Re: Beta-cell burnout?

Jenny wrote:

That study is small and looks only at a one time response to a method of administration very different from what people do in real life. One time response may be very different from daily use over a period of years.

The points you made are all mentioned in the Discussion section of this article. In spite of being sponsored by a couple of companies, other alternatives are also mentioned.

It seems to me that if it was believed the drug really could do wonders for people in the earlier stages of Type 2, some genius at the drug company would have done some studies with those patients, rather than only with those with the elevated A1cs.

Actually the A1c average mentioned for the participants was 6.6% and ranged from 5.9 to 7.3%. While the survey design was for A1c between 6.1 and 8.5%, in practice it came out lower.
"One limitation of our study is that we do not know whether the results can be generalized to all patients with type 2 diabetes, notably those with a longer disease duration and more complex therapy (combination of oral antidiabetic agents, combination of antidiabetic tablets and insulin, or insulin only). The full recovery of first-phase insulin
secretion may, accordingly, be limited to early states of the disease. This, however, can and should be tested in further studies focusing on patients with more advanced stages of type 2 diabetes." http://jcem.endojournals.org/cgi/rapidpdf/jc.2005-1093v1

This makes me wonder, if, as
with other drugs, they use the people with the greatly elevated A1cs because it is much easier to achieve a 1% drop in A1c in those patients rather than in those of us closer to 6% who still have abnormal fasting and abnormal post-meal response. 

In the case of this study this point is mute.

Since it is normal for the beta cell mass to increase in pregnant women, I wonder whether the incretin hormones would be of much effect in women who have had gestational diabetes prior to the onset of T2 DM.

Most important, what does this powerful hormone do to other organs of the body over time? If we've learned one thing from previous drugs, it is that there are receptors for our wonder drugs on organs other than the ones we target and blocking or stimulating them can result in unintended consequences which take years to become visible.

You could have said that for aspirin. It's effects are not totally known after many years of use. NSAIDs like ibuprophren are now being questioned concerning their impact on heart attacks, yet they might save someone from dementia.

I have reservations about Byetta myself, yet it has been tested in excess of 82 months in some patients. Nevertheless, some of the other GLP-1 mimics use mechanism more like the natural hormone and they look more interesting to me.

Frank
.

Relevant Pages

  • Re: Low Dose Chemotherapy with NO SIDE EFFECTS
    ... > breast cancer patients ... It has been reported that insulin increases the cytotoxic ... > effect in vitro of methotrexate by as ... > the Response Evaluation Criteria ...
    (sci.med.diseases.cancer)
  • Re: NIH Intramural Study
    ... > It may be my neuroborreliosis, but I have no memory of any discussion ... Neurologic manifestations of Lyme disease include meningitis, ... metalloproteinase activity in CSF was compared in patients ... battery, auditory brain stem response, and loudness discomfort ...
    (sci.med.diseases.lyme)
  • Re: The LDA is wrong about the IDSA Guidelines
    ... Their blood is full of antibodies. ... only have Lyme DISEASE if we have arthritis is ... what we said 5 years ago in response to Klempner's ... they regularly uses on patients, ...
    (sci.med.diseases.lyme)
  • A Phase II Study of Single-Agent Gemcitabine as a Second-Line Treatment in Advanced Non-
    ... gemcitabine in advanced non-small cell lung cancer as second-line ... Between February 2002 and November 2004, a total of 27 patients, ... response was assessed every two cycles. ... according to common toxicity criteria. ...
    (sci.med.diseases.cancer)
  • Plasmapheresis / Guillain-Barre syndrome
    ... Effects of Prosorba column apheresis in patients with chronic ... refractory rheumatoid arthritis. ... requests for additional information on the response rate of PCT used ... order to assess response rate, ...
    (sci.med)