A Few More Friday Tidbits

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If you are a person that follows herbaland Chinese medicine, you may be interested in reading this article. I say great for the Australian researchers for uncovering someproblems with “traditional” Chinese medicines. The new DNAsequencing technology developed by researchers at Murdoch Universityin Perth, Australia exposed some potentially toxic plant ingredients,allergens, and traces of endangered animals.
This was just the tip of the icebergfor these researchers as they also discovered animal impurities insome products and some cow DNA that in some countries may violatereligious and cultural practices. Not only will this new procedureassist customs agents around the world, but should also help curbtrafficking in endangered wildlife species.
The second tidbit comes from ADA andhow they are patting themselves on the back for laws passed inGeorgia and Alaska to protect school children with diabetes. I amnot quite ready to give the American Diabetes Association full creditfor these victories although this is what they want you to think. How much lobbying was done the ADA has not been reported by eitherstate yet and the one small article I found in an Alaskan newspapersays the law was an effort by several individuals and no mention ofADA was given. I may have more in the future if I can find solidinformation.
The third tidbit also comes from theADA and the European Association for the Study of Diabetes (EASD)because they have issued a joint position statement emphasizingpatient-specific treatment of hyperglycemia in persons with type 2diabetes. The new guidelines are reported concurrently in the April19 online edition of Diabetes Care and in Diabetologia.
The last guidelines specific tomanagement of hyperglycemia were published about 4 to 5 years ago,and developments that are more recent have now been incorporated intothe new guidelines. Why the wait is a question I must ask, as itwould seem with the developments that are coming at an everincreasing rate would demand new guidelines on a more frequent basis.
In the Medscape article, I do notunderstand why the ACCORD study has to be held up as a benchmark. Vivian Fonseca, MD, ADA president of medicine and science states, “Onthe basis of findings from ACCORD (Action to Control CardiovascularRisk in Diabetes study) and other studies, the ADA has set the HbA1cgoal at 7% in general, but with some individualization.” Hopefully, we are seeing a move away from the “one-size-fits-all”mantra, but while this statement is made, I am willing to say thatthe rank and file will continue in their old ways for several years.
"For patients with advancedcardiovascular disease, reduced life expectancy, and multiple medicalproblems, for example, the goal may be higher," Dr. Fonsecasaid. "For patients who are newly diagnosed and verymotivated, the goal may be lower."
Another recent change underlying thenew guidelines is the recognition that many people with diabetes willneed multiple agents. Yes, that is the problem of the ACCORD studyand why it was stopped early, too many problems developed with peopledying from multiple agents and the aggressive nature of them beingpushed on patients to manage blood glucose levels. When is themedical community going to understand that this will not always workand insulin may be the better route when multiple agents arerequired? This is more evidence that insulin should not be themedication of last resort.
I will be working on more about the newguidelines, but when I will have it ready is unknown. In themeantime, here is the full text PDF files for the ADA and for theEASD.