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My Own Accord.

I'm reading through the pile of emails about the ACCORD (Action to Control Cardiovascular Risk in Diabetes) - there are several already this morning - then clicking through to the Dallas News, then to the NY Times front page headline. 

It's all about what sells, right?  Getting the attention of people?  Telling them that "tight control can kill you"?  Anything to get people to click through, right?

Tight control, whether you're type 1 or type 2 diabetic, keeps diabetes-related complications at bay.  This is a fact, proven by countless studies and evidenced by a whole host of patients.  To start telling people that tight control will kill them is irresponsible.  As stated in the dLife Today blog:  "It's important to note that the increased risk was slight, and was specific to only a subset of patients who had two or more risk factors for heart disease outside of diabetes or who had pre-existing heart disease upon entering the study."

But these specifics aren't what sell papers.  Headlines like "Patients getting aggressive diabetes treatment have higher death risk" are the ones my friends and family will click on and become fearful of, knowing full well that I am diabetic and use an insulin pump (considered aggressive treatment).  Thanks to all of the media chatter, people are up in arms about this study, assuming at first glance that results apply to all people with diabetes.  Click here ... for nothing to happen.

Kelly Close of diaTribe and Close Concerns said it best:  "... if you are type 1, you can read this piece with interest, but know that ACCORD has zero to do with you. If you are type 2 and newly diagnosed, keep moving on your plan - ACCORD has zero to do with you. If you have had type 2 for awhile but don't fall into the "high risk" profile, keep your goals intact."

Mom, this study doesn't apply to me.  My control goals remain the same.

Comments

I feel like I will be using that last line a few times in the next couple of days! :D

Here here! Can't wait to have this same conversation with my dad *sigh*...

I too will commit that line to memory. Good post.

Oh, studies...

Why can't we just take the common sense lessons from studies - "If you are at high risk for heart disease - find a way to deal with stress or else you will be putting yourself at even further risk".

While your parents and friends' concern may be spawned by a misled article, they are certainly right to be concerned about your stress level (ie, read your last x-many posts) and it's heart-health effect.

Let's face it, aggressive treatment- being constantly aware and responsible for your levels - can be very stressful.

Rather than reading "PUMPS KILL YOU" into the study, we should be reading "There is a need for better stress management techniques and practises for those diabetics who are pursuing a more aggressive form of treatment".

Scaring people from pumps will only lower one perceived risk while raising another; offering stress management will lower a perceived risk and allow to keep another risk lower.

Michael - I completely agree. Higher stress levels are often a side effect in my quest for good control. And stress, diabetic or not, is crummy on the heart.

It's important to note that this study deals with type 2 diabetics with pre-existing heart condition risks.

My own stress levels? They're a study all their own. ;)

I have about 30 people coming to my house through the weekend and I guarantee someone will bring up the study. Especially Jeff's dad whose is an alarmist, oh and my mom too....shoot. Let the games begin!

Whenever someone brings up diabetes I always polity qualify their knowledge before talking about diet and/or exercise.

i.e. "you know type 1 genetic, not lifestyle based, and is insulin dependent - with the finger pricks and shots right?"

The uninformed are surprised that I'm fit and muscular being a, shock, diabetic!!

Fortunately both of these articles mention "type 2" in the first paragraph - for those that do know the difference.

all the best...

Amen! Tight control is what keeps us healthy and ALIVE! I was very disturbed by this article myself. People with diabets die every day, yes. But that doesn't mean it was the result of the tight control they had!

So true. Thanks for the thoughtful post.
I'm sure there's a million examples of this, but I read an article yesterday about the ACCORD study on Bloomberg that didn't mention at all that the trial involved type 2 patients only. Wow.
The article was originally titled "Diabetics Who Tightly Control Sugar Have Higher Death Rate." Talk about alarmism.
Thanks to all the d-bloggers out there who are getting the facts straight, especially at a time when much of the media isn't.

The amount of news being generated about this study finding is amazing. I blogged about it for a similar reason - this is not a concern for people with type 1. And it's not clear WHAT caused the extra deaths. Remember people in BOTH groups died, and the additional deaths was a small portion of the total deaths. About 3%-4% according to my calculations.

I agreed with Kerri, tight control is still the best thing we can do for now. Until a cure comes along. :-)

I'm sick of studies.

'nuff said.

I'm with Amylia!

Whatever, whatever, I'll do what I want. And what I want is to take care of myself, and for others with both types of diabetes not be scared to do that too. Plus it's a Type 2 thing!
This study is so annoying, it just adds more confusion to the huge mountain that's already there. Of course people who have pre-existing conditions are more likely to die when you add more strenuous control to it. It's like a no brainer. Like there aren't enough Type 2's out there who don't want to take control. Now they will be more afraid because of bad reporting and a dumb study.
This is just as bad as the breast size one...
I'm so sick of the studies, they should stop blaming and frightening. Just find us all a way to make this better!

Rant Over.

Jillian! I love the South Park reference!

I watched something on the ABC Nightly news about this. Of the 400 times they said diabetes, I think they only said type 2 twice.

Way to educate.

Guuuhhhrrrg. This story just calls for a giant *headdesk*.

ugggh this study is ridiculous! i'm with amylia, too

"A higher death risk..."?

Than what exactly? On a long enough time line, the mortality rate for all of us is 0. :)

Good post, Kerri.

Long time reader, first time commenting. I am a 29 year old type 1 and I really like reading your point of view because it is so often similar to my own. So thanks for that! Also, I work in a freakin' hospital with people who are supposed to be somewhat more educated about these things but I still get people asking me all the time about something they read that pertains only to type 2 patients. I sometimes wish there were a different name altogether, rather than type 1 and type 2 since they are so different. When I'm particularly irritated I call type 2 "Type 'I got so fat I got diabetes' Diabetes" but then I feel bad because this is also somewhat of a mischaracterization of type 2.

Thanks again for the info and for your voice!

When I read about this study, two things leapt to mind:

1) The Taeuber paradox (which points out that every one dies from something, and if one thing doesn't kill you, then something else will - i.e., curing cancer doesn't result in huge life expectancy gains), and

2) Spurious correlations (e.g., just because fluoridation is correlated with higher death rates from cancer does NOT mean adding fluoride to our water system causes deaths, it just means that countries that don't have fluoride in their water have folks dying from diarrhea before cancer has a shot at them).

It's difficult to explain competing relative mortality risks and all the nuisances of a research design (as well as their potential shortcomings) in the media, so (unfortunately) we have to wade through shock/schlock headlines and local news coverage that glosses over the details.

Hi Mom,

Thanks for sending me a copy of the NY Times article about the ACCORD study. Interesting stuff. Is there something about your cardiovascular risks that you're not telling me? Sorry, I still think you should test more than a few times a week. Yes, I will still be testing 10+ times a day and using my insulin pump. A1c of

Signed,
Worried T1 daughter to Worried T2 mom


Yeesh. Moms.

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