Can diabetic drugs kill? That may be the take-home lesson from the newest study discussed at the recent American Diabetes Association (ADA) convention in San Francisco. In the ACCORD trial, more than 10,000 diabetic patients were randomized into two groups to either moderately lower blood glucose levels (to reach a level where the progression of the disease remains basically unchanged) or to aggressively lower blood glucose levels (to a level in which the progression of the disease should be significantly halted). The aggressively treated patients had a much lower blood glucose level (but still slightly above normal) than the less medicated patients. After 3 1/2 years, there was no difference between the two groups in the development of cardiovascular disease (one of the primary complications of diabetes). More ominously, those in the aggressively treated group had a 22-percent increase in mortality.
Obviously, there was a lot of hand waving at the conference to try to explain these distressing results. After all, it is well known that lowering blood glucose levels by calorie restriction gives rise to a longer lifespan and greater overall health. So in my opinion the answer is that the drugs used to lower blood glucose levels in diabetics have long-term toxicity. This is part of the sad state of modern medicine, especially in treating diabetics, where drugs have become the all-powerful approach to disease.
This is an almost complete reversal from the past when using diet was the primary intervention to treat diabetes. Today patients may eat whatever they want and simply take more drugs. The reason for this reversal in thinking over the past 25 years in diabetes treatment is the “frustration” that diabetic patients will not follow the dietary guidelines of the ADA. Maybe the patients know that these ADA high-carbohydrate guidelines simply make them feel worse. However, at the highest levels of diabetes research, this type of thinking is beginning to change. In 2005, the Joslin Diabetes Research Center at Harvard Medical School announced its new dietary guidelines for treating diabetes and obesity. Basically these guidelines are the Zone Diet. The Zone Diet is a calorie-restricted diet without hunger or deprivation. This means you can lower blood glucose without increasing mortality. In fact, you will extend your lifespan. It should only take the ADA another generation to understand this.