Guest guest Posted June 23, 2003 Report Share Posted June 23, 2003 Mon, 23 Jun 2003 12:28:33 -0500 HSI - Jenny Thompson Double Whammy Double Whammy Health Sciences Institute e-Alert June 23, 2003 ************************************************************** Dear Reader, Patients with type 2 diabetes can reduce the risk of a heart attack or a stroke by 25 percent by using cholesterol- lowering statin drugs - even if they don't have elevated cholesterol levels - according to two recent studies. I'm sure that's all the information that many diabetic patients will ever hear as their doctors write out prescriptions for popular statins. But you can be certain that there are gremlins in the details. ----------------------------- Deep pockets ----------------------------- Here are the high points of the two studies: A five-year trial from Britain's Oxford University that tested the statin Zocor on almost 6,000 subjects with type 2 diabetes found that the drug reduced the rate of heart attacks and strokes by about a quarter. A four-year study of nearly 3,000 type 2 diabetics was halted last week when preliminary results showed that the statin Lipitor lowered their risk of heart attack and stroke " significantly. " Specifics of the results from the University College of London study are not yet available. Researchers stopped the study because they felt that it was unethical to deprive the placebo group of the possible life- saving effects of the drug. Large trials like this over a long period of time are very expensive - far too expensive for independent research. So it's not really a surprise that Merck (the maker of Zocor) funded the Oxford research, and Pfizer (the maker of Lipitor) wrote the checks for the University College of London study. It is interesting, however, that the announcement of the halting of the Lipitor trial came just two days after the Zocor results were published. With potentially billions of dollars of market share at stake, you have to wonder if the Pfizer execs might have made a snap decision to put the breaks on the trial just to steal the thunder from the Zocor announcement and claim their share of the T2D market. Having seen how the bottom line mentality of these huge drug companies work, I wouldn't put it past them. ----------------------------- Good as gold ----------------------------- Obesity, as we're frequently reminded in the media these days, is reaching " epidemic " proportions in the US. And obesity among middle-aged people frequently leads to type 2 diabetes. There are currently an estimated 150 million diabetics worldwide, and 17 million of them are in the United States. And needless to say, those numbers are on the rise. So, if you manufacture a well-known drug that makes billions of dollars every year, the gold mine you're already sitting on would expand considerably if you could convince even a small percentage of 150 million diabetics that they need your drug to save their lives. But just how impressive are those " significant " study results? There's no question that diabetics are at greater risk of heart attack and stroke than people who are in good health. Now, just by reading to this point, you know I'm not a fan of statin drugs (and that's without reading the dozens of other e-Alerts I've written about their overuse and potential danger to your health). But if taking a statin genuinely reduces a diabetic's risk of heart attack and stroke by 25 percent, isn't that really worth any additional risk? Perhaps, but keep in mind that many diabetics are already taking prescription drugs to treat hyperglycemia, blood pressure, and other problems. In extreme cases most of those prescriptions may be necessary, but for millions of people there are entirely better ways to cope with type 2 diabetes and reduce the risk of cardiovascular events at the same time, without becoming a Pfizer or Merck customer for life. ----------------------------- Behavior modified ----------------------------- Most cases of type 2 diabetes are the result of poor diet and insufficient exercising habits that catch up with us as we age. But the insulin resistance that triggers type 2 diabetes can often be reversed by modifying the diet and beginning a regular exercise program. In the e-Alert I sent you last year titled " Common Sense Approach To Treating Type II Diabetes " (2/13/02), I told you about a New England Journal of Medicine study involving more than 3,200 adults (average age was 51) who were diagnosed with pre-diabetic elevated glucose levels. Subjects were divided into three groups: one group received a daily dose of the prescription antihyperglycemic drug Glucophage; one group received a daily placebo; and one group participated in an intensive program with a goal of at least 7 percent weight loss through diet adjustment, two and a half hours of moderate exercise each week, and educational sessions to reinforce behavior modification. After following these subjects for an average of almost 3 years, the researchers found that Glucophage reduced the incidence of diabetes by about 30 percent versus placebo, but lifestyle changes slashed the incidence rate by more than HALF - a full 58 percent. Plus, patients in the Glucophage group had SIX TIMES more gastrointestinal side effects than those in the exercise and diet group. ----------------------------- Here comes the pitch ----------------------------- On the heels of the Lipitor and Zocor trials, I'm sure that we'll be hearing much more from the mainstream about the wonderful benefits that type 2 diabetics can enjoy with a daily statin dose. And it won't be a hard sell. The " magic pill " pitch rarely fails to win over busy doctors and their patients who may feel overwhelmed and desperate for a simple solution. And already the American Diabetes Association is considering a change in their guidelines to include a statin drug recommendation. But as we've learned over the years and through many studies, quick fixes often create as many problems as they solve. It's certainly harder to exercise and stick to a diet (no one knows that better than me), but the rewards are far healthier than creating a dependence on a dangerous mix of pharmaceuticals. ************************************************************** ...and another thing Dr. Bill caught me. That is - an HSI member who signs himself simply " Dr. Bill, " sent an e-mail to point out an omission in last week's e- Alert " Nothing But Net " (6/17/03), in which I compared four high-protein, low-carb bars, and one bar that was high-carb, low-protein. Dr. Bill wrote: " Maybe I'm blind, but in your reporting I didn't find the number of grams of protein, in what are billed as high protein bars. " Good news - you're not blind, Dr. B. I was so focused on the carb column - and couldn't get the taste of that " ultimate " one out of my mouth - that I completely overlooked noting the proteins. In addition, someone else pointed out that they'd like to know the sodium content of each bar as well. So here's the info I left out last Tuesday. (Keep in mind, these numbers are only for the flavor listed.): Pure Protein (S'mores): 21 grams protein / 70 mg sodium Atkins Advantage (Chocolate Peanut Butter): 19 grams protein / 180 mg sodium Carb Solutions High Protein Bar (Chocolate Cappuccino Crisp): 26 grams protein / 170 mg sodium Ultimate Lo Carb Bar (Amaratto Irish Cream): 21 grams protein / 340 mg sodium Fruit & Nut Delight (Fruit and nut): 6 grams protein / 72 mg sodium This consumer reporting business is harder than it looks! To Your Good Health, Jenny Thompson Health Sciences Institute ************************************************************** Sources: " MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial " The Lancet; 361: 2005-16, 6/14/02, thelancet.com " Lipitor Cuts Diabetics' Heart Attack Risk " Ransdell Pierson, Reuters, 6/16/03, reuters.com " Patients Taking Pfizer's Lipitor Show Significant Cardiovascular Benefit, Major Study Shows " Canada NewsWire, 6/16/03, newswire.ca " Study Backs Statin Drugs for Millions of Diabetics " Reuters, 6/16/03, reuters.com " Statins Seen As Aid to Diabetics " Thomas H. Maugh II, The Baltimore Sun, 6/16/03, sunspot.net " Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin " The New England Journal of Medicine 2002;346:393-403, nejm.org Copyright ©1997-2003 by www.hsibaltimore.com, L.L.C. The e-Alert may not be posted on commercial sites without written permission. ************************************************************** Before you hit reply to send us a question or request, please click here http://www.hsibaltimore.com/ealert/questions.html ************************************************************** Gettingwell- / Vitamins, Herbs, Aminos, etc. To , e-mail to: Gettingwell- Or, go to our group site: Gettingwell SBC DSL - Now only $29.95 per month! Quote Link to comment Share on other sites More sharing options...
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