Word: heart
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...trial, involving 9,300 patients who had high blood sugar and were at high risk of developing diabetes, measured the benefit of drugs that blunt the sharp peaks and valleys in blood glucose levels that occur after eating. Neither study showed benefits of these treatments in reducing risk of heart disease...
...these studies included several thousand diabetes patients, which bolsters the reliability of their results, it doesn't mean they are the final word on the tested treatments. In the blood-fats arm of the ACCORD study, for instance, about 40% of the volunteers had already had a previous heart event and the remainder had risk factors, other than diabetes, that put them at high risk for heart disease, notes Dr. Om Ganda, director of the lipid clinic at Joslin Diabetes Center in Boston. That means the trial was not truly a primary-prevention study designed to test whether aggressive drug...
...researchers had hoped that treated patients would lower their risk of heart events because they were given both statin drugs, which curb the liver's production of cholesterol, and a fibrate, which mops up harmful triglycerides in the blood and boosts levels of "good" cholesterol. But all of the volunteers either already suffered from heart disease, or had two or more major risk factors for heart problems - including cigarette smoking, family history and high cholesterol - in addition to diabetes. That may have pushed their diabetes too far along to allow them to see any benefit from the drugs. "This...
Another reason these patients showed no significant heart benefits, he says, may be that most of them never needed the fibrate to begin with. About two-thirds of the patients in the trial already had triglyceride levels below those at which doctors would normally prescribe the drug, which skewed the study results toward the negative side...
...fact, when the trial's investigators looked specifically at diabetics with the highest triglyceride levels, they did see a benefit, with those patients enjoying a lower risk of heart disease than the volunteers with lower triglyceride levels. "Maybe one can say that, at a later stage of the disease, adding a fibrate is not spectacularly beneficial except for this subgroup," says Ganda...