This blog tracks updates to the Blood Sugar 101 Web site.

Thursday, November 8, 2012

More Evidence that Sulfonylureas Are Bad for the Heart

Page Changed: Amaryl, Glyburide, Prandin, Starlix: Drugs that Stimulate Insulin Secretion"

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And if that wasn't enough, a study of the records of over 250,000 veterans found that "...for every 1,000 patients who are using metformin for a year there are two fewer heart attacks, strokes or deaths compared with patients who use sulfonylureas."

Science Daily: Metformin Offers Cardio Benefits Over Sulfonylureas in Diabetes,

Study Suggests Comparative Effectiveness of Sulfonylurea and Metformin Monotherapy on Cardiovascular Events in Type 2 Diabetes Mellitus: A Cohort Study Christianne L. Roumie, et al. Ann Intern Med. 6 November 2012;157(9):601-610

Monday, November 5, 2012

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What If You Can't Always Hit Your Target?

Many of us will see blood sugars higher than we'd like. The good news is that it takes many years of exposure to high blood sugars to damage your organs. If you spike occasionally, but maintain good control overall, your risk of complications is far lower than people whose blood sugar is routinely going up over 200 mg/dl for an hour after every meal--the target that the ADA recommends and most doctors consider "great control." Obsession and eating disorders are not healthy, and diabetes makes it very easy to become obsessed and develop an eating disorder. A few hours a week over your target blood sugar range are not an emergency. It's when you are spending a few hours every day over your target range that it's time to ramp up your efforts to get good control.Not so surprisingly, it is when you are spending several hours a day over 140 mg/dl (7.7 mmol/L) and seeing blood sugars spiking into the truly dangerous 200 mg/dl range (11 mmol/L) that your A1c will rise into the middle 6% range and your heart attack risk and risk of other complications will start to become significant.

Sunday, November 4, 2012

The Rate of Obesity Has Skyrocketed, but The Rate of Diabetes Has Remained Relatively Low

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Obesity Has Risen Dramatically While Diabetes Rates Have Not

The rate of obesity has grown alarmingly over the past decades, especially in certain regions of the U.S. The NIH reports that "From 1960-2 to 2005-6, the prevalence of obesity increased from 13.4 to 35.1 percent in U.S. adults age 20 to 74.7." If obesity was causing diabetes, you'd exect to see a similar rise in the diabetes rate. But this has not happened.

The CDC reports that "From 1980 through 2010, the crude prevalence of diagnosed diabetes increased ...from 2.5% to 6.9%." However, if you look at the graph that accompanies this statement, you see that the rate of diabetes diagnoses rose only gradually through this period--to about 3.5% until it suddenly sped upward in the late 1990s. This sudden increase largely due to the fact that in 1998 the American Diabetes Association changed the criteria by which diabetes was to be diagnosed, lowering the fasting blood sugar level used to diagnose diabetes from 141 mg/dl to 126 mg/dl. (Details HERE)

Analyzing these statistics, it becomes clear that though roughtly 65 million more Americans became fat over this period, only 13 million more Americans became diabetic. And to further confuse the matter, several factors other than the rise in obesity and the ADA's lowering of the diagnostic cutoff also came into play during this period which also raised the rate of diabetes diagnoses:

Diabetes becomes more common as people age as the pancreas like other organs, becames less efficient. In 1950 only 12% of the U.S. population was over 65. By 2010 40% was, and of those 40%, 19% were over 75.(Details HERE.)

At the same time, the period during which the rate of diabetes rose was also the period in which doctors began to heavily prescribe statins, a class of drugs we now know raises the risk of developing diabetes. (Details HERE.)