[nfb-talk] Fw: Drug Prevents Type 2 Diabetes in Majorityof High-Risk Individuals

Tue Apr 5 03:10:07 UTC 2011

My quarrel is not with the method of the study but with the small number of
participants.

Mike

-----Original Message-----
From: nfb-talk-bounces at nfbnet.org [mailto:nfb-talk-bounces at nfbnet.org] On
Behalf Of Steven Johnson
Sent: Monday, April 04, 2011 3:12 PM
To: 'NFB Talk Mailing List'
Subject: Re: [nfb-talk] Fw: Drug Prevents Type 2 Diabetes in Majorityof
High-Risk Individuals

John, I believe you are correct as I did pass this information onto my
Supervisor who is an R.N. and she sent me the actual study she had received
in one of her journals.

Steve

-----Original Message-----
From: nfb-talk-bounces at nfbnet.org [mailto:nfb-talk-bounces at nfbnet.org] On
Behalf Of John Heim
Sent: Monday, April 04, 2011 10:44 AM
To: NFB Talk Mailing List
Subject: Re: [nfb-talk] Fw: Drug Prevents Type 2 Diabetes in Majorityof
High-Risk Individuals

Most likely it was a double blind study, not a longitudinal study so
socio-economic factors would probably not be an issue.  In a double blind
study, the participants are selected at random to receive either a drug or a

placebo. Even the doctor doing the study doesn't know which group a
particular participant is in. It doesn't make it impossible that just by
chance, everybody who took the drug smokes and therefore the results are
invalid. But it makes it very unlikely. So what the author of the study does

is to calculate the probability that something like that could have
happened. Somewhere in the study there would be a statement saying something

like, "There is a 95% probably that our findings are not due to chance."

I doubt the New England Journal of Medicine would publish a study without
the appropriate safe guards and calculations. There's always a chance that
the New Englad Journal of Medicine missed something, that the findings
represent a statistical fluke, or that the researcher  made a mistake or
cheated. But still, this is a pretty big deal. A study with over 600
participants is nothing to sneeze at.

----- Original Message -----
From: "Mike Freeman" <k7uij at panix.com>
To: "'NFB Talk Mailing List'" <nfb-talk at nfbnet.org>
Sent: Saturday, April 02, 2011 8:31 AM
Subject: Re: [nfb-talk] Fw: Drug Prevents Type 2 Diabetes in Majorityof
High-Risk Individuals

> It's awfully early to wax rhapsodic about this; 602 people isn't what 
> I consider a statistically-significant sample.  Try half a million and 
> I'd be more apt to believe it.  Moreover, I wonder to what extent 
> socioeconomic, ethnic and other issues were taken into account.  
> Medical studies are notoriously lax when it comes to inclusion of such 
> factors in their analysis.
>
> Mike
>
>
> -----Original Message-----
> From: nfb-talk-bounces at nfbnet.org [mailto:nfb-talk-bounces at nfbnet.org] 
> On Behalf Of Ed Meskys
> Sent: Saturday, April 02, 2011 6:24 AM
> To: sandy meskys; nfb-talk
> Subject: [nfb-talk] Fw: Drug Prevents Type 2 Diabetes in Majority of 
> High-Risk Individuals
>
>
> ----- Original Message -----
> From: "Louis Gosselin" <gosselin_louis at MYFAIRPOINT.NET>
> To: <NHBLIND-TALK at LISTSERV.ICORS.ORG>
> Sent: Saturday, April 02, 2011 9:20 AM
> Subject: Drug Prevents Type 2 Diabetes in Majority of High-Risk 
> Individuals
>
>
> Drug Prevents Type 2 Diabetes in Majority of High-Risk Individuals
> 1-Apr-2011
> March 2011 - A pill taken once a day in the morning prevented type 2 
> diabetes in more than 70 percent of individuals whose obesity, 
> ethnicity and other markers put them at highest risk for the disease, 
> U.S. scientists reported today.
> The team also noted a 31 percent decrease in the rate of thickening of 
> the carotid artery, the major vessel that supplies blood to the brain. 
> The study, which enrolled
> 602 participants through The University of Texas Health Science Center 
> San Antonio and seven collaborating centers, is described in the New 
> England Journal of Medicine and has direct implications for the care 
> of 79 million Americans who are pre-diabetic.
> "It's a blockbuster study," said senior author Ralph DeFronzo, M.D., 
> professor in the School of Medicine and chief of the diabetes division 
> at the UT Health Science Center San Antonio. "The 72 percent reduction 
> is the largest decrease in the conversion rate of pre-diabetes to 
> diabetes that has ever been demonstrated by any intervention, be it 
> diet, exercise or medication."
> Multiple-year follow-up
> Dr. eFronzo led the trial of pioglitazone, which is marketed as Actos 
> by Takeda Pharmaceutical Co. Ltd. The Japanese company provided an 
> independent investigator grant to Dr.
> DeFronzo
> to conduct the ACT Now study. Some patients were followed for as long 
> as four years; the average follow-up was 2.4 years.
> Pioglitazone is widely used as an insulin sensitizer in patients with 
> type

> 2
> diabetes.
> In the ACT Now study, participants were chosen because of their high 
> risk for diabetes, including obesity, family history and impaired 
> glucose tolerance as demonstrated by a glucose test.
> "The drug shows outstanding results," said Robert R. Henry, M.D., 
> president, medicine and science, of the American Diabetes Association. 
> "It is the most efficacious method we have studied to date to delay or 
> prevent the onset of type 2 diabetes."

> A
> study
> co-investigator, Dr. Henry is professor of medicine at the University 
> of California, San Diego, and chief of the section of endocrinology 
> and diabetes at the VA San Diego Healthcare System.
> Blood vessel damage prevented
> Robert Chilton, D.O., FACC, a UT Health Science Center San Antonio 
> cardiologist who was not involved with the study, said the slowing of 
> carotid artery thickness indicated that the participants' glucose was 
> well controlled, preventing blood vessel damage that leads to heart 
> attacks, strokes and peripheral vascular disease.
> Individuals who have diabetes have the same high risk of having a 
> first heart attack as do non-diabetic people who already had a heart 
> attack, he noted.
> "The drug was able to postpone conversion to diabetes in 72 percent of 
> people,"
> Dr.
> Chilton said. "The only thing that could potentially beat that is the 
> free pill no one seems to be able to take - diet and exercise."
> Insulin resistance
> Type 2 diabetes involves abnormalities with insulin, a hormone 
> secreted by beta cells in the pancreas. Insulin helps the body store 
> and use sugar from food, but in type
> 2 diabetes the body is insulin resistant, that is, it inefficiently 
> responds
>
> to
> the
> hormone. With time the beta cells in diabetic patients start to die, 
> resulting in less insulin to handle the demands. Levels of the hormone 
> become progressively lower and sugar levels are increased 
> progressively, damaging blood vessels and organs.
> Dr. Henry said the ACT Now study highlights the importance of insulin 
> resistance in the development of type 2 diabetes and how, by treating 
> this resistance, the beta cell secretion of insulin is preserved for a 
> longer period of time.
> Pioglitazone was well tolerated by participants, with weight gain and 
> fluid retention observed at the dose used in the study. Dr. DeFronzo 
> said those side effects
>
> can
> be mitigated by using a lower dose that works equally well. 
> Pioglitazone stimulates appetite while at the same time shifting fat 
> around in the body, taking it out of muscle, the liver and beta cells 
> and putting it in subcutaneous fat depots under the skin where it is 
> inert and not harmful, he said.
> "No drug is perfect," Dr. DeFronzo said. "This particular medication 
> does two things
> - improves insulin resistance and improves beta cell function, which 
> are the
>
> two
> core defects of diabetes."
> Co-authors and centers: Pioglitazone for Prevention of Diabetes in 
> Impaired Glucose Tolerance, Ralph A. DeFronzo, M.D.1*, Devjit 
> Tripathy, M.D., Ph.D.1*, Dawn C.
> Schwenke,
> Ph.D., M.S.2,3, MaryAnn Banerji, M.D., F.A.C.P.4, George A. Bray, 
> M.D.5, Thomas A.
> Buchanan, M.D.6, Stephen C. Clement, M.D.7, Robert R. Henry, M.D.8, 
> Howard N.
> Hodis,
> M.D.6, Abbas E. Kitabchi, Ph.D., M.D., F.A.C.P., F.A.C.E.9, Wendy J. 
> Mack, Ph.D.6, Sunder Mudaliar, M.D.8, Robert E. Ratner, M.D., 
> F.A.C.P.10, Ken Williams, M.Sc.11, Frankie B. Stentz, M.S., Ph.D.9, 
> Nicolas Musi, M.D.1, and Peter D. Reaven,
> M.D.2
> for the ACT NOW Study
> *Both authors contributed equally to the manuscript Texas Diabetes 
> Institute and University of Texas Health Science Center, San Antonio, 
> TX; Phoenix VA Health Care System, Phoenix, AZ; W.P. Carey School of 
> Business, Arizona State University, Tempe, AZ; SUNY Health Science 
> Center at Brooklyn, Brooklyn, NY; Pennington Biomedical Research 
> Center/LSU, Baton Rouge, LA; University of Southern California Keck 
> School of Medicine, Los Angeles, CA, Division of Endocrinology & 
> Metabolism, Georgetown University, Washington, DC; VA San Diego 
> Healthcare System and University of California at San Diego; 
> University of Tennessee, Division of Endocrinology, Diabetes and 
> Metabolism, Memphis, TN;
> 10 Medstar Research Institute, Hyattsville, MD; 11KenAnCo 
> Biostatistics, San Antonio, TX
> Source: University of Texas Health Science Center at San Antonio
>
>
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