Harvard has finally taken interest in a study performed on diabetics (called ACCORD). I say finally because the study was published two years ago and it showed us something very important: Some people with type II diabetes should not be given too many medications at once. In ACCORD, People who were trying to be good, who did what their doctor ordered when prescribed an aggressive regimen of diabetes medications, were at higher risk of dying than those who didn’t comply or were treated less aggressively.
For the past two years, most medical policy leaders have ignored these findings, claiming the study was flawed. Shame on them.
It’s about time diabetes specialists take this issue seriously.
What they admitted at the May meeting of the American Association of Clinical Endocrinologists was that the finding that patients on more aggressive treatment died more often than those who didn’t get the aggressive treatment was the opposite of what they expected and “nobody saw it coming.” (Are you getting tired of hearing that?)
The patients who were more likely to die were those who started out with higher A1c numbers and had such bad diabetes that as many as four medications failed to push their numbers under 7.0. (A1c is a measure of blood sugar control, normal numbers are under 5.7, over 8.0 indicates poor control of diabetes).
They’re not sure why people died, in fact, they’re still calling it a mystery (see reference, below). But it’s not really that mysterious if you think about it from a whole-person perspective.
When diabetes is so bad that a person has to take multiple medications, it’s not “genetic” or “hereditary.” It’s because years of bad eating habits and lack of exercise has damaged their tissues at a cellular level. No pill on Earth can fix that.
Depending on pills, and not changing diet, has serious consequences.
This sounds like common sense, but too many “thought leaders” in medicine don’t use common sense, and only “discover” what is often obvious to us regular doctors after a study tells them it’s so. Here’s what I think should have been obvious to the people who designed ACCORD:
Artificially lowering blood sugar with multiple medications is a major stress on the body and fails to repair the tissue damage. So by dropping blood sugar with pills, doctors are forcing some people to place undue stress on their tissues. Now their tissues can’t get enough sugar to fulfill their energy requirements (due to the cellular damage) and, even though blood sugar levels may look better, this person with bad diabetes is now even more metabolically stressed. This stress can cause arrythmias and other metabolic disruptions that can, according to ACCORD, be fatal.
Are you in danger?
Fatigue may be a sign that your dosage may bee too high. I’ve noticed that some people tell me they feel really tired when they take their meds and these tend to be those diabetics who have A1c numbers over 10. I have them reduce their dosage, and aim for gradual, not sudden, reduction of A1c. I also explain that they need to follow a low carb, healthy diet, and start exercising, in order to repair their tissues at that cellular level.
If you are on one or more diabetes medications and you think the pills are making you feel tired, I mean really tired—so tired you’ve thought about quitting them—you need to rush to your doctor’s office and let him or her know your dosage may be too high.
Reference: Subanalysis Sheds Light on HbA1c Mystery in ACCORD, Family Practice News, May 15, 2010, by Miriam E Tucker