October 7, 2009

Recent Research: Same Old Same Old

I have not been blogging much about recently published diabetes-related research papers because there has been nothing in any of the major journals worth noting.

As usual, the published research breaks down into the usual categories:

1) Lots of research in rodents fed "high fat diets" that confirm the religious beliefs of the researchers, i.e. fat is bad. The "low fat diets" are always high carb/high fat diets. Even when they aren't the fact that rodents are adapted to completely different diets than humans and that they have differences in their pancreases and digestive systems from humans render 99% of the rodent research meaningless.

2) Lots of associational studies where epidemiologists "prove" that diabetes can be prevented with exercise and low fat or low meat diets by analyzing epidemiological studies that really just show that thin people are less likely to develop diabetes. These studies never eliminate the possibility that thin people are thin because they don't have the underlying genetic flaws that lead to abnormal glucose tolerance--primarily defective beta cells and mitochondria--and hence can eat high carb diets without gaining the weight people with genetic problems gain on that diet.

3) Lots of drug studies where people with A1c of 8-11% are given a drug that drops their A1c around .5% which the researchers conclude shows the drug (always extremely expensive) is extremely effective even though the resulting A1c is high enough to guarantee complications.

4) A few studies run in an attempt to come up with a way of justifying the widespread prescribing of yet another expensive, side effect prone non-diabetes drug to everyone with diabetes. Drugs for depression and psychiatric drugs prescribed for neuropathy feature heavily here.

5) A few very troubling studies that are misinterpreted to conclude that lowering blood sugar is dangerous. Invariably the blood sugar has been lowered with oral drugs that have nasty cardiac side effects. Even in these studies, though, lowering blood sugar significantly decreases kidney failure and neuropathy.

6.) A few studies paid for by food industry organizations which prove based on test tube findings that this, that or another food has miracle healing properties and can reverse diabetes. These studies have in common that blood sugar in people with diabetes is never tested after a sustained period of eating the miracle food.

So for now, nothing has changed.

The best way for someone with Type 2 diabetes to lower blood sugar is still to cut back on carbs, add metformin if they can tolerate it, and start insulin as soon as possible if the first two steps didn't achieve normal blood sugars.

The best way to combat the pain of diabetic neuropathy is to keep your blood sugar under 140 mg/dl at all times. The technique described HERE will do that for most people.

Despite what you read and what doctors tell people, losing weight will NOT reverse diabetes or eliminate insulin resistance. That some studies show this is only because the low calorie diets used to achieve weight loss require the study subjects to cut way down on food which caused them to cut back significantly on carbohydrates no matter what kind of diet they are eating. The good news is you don't have to lose weight to improve your blood sugar. All you have to do is cut back on carbs.

And on that subject, doctors (and most researchers) still have no clue that cutting way down on carbs can normalize blood sugars for most people newly diagnosed with Type 2 and many who have had it for a long time.

Environmental factors are clearly causing a surge in obesity and diabetes. High on the list of these are the domination of our food supply by artificially created food ingredients: High fructose corn syrup turns into insulin-resistance-producing liver fat. Trans fat clogs arteries because your body has no way of removing it. MSG bypasses the normal hunger control mechanisms in the brain and is hidden in most processed and fast foods under deceptive ingredient names. It makes people overeat. The phosphates in sodas and processed foods are also hard on your kidneys. The best thing a person with diabetes can do is to learn to cook from scratch and make as much food at home themselves from basic ingredients.

The side effects of the most heavily marketed drugs continue to be very troubling and the medical press continues to ignore them.

Avandia and Actos are too dangerous for anyone to use. Long term they cause serious osteoporosis. Short term they cause weight gain and the possibility of crippling edema which can lead to heart failure or macular edema leading to blindness.

Sulfonylureas have long been linked to possible heart problems and most recently to a higher risk of cancer.

Januvia and Onglyza cause disturbing changes in the immune system, including rashes, permanent sinusitis, and of most concern they turn off a cancer surpressor gene.

Byetta appears to be helpful as a weight loss drug to one third of those who try it. The possible connection with pancreatitis does not appear to be significant.

Metformin is by far the safest drug available to people with diabetes (unless they have liver or kidney disease) and appears to fight cancer.

Insulin taken early after diagnosis greatly improves the long term outcome for people with Type 2 diabetes but high doses of insulin may promote cancers, so you want to take the very lowest doses of insulin possible, which means you need to keep your carbs low and take metformin with your insulin if possible.

If you are new to diabetes, that's what you need to know in a nutshell.

Too bad the people paid to do diabetes research don't know most of this!



dampmop said...

Thanks for the summary and for clarifying so much of the troubling research we've been hearing about. Your conclusions have certainly been accurate in my husband's case.

Diana said...

Hi Jenny,
I just wanted to back-up what you are saying with my story for any newbies that may be reading this.(I'll try to keep it brief).
I started reading your site (and blood sugar 101) in the summer of 2008. I was not yet diagnosed with Type 2, but had a hunch because I had begun a low carb diet in June 2008 and was feeling 100% better.
Jan 2009, I was dx'd Type 2,(hadn't been for a physical in years, maybe 10!). My A1c was 7.2 (wondering what it would have been before low carb?). Anyway, I began monitoring my blood sugar before, 1 hour and 2 hours after meals, and refined my diet even more. April
A1c was 6.4 (just had shoulder surgery- raised my sugars a bit). August A1c was.....5.1!!!!!!! and holding steady.
I just want everyone to know that this WORKS!! I am so thankful to have found this site. It probably saved my life. I shudder to think how my diabetes would be managed (or not) if I didn't know what I have learned here. If I had been diagnosed a couple of years earlier, I would have been heading down the wrong path for sure. A big THANK YOU!

Diabetic said...

I am using Janumet morning and night after breakfast and dinner. Januvia is 500 mg and metformin 1000 mg combination. Do you think I can eliminate Januvia and what dosage of Metformin is safe.
Many thanks.

renegadediabetic said...

"Too bad the people paid to do diabetes research don't know most of this!"

Yep, they're too wrapped up in ways to make $$$ for big pharma. Cutting carbs doesn't make any $$$ for the medical-pharmaceutical establishment.

Jenny said...


Your question is one that must be answered by your physician. Print out the information you will find on the Januvia page and ask him to discuss your options in light of that data. You might consider printing out Dr. Goldstein's letter to the Annals of Internal Medicine for him too. The link is on the Januvia page.

This information is not well understood by doctors, and a thoughtful doctor should give it some consideration. Mine did when I brought it to her attention.

Anonymous said...

As usual Jenny, you have a way of cutting though all the garbage out there.

Low-carb works. What you say is fact.

But politics and the lure of money are alive and well in the mammoth diabetes industry.

William Houser said...

Do the people who put out this misleading and\or dangerous research ever suffer any penalty for it? Or is the fact that you would trade your personal honour for money or to advance your personal agenda a resume enhancement for someone looking to do a "cooked" study? The first and best thing I did after I was diagnosed was to start my own research and buy Blood Sugar 101. I think the do-it-yourself nature for the management of this disease is the hardest thing for us newbies to get our heads around.

Diabetic said...

Hi Jenny,
Thanks. I will discuss with my physican and discuss the Januvia medication. Incidentally I have lost about 10lbs of weight. I wonder if that is linked to Januvia alone. Recently I have reduced carbs it does seem that 1 hour after food the sugar control is better.