Re: ADVANCE Trial Preliminary Report

dumb_fishie99 wrote:

ok, wait a minute. Sounds like this study was for Type 2's who
already had heart failure.

Not really. See the excerpt from the RESEARCH DESIGN AND METHODS
below.


anyway, I never heard that high post-prandial bg's restricts
blood flow. why would it?

It is not significant that you have never heard of it.

Alos, I don't want any hypoglucemic drugs.

Metformin is considered a hypoglycemic drug because it reduces hyperglycemia or high blood glucose levels.

I want metformin,
and I read that metformin can actually benefit other things
that insulin sensitivity, like it can improve your circulation,
and lower your blood pressure and cholesterol too:

The Multiple Benefits of Metformin

http://tinyurl.com/3sozyq

BioMarker Pharmaceuticals Develops
Anti-Aging Therapy

http://tinyurl.com/4463zy

(you have to scroll about half way down to get to
the bit about metformin)

anyway, my plan is to go on metformin. I don't wanna
go on insulin before I have to!

Metformin is a good drug, but it has it's limitations, i.e., some people can't handle it gastrointestinal effects such as diarrhea and others with reduced kidney functions also have problems with it.


"RESEARCH DESIGN AND METHODS
Among type 2 diabetic patients regularly attending the Diabetes Clinic of University of Padua, we enrolled 20 consecutive patients with a diagnosis of type 2 diabetes for ≥6 months but ≤10 years, aged ≤60 years, with a BMI of 26.4 ± 1.4 and HbA1c (A1C) of 7.2 ± 1%. All patients were managed by dietary therapy. Exclusion criteria included any hepatic disease, renal disease (plasma creatinine >1.5 mg/dl), cigarette smoking, alcohol intake, arterial hypertension (blood pressure >130/85 mmHg), hypercholesterolemia (total cholesterol >250 mg/dl), hypertrgliceridemia (triglyceride >200 mg/dl), or the presence of micro- or macrovascular complications. Microangiopathy was excluded by an ophtalmologic exam of the retina and by at least three determinations of albuminuria excretion rate. Macroangiopathy was excluded by the palpation of peripheral pulses, ankle brachial pressure ratio, and echocolordoppler ultrasound of the carotid arteries. Diabetic patients were not taking any drugs. They were on a standard diet containing at least 50% of calories as carbohydrates. Before, to include a patient in this study, he or she underwent (in chronological order) stress perfusion imaging with technetium during exercise and dipyridamole echocardiography. The negativity of these diagnostic procedures allowed exclusion of subjects with the presence of obstructive coronary artery disease." http://care.diabetesjournals.org/cgi/content/full/29/1/95

One limitation was that only 20 patients were in the study, but they were only slightly overweight (BMI of 26.4) and while not in the 6% club, had better blood glucose control (HbA1c ~7.2) than a majority of T2DMs in the U.S.

The article has been cited by a number of other articles including Insulin at physiological concentrations increases microvascular perfusion in human myocardium - http://ajpendo.physiology.org/cgi/content/abstract/293/5/E1250.
Yet the interesting point in the article was that rapid acting insulin at least partially restored postprandial blood flow to the heart.

It is not that there aren't conflicting reports:
Silent Ischemia in Diabetes Not as Threatening as Thought �DIAD Study -
http://www.diabetesincontrol.com/results_print.php?storyarticle=5827.

On the other hand, my mother, my sister, my nephew, and a cousin, all T2DMs, suffered death from congestive heart failure. My sister-in-law, also a T2DM, recently died with a heart attack. She had sleep apnea and her heart had stopped 82 times in an hour while sleeping in a test done 3 weeks before her death. A lack of oxygen carried by the blood was involved in all of these cases and resulted in heart muscle failure.

Google's define search for ischemia definitions - http://tinyurl.com/3hk6x6.

Definition of Ischemia
1. Ischemia: Inadequate blood supply (circulation) to a local area due to blockage of the blood vessels to the area.
2. Ischemia occurs when living tissue is deprived of oxygen. While any decrease in the oxygen supply to tissue can be called ischemia, in reality there is a threshold that must be crossed before true ischemia occurs. This is a result of biological processes that give living tissue a certain amount of reserve capacity. This reserve capacity differs among tissue types. For example, the arm muscles have a higher reserve capacity than the heart.

Frank


.

Relevant Pages