >http://groups.google.com/group/alt.support.diabetes/msg/eb22e6e360a74...
> >
> > > > > > It is time to direct the focus on removing the harmful black fat
> > > > > > (visceral adipose tissue aka VAT) that is the source of the
> > > > > > proinflammatory adipocytokines (PIACs) that are fueling the
> > > > > > inflammatory cascade which is the proximate cause of the insulin
> > > > > > resistance (IR/MetS) that caused the type-2 diabetes from the outset:
> >
> > > > > And visceral adipose tissue is "black fat"....why, exactly?
> >
> > > > The same reason that subcutaneous adipose tissue is white fat.
>
> > > I am unable to unearth a single reference wihch describes VAT a
> > > being "black".
> >
> > > Perhaps you will provide one or more?
>
> > GOD has provided those who work at slaughterhouses to testify to this.
> >
> > They call the VAT of slaughtered animals...
> >
> > B L A C K F A T
>
> Actually, I'd rather talk about human adipose tissue
It is the collective clinical experience of those of us, who are
practicing physicians, who also have biomedical research experience
visiting slaughterhouses, that human VAT is essentially the same as
animal VAT so that calling it "black fat" remains appropriate.
May reading this help motivate folks to eat less, down to the right
amount:
Prayerfully in the infinite power and might of the Holy Spirit,
Andrew <><
--
Andrew B. Chung, MD/PhD
Lawful steward of http://EmoryCardiology.com
Swordbearer for the KING of kings and LORD of lords.
http://HeartMDPhD.com/Sword
feli...@gmail.com
restoring snippage:
> > Actually, I'd rather talk about human adipose tissue
> > and I'd rather take the word of medical researchers over
> > hearsay alleged to have come from unspecified
> > slaughterhouse workers.
> > And what medical researchers say about human VAT
> > is that it is primarily white in color, with a minor component
> > which is brown, due to the presence of mitochondria.
> > The fraction of brown VAT to white VAT drops sharply
> > in adulthood, with some workers unable to identify
> > any at all.
> It is the collective clinical experience of those of us, who are
> practicing physicians, who also have biomedical research experience
> visiting slaughterhouses, that human VAT is essentially the same as
> animal VAT so that calling it "black fat" remains appropriate.
Again, I will take word of published studies in peer-review journals
over that of one practicing -- although I am lately given to
understand
that "practicing" is controversial in this case -- over the word of
one
person claiming to speak, with zero independent confirmation,
for the "collective clinical experience of those of us, who are
practicing physicians".
No physician who I know personally would dream of making so
sweeping, and so upsupportable a claim.
But as always, the interested reader should decide for him/herself:
Andrew B. Chung, MD/PhD
J666
>
> It is the collective clinical experience of those of us, who are
> practicing physicians, who also have biomedical research experience
> visiting slaughterhouses, that human VAT is essentially the same as
> animal VAT so that calling it "black fat" remains appropriate.
>
OAF
Actually with apes and monkeys who are with Dr. Chung in Chung's
captivity in Omersatan, this is true and is one more sign that the
monkeys have taken over Chung's postings or even his mind.
Let us pray for Dr Chung's fast and safe release even though for some
reason God has not chosen to respond to our prayers
Andrew B. Chung, MD/PhD
J666
<heartdo...@emorycardiology.com> wrote:
> http://HeartMDPhD.com/Convicts/OriginalAssinineFool
OAF
This is one more sign that the monkeys have taken over Chung's
postings and even mind.
We have heard that Dr. Chung is up to 2 gallons of bananas a day and
will remain at that level because OmaGOD, the God of the apes, monkeys
and chimpanzees in Omersatan had written in the holy Book, Volume,
that need 2 gallons of bananas everyday per person as OmaGOD supplied
to Mosesape et al when wandering for 40 years in the jungle. This
gets the VAT, Vital Ape Tissue, to the optimal amount.
Let us pray for Dr Chung's fast and safe release and his return to his
usual state of mental health even though for some reason God has not
chosen to respond to our prayers. We must believe that the Holy
"Father Knows Best."
Andrew B. Chung, MD/PhD
> Andrew, in the Holy Spirit, boldly wrote:
>
> > http://HeartMDPhD.com/Convicts/OriginalAssinineFool
>
> OAF
This simply shows your sockpuppet has "black fat" in its brain:
http://HeartMDPhD.com/BlackFat
May we, who are Jesus' brethren, continue to rebuke you at each GOD-
given opportunity as GOD desires:
http://HeartMDPhD.com/Convicts/Rebukesatan
<><
... by being hungrier:
http://TruthRUS.org/KnowingGOD
Hunger is wonderful :-)
http://HeartMDPhD.com/Convicts/CrazyOne
http://HeartMDPhD.com/Convicts/CrazyTwo
http://HeartMDPhD.com/Convicts/CrazyThree
http://HeartMDPhD.com/Convicts/CrazyFour
http://HeartMDPhD.com/Convicts/Bob
... gone:
http://YouTube.com/watch?v=Qb6d_z5C35E
http://HeartMDPhD.com/Love/TheTruth
http://HeartMDPhD.com/HolySpirit/BeBlessed
Amen.
Prayerfully in the infinite power and might of the Holy Spirit,
J666
This is one more sign that the monkeys have taken over Chung's
postings and even mind.
We have heard that Mark D. Sade is opening a BDSM Club in Omersatan -
our worry is that Dr. Chung will be Mark D. Sade's bondservant.
We are making arrangements to open a branch office in Omersatan to be
better work to get Dr. Chung's release.
Let us pray for Dr Chung's fast and safe release and his return to his
usual state of mental health even though for some reason God has not
chosen to respond to our prayers. We must believe that the Holy
"Father Knows Best."
On Feb 12, 5:07 pm, "Two" Poundus/Andrew B. Chung,typed in Omersatan
> Lawful steward ofhttp://EmoryCardiology.com