Oral Glucose Medications Increase Mortality in Type 2 Diabetes Patients

Wednesday, September 10, 2008 by: Helmut Beierbeck
Tags: diabetes medications, health news, Natural News

eTrust Pro Certified

Delicious Pin It
(NaturalNews) Poor blood glucose control puts diabetics at increased risk for cardiovascular disease (CVD). Every percentage point increase in glycated hemoglobin levels (a blood glucose marker) above normal values raises the relative CVD risk by roughly 20% (1). The percentage of glycated hemoglobin, more specifically hemoglobin A1c (HbA1c), is a measure of average blood glucose levels over the previous 2 to 3 months. Healthy HbA1c levels range from 4% to 6%.

Although this positive correlation between blood glucose levels and CVD had been known, no clinical trials had ever tested the effect of lowering glucose levels on cardiovascular risk. Two major clinical trials, the ACCORD and ADVANCE trials, were therefore undertaken to determine whether intensive pharmacological intervention to lower HbA1c levels in type 2 diabetics reduced the risk of major cardiovascular events.

The ACCORD and ADVANCE trials had a number of features in common:

* Both studies were large-scale trials, each enrolling more than 10,000 patients. The ACCORD trial recruited patients from the U.S. and Canada. The ADVANCE trial was spread over more than 200 medical centers in twenty countries around the world.

* Both studies enrolled patients who were middle-aged or older, with type 2 diabetes and either established cardiovascular disease or cardiovascular risk factors.

* In both studies, half the patients received intensive care with aggressive pharmacological intervention. The comparison group received standard therapy.

* In addition to oral glucose lowering drugs, many patients in both trials also received medications to control blood pressure, cholesterol levels and blood clotting.

* The primary difference between the two studies was the choice of oral diabetes drugs. The ACCORD trial used mainly thiazolidinediones. Patients in the ADVANCE study were given the sulfonylurea drug gliclazide, plus insulin or thiazolidinediones as needed to achieve target HbA1c levels.

The results of these two clinical trials were published in the June 12, 2008 issue of the New England Journal of Medicine, together with a couple of commentaries (2-5). Both trials succeeded in lowering glucose levels. The final average HbA1c values were 6.5% and 7.5% with the intensive and standard regimen, respectively.

However, both trials clearly failed in their primary objective, to reduce the number of deaths from cardiovascular disease. The ADVANCE trial found no drop in CVD, but confirmed that lowering glucose levels decreases the risk of microvascular complications, specifically renal failure and retinopathy (3). In the ACCORD trial the death rate actually increased in the intensive treatment group; the trial was halted and patients were switched from intensive to standard therapy (2).

These results come on the heels of a May 21, 2007 warning by the FDA that another thiazolidinedione drug, Avandia (rosiglitazone), increases the risk of major cardiovascular events:

"Recently, the manufacturer of Avandia (GlaxoSmithKline) provided FDA with a pooled analysis (meta analysis) of 42 randomized, controlled clinical trials in which Avandia was compared to either placebo or other anti-diabetic therapies in patients with type 2 diabetes. The pooled analysis suggested that patients receiving short-term (most studies were 6 months duration) treatment with Avandia may have a 30-40 percent greater risk of heart attack and other heart-related adverse events than patients treated with placebo or other anti-diabetic therapy. These data, if confirmed, would be of significant concern since patients with diabetes are already at an increased risk of heart disease." (6)

The failure of these trials to reduce cardiovascular risk by pharmacological means does not disprove a connection between glucose levels and cardiovascular disease:

"Neither the ADVANCE trial nor the ACCORD trial undermines the importance of meeting the current guidelines for care, and they should not be interpreted as diminishing the importance of glycemic control." (4)

The ACCORD and ADVANCE trials failed because of the chosen methodologies. The pharmaceutical cocktail used in the two studies either didn't work or made matters worse:

"As clearly stated by the investigators in the ACCORD trial, the potential existed for undetected adverse effects owing to an increased number of changes in drug regimens and an increased use of multiple drug classes and at increased doses." (5)

Glycemic control is achievable by lifestyle and dietary changes, something that was apparently not emphasized in either trial. Even mainstream medicine acknowledges the effectiveness of diet modifications in preventing and managing diabetes:

"But this epidemic [of CVD with rising blood glucose levels] is not inevitable -- it may be thwarted if we take action now. We know that lifestyle changes can dramatically reduce the incidence of diabetes and slow the hemoglobin A1c increase in both diabetic and nondiabetic individuals. Broadly adopted lifestyle changes should therefore reduce diabetes-related eye, kidney, and nerve disease. Regardless of whether these lifestyle changes are ultimately proven to reduce cardiovascular disease in our society, public health approaches to facilitate them urgently need to be implemented. Structural changes to our society that reduce caloric intake and increase physical activity today will lower hemoglobin A1c levels and reduce society's rates of diabetes, the consequences of diabetes, and possibly cardiovascular disease tomorrow." (1)

"People with diabetes have the same nutritional needs as anyone else. Along with exercise and medications (insulin or oral diabetic pills), nutrition is important for good diabetes control. By eating well-balanced meals in the correct amounts, you can keep your blood glucose levels as close to normal (non-diabetic level) as possible." (7)

Type 2 diabetes is considered a lifestyle disease, and it can be prevented and even reversed through proper diet and exercise. Follow a low glycemic eating plan if you don't want to become a guinea pig and a source of income for the pharmaceutical industry.


1. Gerstein HC. Glycosylated hemoglobin: Finally ready for prime time as a cardiovascular risk factor. Ann Intern Med 2004;141:475-476. (http://www.annals.org/cgi/reprint/141/6/475....)

2. Effects of intensive glucose lowering in type 2 diabetes. The action to Control cardiovascular risk in diabetes study group. N Engl J Med 2008;358(24):2545-2559. (http://content.nejm.org/cgi/reprint/358/24/2...)

3. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. The ADVANCE collaborative group. N Engl J Med 2008;358(24):2560-2572.

4. Dluhy RG et al. Intensive glycemic control in the ACCORD and ADVANCE trials. N Engl J Med 2008;358(24):2630-2633. (http://content.nejm.org/cgi/reprint/358/24/2...)

5. Cefalu WT. Glycemic targets and cardiovascular disease. N Engl J Med 2008;358(24)2633-2635. (http://content.nejm.org/cgi/reprint/358/24/2...)

6. FDA issues safety alert on Avandia, May 21, 2007. (http://www.fda.gov/bbs/topics/NEWS/2007/NEW0...)

7. Nutrition & Recipes. American Diabetes Association. (http://www.diabetes.org/nutrition-and-recipe...)

About the author

Helmut Beierbeck has a science background and a strong interest in all scientific aspects of health, nutrition, medicine, weight loss, or any other topic related to wellness. You can follow his ruminations on his blog http://healthcomments.info and leave comments on this or any other health-related topic.

Get breaking news alerts on GMOs, fluoride, superfoods, natural cures and more...
Join over four million monthly readers. Email privacy 100% protected. Unsubscribe at any time.

Have comments on this article? Post them here:

comments powered by Disqus

Take Action: Support NaturalNews.com

Email this article to a friend

Permalink to this article:

Reprinting this article: Non-commercial use OK, cite NaturalNews.com with clickable link.

Embed article link: (copy HTML code below):
Most Popular
Today | Week | Month | Year

See all Top Headlines...


Now Available at ShopNaturalNews.com

O3 Essentials OraJuvenate™
A powerful, cleansing dental cream for maximum oral/dental health.
New Cancer Solutions
Over 3 hours of content covering today’s best cancer tests, how to kill cancer cells and the best diets and exercise routines.
Freeze-Dried 100% Organic Whole Corn
Our freeze-drying method preserves taste, texture and nutrients better than any other food preservation method ever invented.
Fenix TK35 Flashlight
Tough, waterproof, extremely bright and it’s touted to throw an 800+ lumen beam more than 1,000 feet into the night.
Inca Treasure Smoothie Pack
This pack of our four most popular superfoods from South America is the perfect combo pack for smoothie lovers.
Pink Himalayan Salt
This salt delivers significant levels of magnesium, zinc and selenium, with trace levels of dozens of other elements.
Pinhole Glasses - Aviator Style
Pinhole glasses are becoming famous for helping people improve their vision without the risks of laser surgery.
Oxy-Rich Facial Serum
O3 Essentials Jojoba Oxy-Rich Facial Serum is cellular nourishment for your skin. Helps smooth fine lines while enhancing tissue elasticity.
Freeze-Dried 100% Blackberry Halves
Our freeze-dried blackberry halves are grown in Serbia under strict organic standards.

Also on NaturalNews:

Health Ranger Videos
Activist music
CounterThink Cartoons
Food documentaries
FREE Special Reports
Colloidal Silver

Advertise with NaturalNews...

Support NaturalNews Sponsors:

Advertise with NaturalNews...

Most Popular Stories

Flu shot kills 19-year-old, but vaccine industry still has total immunity against lawsuits
Here's a nutty fact: Eating more tree nuts lowers the risk of all-cause death by up to 20 percent
Six important facts you're not being told about lost Malaysia Airlines Flight 370
Malaysia Airlines Flight 370 now clearly a government cover-up: All evidence contradicts official story
10 other companies that use the same Subway yoga mat chemical in their buns
BLM fracking racket exposed! Armed siege and cattle theft from Bundy ranch really about fracking leases
High-dose vitamin C injections shown to annihilate cancer
U.S. treating meat with ammonia, bleach and antibiotics to kill the '24-hour sickness'
USDA to allow U.S. to be overrun with contaminated chicken from China
Vaccine fraud exposed: Measles and mumps making a huge comeback because vaccines are designed to fail, say Merck virologists
Battle for humanity nearly lost: global food supply deliberately engineered to end life, not nourish it
Diet soda, aspartame linked to premature deaths in women

25 Amazing Facts About Food

This FREE downloadable report unveils a collection of astonishing and little-known facts about the food we eat very day. Click here to read it now...


Resveratrol and its Effects on Human Health and Longevity - Myth or Miracle.

Unlock the secrets of cellular health with the "miracle" nutrient Resveratrol Click here to read it now...


Nutrition Can Save America

FREE online report shows how we can save America through a nutrition health care revolution. "Eating healthy is patriotic!" Click here to read it now...

The Healing Power of Sunlight and Vitamin D

In this exclusive interview, Dr. Michael Holick reveals fascinating facts on how vitamin D is created and used in the human body to ward off chronic diseases like cancer, osteoporosis, mental disorders and more. Click here to read it now...

Vaccines: Get the Full Story

The International Medical Council on Vaccination has released, exclusively through NaturalNews.com, a groundbreaking document containing the signatures of physicians, brain surgeons and professors, all of which have signed on to a document stating that vaccines pose a significant risk of harm to the health of children. Click here to read it now...

Health Ranger Storable Organics

GMO-free, chemical-free foods and superfoods for long-term storage and preparedness. See selection at www.StorableOrganics.com

Recommended Resources On:

Natural News trends
Health Ranger news
Natural News GMOs
Mike Adams tracker
Natural News photos
Natural News Global
Natural News in focus
Natural News connect
Natural News shocking stories
Natural News radar
Health freedom
Dr. Paul Offit

This site is part of the Natural News Network © 2014 All Rights Reserved. Privacy | Terms All content posted on this site is commentary or opinion and is protected under Free Speech. Truth Publishing International, LTD. is not responsible for content written by contributing authors. The information on this site is provided for educational and entertainment purposes only. It is not intended as a substitute for professional advice of any kind. Truth Publishing assumes no responsibility for the use or misuse of this material. Your use of this website indicates your agreement to these terms and those published here. All trademarks, registered trademarks and servicemarks mentioned on this site are the property of their respective owners.

eTrust Pro Certified Android app on Google Play

Sign up for the FREE Natural News Email Newsletter

Receive breaking news on GMOs, vaccines, fluoride, radiation protection, natural cures, food safety alerts and interviews with the world's top experts on natural health and more.

Join over 7 million monthly readers of NaturalNews.com, the internet's No. 1 natural health news site. (Source: Alexa.com)

Your email address *

Please enter the code you see above*

No Thanks

Already have it and love it!

Natural News supports and helps fund these organizations:

* Required. Once you click submit, we will send you an email asking you to confirm your free registration. Your privacy is assured and your information is kept confidential. You may unsubscribe at anytime.