What is it about adding oral medication
on top of oral medication that romances researchers to believe this
is the only way to treat type 2 diabetes? In my reading over the
last five years, it seems that unless researchers can have a cocktail
of oral diabetes medications, the researchers are not interested.
I doubt I will find out, but it is
interesting to speculate, especially after this from Yale School of
Medicine. Here researchers discovered that aggressive glycemic
control may not reduce risk of kidney failure. The researchers found
that comparing usual treatment and controlling glucose with higher
doses of medication did not improve the chances of preventing kidney
failure.
Since the results are cloaked behind
the veil of money, I am not able to determine what procedures were
used and what combinations of medications, if any, were used. The
write up about the research hides much information that could be of
value. I will say this as I think it could be true also. The
research did not reach the conclusion desired so they salvage
something and explain the minimum to justify the study.
Since insulin is not mentioned or any
other medication by name, it is difficult to give any reliability to
this study. My interpretation is that this is again junk science and
because the results were not what they wanted, we the patients learn
nothing. If they had mentioned the medications by name and really
tried to inform us, we may have learned which medications are useless
for treating end-stage renal problems. I also have to believe that
insulin was not part of the study and only oral medications were
considered.
Since before the ACCORD study, stacking
oral medications seems to be the only way to do studies. With the
exception of Metformin which slows the release of glucose from the
liver, oral medications work on the pancreas to produce more insulin
and this means a quicker demise of the pancreas because it cannot
continue to force out insulin as it is asked to do. Yet, this seems
to be the only topic for research.
Therefore, I think it is time that
studies are required to have a insulin control group to compare the
results of oral medications against to see which gives the most
efficient treatment. Then maybe the studies could have more meaning
and give people with type 2 diabetes some actual comparisons for
determining which treatment to use. Granted, some additional testing
would be required of the pancreas before and after the study to
determine the amount of insulin the pancreas is capable of producing.
This could also open new analysis for
consideration as this is seldom mentioned in any of the current or
recent studies. Who knows, we could have many study participants
that are producing small amounts of insulin and incapable of more
insulin production. This could produce misleading results for any
study if these are the people participating in the study produce
small amounts of insulin and the people in the control group can
produce greater quantities of insulin. The reverse scenario would
produce even more inflated results which the study wants. Yet this
is something seldom seen even in studies given wide publication and
not put behind a wall of money.
If it is the desire to prevent the
general public from analyzing the study, then there needs to be a
standard criteria published that will let the public know that these
procedures were followed. Until this is done, we need to be
skeptical of most studies and how much we should rely on their
accuracy. Oral diabetes medications have their place and study
under different scenarios is needed; however, a group within any
study needs to be using insulin for a more accurate comparison.
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