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Insulin use by diabetics associated with greater risk of dying over a decade compared to other diabetic therapies

Insulin use by diabetics associated with greater risk of dying over a decade compared to other diabetic therapies

Friday, February 8, 2013. In an article published online on January 31, 2013 in The Journal of Clinical Endocrinology & Metabolism, Welsh researchers report an increased risk of adverse effects, cancer and death over a ten year period among diabetics treated with insulin in comparison with other treatments.

Professor Craig J. Currie of Cardiff University and his associates evaluated data from the UK General Practice Research Database, 2000-2010 for 84,622 patients with type 2 diabetes who received glucose-lowering drugs. Subjects were treated with metformin, sulfonylurea drugs, insulin, metformin plus sulfonylureas, or metformin and insulin for no less than 180 days.

Compared with those who used metformin alone, treatment with sulfonylurea drugs was associated with a 43.6 percent greater risk of experiencing an initial adverse cardiac event or cancer, or death from any cause during the decade examined. For insulin alone, the risk was 80 percent higher and for insulin combined with metformin, the risk was 31 percent higher. Among those with no prior history of the events, insulin therapy was associated with nearly twice the risk of heart attack, a 73.6 percent higher risk of major adverse cardiac events, a 43.2 percent greater risk of stroke, a 43.7 greater risk of developing cancer, 3.5 times the risk of kidney complications, and more than twice the risk of neuropathy or dying from any cause in comparison with the risks experienced by those who used metformin.

"By reviewing data from CPRD between 1999 and 2011 we've confirmed there are increased health risks for patients with type 2 diabetes who take insulin to manage their condition," stated Dr Currie, who is affiliated with Cardiff University's School of Medicine.

"Insulin treatment remains the most longstanding blood-glucose-lowering therapy for people with type 2 diabetes, with its use growing markedly in recent years," he noted. "However, with new diabetes therapies and treatments emerging there has been a new spotlight on treatments to ensure what the best and safest form of diabetes treatment is.

"Patients currently being treated with insulin should not, under any circumstances, stop taking their medications, and it is important to emphasize that this report related to only type 2 diabetes which typically starts in older people who are overweight," he cautioned. "Each patient's individual circumstances are different and treatment decisions are managed by their clinician with all of their medical history fully considered."

"Anyone who is concerned should speak to their GP first before taking any action on managing their condition," he added.

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Hydrogen sulfide on the longevity horizon

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An article published online on January 7, 2013 in the journal Molecular and Cellular Biology summarizes the increasing evidence for hydrogen sulfide (H2S), a gas produced in the body that declines with aging, in the promotion of longevity.

Zhi-Sheng Jiang and colleagues at the University of South China in Hunan reviewed the cardiovascular, anti-inflammatory and antioxidant benefits of hydrogen sulfide as well as its effect on the gene klotho, which is involved in lifespan extension. "Data available so far strongly suggest that H2S may become the next potent agent for preventing and ameliorating the symptoms of aging and age-associated diseases," Dr Jiang stated.

In the cardiovascular system, hydrogen sulfide promotes relaxation of the vascular endothelium and smooth muscle cells, and suppresses the formation of macrophage-derived foam cells that occurs during the development of atherosclerosis. Increased hydrogen sulfide levels have been correlated with reduced coronary heart disease severity.

The antioxidant effect of hydrogen sulfide prevents oxidative damage that has long been associated with age-related conditions. It also inhibits pro-inflammatory factors that further contribute to age-related disease. In addition, H2S upregulates the gene klotho, which extends lifespan through several pathways. Other potential areas of benefit for hydrogen sulfide include central nervous system disorders such as Alzheimer's and Parkinson's diseases, diabetes and cancer. (The anticancer compound sulforaphane releases relatively large amounts of hydrogen sulfide.)

"A better understanding of the roles of H2S in aging can provide insights into potential therapeutic interventions against aging and reduce age-associated diseases," the authors write. "More specifically, data available so far strongly suggest that H2S may become the next potent preventive and therapeutic agent for preventing and ameliorating the symptoms of aging and age-associated diseases, and this should be addressed in future studies."

Tune in to Healthy Talk Radio on WNN Wednesdays at 1:00 pm ET with Michael A. Smith, MD

Dr. Mike, the country doctor with a city education, takes to the radio airwaves hosting Healthy Talk, dedicated to bringing you the most current health information available from respected experts in the fields of health, wellness, fitness, and medicine.

On Wednesday, February 13, Dr. Smith presents "Surviving American Medicine," with Dr. Cary Presant. Dr. Presant is one of America's Best Doctors, and currently serves as an internist, hematologist and oncologist in Los Angeles. He will join Dr. Mike on the next episode of Healthy Talk radio to discuss his new book Surviving American Medicine: How to Get the Right Doctor, Right Hospital and Right Treatment with Today's Health Care.

The Fit Foody, Mareya Ibrahim, will also join Dr. Mike. She is a chef, writer, educator and award-winning inventor of Eat Cleaner . . . the only consumer line of food wash and wipes that is lab proven effective in cleaning produce and extending shelf life, naturally.

Listen in live on Wednesday, February 13 at 1:00 pm ET at http://www.lef.org/healthytalk/

And if you missed the previous show, Dr. Mike discussed new medication rules with the country's leading ADHD expert Dr. Charles Parker. You can listen at http://www.lef.org/healthytalk/

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