Diabetes Forums » Living with Diabetes » Diabetes » ACCORD interpretation reconsidered ...


Welcome to Diabetes Forums!

You are currently viewing our boards as a guest which gives you limited access to view most discussions and access our other features. By joining our free community you will have access to post topics, communicate privately with other members (PM), respond to polls, upload content and access many other special features.

Registration is fast, simple and absolutely free so please, join our community today!

If you have any problems with the registration process or your account login, please contact contact us.


Reply
ACCORD interpretation reconsidered ... LinkBack Thread Tools Display Modes
  #1 (permalink)  
Old 06-09-2009, 02:59 PM
Senior Member
I am a: Type 1.5
 
Join Date: Feb 2009
Location: KCMO
Posts: 5,422
ACCORD interpretation reconsidered ...

Analyses raise new questions about diabetes care - Yahoo! News

Well, well .... please discuss among yourselves ...
__________________
Linda

Initial A1c Feb 6 09: 12%
Aug 24 A1c (MD office) 5.5%
Jul ... C-pep 1.3, GAD-65 > 30

metformin 1000 mg BID
Simvastatin 80 mg
Ramipril 5 mg
T4 125 mcg
baby aspirin
Vitamin D3, 2000 IU (blood values normal, advised to continue this dose by endo)
CoQ10 100 mg
Eating 70 - 90 g carb per day
Interval training on recumbent cycle
BMI is down to ca. 25.8



According to Joslin's Diabetes, 2005 ed., 5 - 30% of those diagnosed as Type 2 actually have LADA.
Reply With Quote
  #2 (permalink)  
Old 06-10-2009, 12:56 AM
Harold's Avatar
Super Moderator
I am a: Type 2
 
Join Date: Feb 2002
Location: Do Dah, OZ, aka Kansas
Posts: 5,098
You might wan to read this thread and link to the abstract.
Reply With Quote
  #3 (permalink)  
Old 06-10-2009, 01:49 AM
Senior Member
I am a: Type 1
 
Join Date: Jan 2007
Location: UK, Hampshire
Posts: 740
You might want to read this critique of the study, you may not agree with all the authors points

http://junkfoodscience.blogspot.com/...ontrol-of.html

The bit you might be interested in is this graph...



Taken altogether the studies show no overall benefit to mortality, but what you will notice is a left to right shift in mortality as we travel through the studies. VADT and ACCORD come out above 1.0, although the VADT result should be read as no difference in mortality between treatment and placebo group. The ACCORD study does however show a significant increase in deaths.

What is interesting however is the following difference between VADT/ACCORD & UKPDS

Quote:
Junkfoodscience wrote
In fact, the meta-analysis found greater risks of dying among those with the most intensive pharmacological management of blood sugars. The two trials (VADT and ACCORD) showing the highest risks for overall deaths were on patients with the more advanced diseases (10-12 years from first diagnosed compared to 8 years in all but one* of the other trials). The patients also had the highest HbA1c levels at the start of the trials (9.4 - 8.3% compared to 7.9 - 7.1% in the other trials), meaning they also required more medications to bring their HbA1c levels below 7%. More intensive pharmacological management and advanced disease was associated with greater risks of dying.
caveat - these are the blogger's conclusions not the study authors, but however it is a serious challenge. If you have had type 2 for a long time and need lots of medication to attain an A1c below 7.0%, trying to keep it there might actually shorten your life. You might be better off aiming higher.

It would be nice if there was just a simple and straightforward answer <sigh>
Reply With Quote
  #4 (permalink)  
Old 06-10-2009, 08:37 AM
Senior Member
I am a: Type 1.5
 
Join Date: Feb 2009
Location: KCMO
Posts: 5,422
I have read similar criticism of ACCORD elsewhere, REDLAN -- was it Taubes, again?

And it is a very interesting point about the difference in medication usage. (ie, "pharmacological intervention).
__________________
Linda

Initial A1c Feb 6 09: 12%
Aug 24 A1c (MD office) 5.5%
Jul ... C-pep 1.3, GAD-65 > 30

metformin 1000 mg BID
Simvastatin 80 mg
Ramipril 5 mg
T4 125 mcg
baby aspirin
Vitamin D3, 2000 IU (blood values normal, advised to continue this dose by endo)
CoQ10 100 mg
Eating 70 - 90 g carb per day
Interval training on recumbent cycle
BMI is down to ca. 25.8



According to Joslin's Diabetes, 2005 ed., 5 - 30% of those diagnosed as Type 2 actually have LADA.
Reply With Quote

Reply


Thread Tools
Display Modes
Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

vB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are On

» Log in
User Name:

Password:

Not a member yet?
Register Now!

All times are GMT -7. The time now is 08:52 PM.

For Advertising:

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33