A Diabetes Study health club

Re “Study Undercuts Diabetes Theory” (front page, Feb. 7):

While the interim results of the Accord trial may be disappointing to patients with Type 2 diabetes, it is important to remember that there is incontrovertible evidence from the 20-year Diabetes Control and Complications Trial that controlling high blood glucose levels does indeed prevent vascular complications.

The most recent data from this trial even demonstrated a benefit of intensive treatment of blood glucose on cardiovascular disease, an effect that persisted many years after the formal study ended.

Of course, patients with Type 2 diabetes have many other risk factors for heart disease in addition to high blood glucose, including older age, overweight or obesity, high blood pressure and abnormal lipids. The interplay between all these risk factors and glucose is likely the reason that people with diabetes are at such high risk for heart attacks.

Finally, it is clear that people with Type 2 diabetes are at the same risk for developing eye, kidney and nerve problems from high blood glucose levels as patients with Type 1 and therefore will benefit from proper control of blood glucose.

Also, since the level of blood glucose control being tested in the Accord trial was significantly lower than that ordinarily achieved in medical practice, their results should not be taken as evidence that current standards should be abandoned. For all these reasons, most diabetes experts will continue to tell their patients to keep their blood glucose levels as near to normal as feasible.

Jill P. Crandall
Harry Shamoon
Bronx, Feb. 7, 2008

The writer are medical doctors at the Diabetes Research Center, Albert Einstein College of Medicine.

•

To the Editor:

The results of the Accord study are not surprising. Diabetes is not a disease of blood sugar; it is a disease of faulty hormonal signaling, particularly insulin and leptin.

The increased mortality seen in the diabetics in this study is not from lowering the sugar, but from the treatment that neglects and often worsens the underlying cause of insulin resistance.

Until medical “science” begins to recognize the difference between symptoms and disease we will continue to see results such as this and the recent Vytorin (Enhance) cholesterol-lowering study, where the treatment itself becomes the disease.