Tight Blood Sugar Control and CVD Mortality. December 1, 2017

Joslin Diabetes Center. "Trial suggests way to personalize heart health in diabetes: Genetic analysis links the hormone GLP-1 with cardiovascular mortality risks." ScienceDaily. ScienceDaily, 29 November 2017. <http://ift.tt/2zGpnxj;.

Interesting. So, heart mortality risk in diabetic patients depend on personality, right? Otherwise how to personalize the way of treatment?  Really, how it looks like to treat patients according to personal response to the treatment?  But most important, way it is just now surfaced that every one patient is different and treatment works or does not work differently? Is this something new? Not at all. I need 300 units of insulin, diabetics type 1 who is insulin dependent and can even die if they skip one shot of insulin may take 10 units of insulin. This is how different we are. Still, we are the same, we both need insulin to be as healthy as we can, regardless it is 300 units a day or 10 units a day.
     There is nothing personal, just protocol. If one is diabetic, have elevated level of sugar in blood, one must take insulin added in injections to prevent timeless beta cells distraction and to fix the insulin secreting, storing, and releasing cells.

     Among people with diabetes and high risk of CVD, it found that those who achieved extremely tight glycemic control showed higher risks of fatal heart attacks than those who did not, he says.

Paradox, is not it?  Looks like first statement that People with diabetes are in higher risk of CVD development is wrong. Looks like diabetes prevent CVD, right? How it happened? The result of the trial interpreted wrong. Or trail organization is wrong. Or it is diabetes helps to preserve our heart, which is really not true. So, let us take a look at the trial and its results interpretations.

(The most common measurement for glycemic control is a "hemoglobin A1C" or HbA1C test, which reflects average blood glucose levels over several months. Those in the trial's intensive-control group sought to reduce their HbA1C levels below 6%, while those following standard guidelines aimed for HbA1C levels below 8%).

First discrepancy. HbA1C below 6% really tight blood sugar control. The question is, what was initial level of sugar in blood before trial started? A1C <6%  is almost normal level of sugar.  I still have higher then 7% even I take high dose of insulin. It dropped fast from 9% but then it does not go down from 7.4%
The first problem with trial, they do not take participants in the same stage of diabetes development. To consider trial participants must be:
 the same age,
the same level of A1C 
the same condition of heart and blood vessels, meaning the level of cholesterol, BP, the ECG, the coagulation of blood, and many other marks must be the same, including amount of heart attacks participant already passed. I do not think it was the case in the participants'  choice.

While the link between higher risks of fatal heart attacks and lower GLP-1 levels after 12 months of intensive glycemic control was unexpected, it fit with what is known about the hormone. "GLP-1 is produced by intestinal cells, and its main action is to stimulate insulin secretion from beta cells, but the hormone also has a beneficial effect on the heart and blood vessels that is independent from its action on insulin secretion," says Doria.

 All around and about, still if GLP-1 is stimulation for beta cells insulin secretion then I do not get the reason to be surprised. There is nothing as paradox. Simple, for awhile the stimulation work. But it is not reasonable to flog death horse and expect to win race. GLP - 1 agonists such as Byetta and Victosa already show up the high risk of mortality. In other words, there is nothing about tight blood sugar control. It is all about medicine which was used in trial. This only supported many climes that Byetta and Victosa lead to CVD increased mortality.

 The U.S. Food & Drug Administration has approved several GLP-1 "agonist" drugs (injectable GLP-1-like molecules) for people with type 2 diabetes, Doria says. In addition to lowering blood glucose, these drugs have been shown to improve cardiovascular health of diabetic patients. An earlier class of drugs known as DPP4 inhibitors, given orally, aims to provide similar effects by preserving the hormone in the bloodstream.

 I am lost. Really, what they are talking about? Say me, how am I wrong? IO just not able to get logic of MD. Well, I lost it long time ago. So by now I use my logic, my education, and my brain to take care and treat diabetes type 2.Personally I never did, and I never will do take Victosa or Byetta, or any stimulant to increase insulin level in my blood. I do not afraid needle. I can handle them, four times every day, day after day. I am OK with that. For that reason I try to keep my blood sugar under as tight control as I can. Personally I do not have any idea how within 12 month blood sugar dropped down to less then A1C < 6%? Really I am very skeptical. A1C may drop from 9.4% down to 7%, just withing12 month. To reduce A1C from 7% down to less then 6% is another story. Sugar still frozen on this point and does not go down.
      To get blood sugar control sugar must be discharged from every one tissue and organ of our bodies. Sugar is not only in blood. Really our even tears are sweet. Our bones and all body liquids are sweet. These sweetness go out and enter into blood stream.It is not simple meal - sugar tract. The process is much more complicated.

If the latest Joslin study is confirmed by other research, it will suggest that people with diabetes eventually might be tested for the genetic risk marker associated with lower GLP-1 levels. This testing could be done relatively inexpensively, Doria says, and patients who carry this marker might be particularly good candidates for using GLP-1 drugs to improve their glycemic control.

 This is the point. The problem MD and all team see in hypoglycemic control. In contrary, it is only symptom. The cause of the problem in low insulin secretion, in ill pancreas and its Island. Probably many of us have even bigger problem. Fibrosis and hydration, and many many other causes which led to development of diabetes. BTW Victosa and Byeta already long time on market. Did these med. decreased diabetics type 2 mortality? Not at all.
     Let us try another way to address to blood sugar control and diabetes treatment. Let us test how insulin effect numbers diabetics type 2. Probably it will really save Big Money to public needs. No amputations, no scooters, no home aides, less visits to Er hospitals and MD clinics. Just let us try.

via Ravenvoron