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Published online 6 June 2008 | Nature | doi:10.1038/news.2008.879
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Aggressive approach to diabetes proves harmful
Attacking blood sugar levels with high drug doses can be dangerous.
Patients with type 2 diabetes, a high risk of cardiovascular disease, and who use aggressive measures to reduce their blood sugar levels could actually be shortening their lives, according to a large clinical trial. The results contradict the established theory that diabetics benefit from driving down their excessively high blood sugar levels as forcibly as possible.
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In such as article there are some fundamental bias, NEJM ignore or overlook as paper authors, as I have written them earlier. Not all diabetics are created EQUAL. In fact, tere are not diseases, but diseased individuals, whose Biophysical-Semeiotics Constitution doctors must know perfectly. In addition, Single Patient Based Medicine, based on these constitutions (http://medicine.plosjournals.org/perlserv/?request= read-response), may highlights this fundamental point. For instance, CAD occurs exclusiveli in diabetics involved by Inherited Real Risk of acute coronary disorders, recognized since birth with a stethoscope (Lecture, V Virtual International Congress of Cardiology. 2007. http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php). In any case, diabetics have to mantain necessarily their glycosilated haemoglobin as well as glucose blood level possibly in normal ranges. Importantly, interventions are needed to improve physical activity and correct diet, ethimologically speaking, in communities nationwide in well-defined individuals on very large scale, involved by both “diabetic and dyslipidaemic†constitution and particularly by Inherited “diabetic†Real Risk, characterized by newborn-pathological type I, subtype b) Endoarterial Blocking Devices in Langheran’s islet microcirculatory bed. Infact, evidence from several studies indicates that obesity and weight gain are associated with an increased risk of diabetes (www.semeioticabiofisica.it). Certainly, the prevalence of obesity among individuals, i.e., body mass index (BMI), based on self-reported weight and height, increased significantly over the last decades, worsening the real type 2 Diabetes mellitus prevalence around the world. Both BMI and weight gain are major risk factors for diabetes, but exclusively in presence of remarkable inherited predispositions, cited above. In conclusion, aggressive approach to diabetes can be harmful, but exclusively if physicians are not able to differentiate diabetics, as regards the above-mentioned constitutions and inherited real risk ,which allows also to conduct a reliable therapeutic monitoring, bedside assessing the functions of target biological systems.
The results illustrate at least a few important points: 1) diabetes is a disease involving multiple organs and metabolic dysfunction and not merely increased blood sugar; 2)the agressive lowering of blood sugar, like the aggressive lowering of cholesterol does more harm than good for similar biochemical reasons (though not necessarily the same mechanisms); and 3) the data from newer drugs like exenatide and pramlintide which appear to treat more than just blood sugar control may afford a better clinical outcome. Ijaz S. Jamall, Ph.D., DABT, Sacramento, California, USA
results pose some important challenges for the patients . Reduce the sugars to near normal levels ,you have the risk of heart attacks.Do not reduce the sugars to acceptable levels you have the risks of kidney failure. Somewhere in this maze we need to tread the middle path. H.N.Ramakrishna