Aggressive Glucose Control May Not Stop Kidney Failure

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What is it about adding oral medicationon top of oral medication that romances researchers to believe thisis the only way to treat type 2 diabetes? In my reading over thelast five years, it seems that unless researchers can have a cocktailof oral diabetes medications, the researchers are not interested.
I doubt I will find out, but it isinteresting to speculate, especially after this from Yale School ofMedicine. Here researchers discovered that aggressive glycemiccontrol may not reduce risk of kidney failure. The researchers foundthat comparing usual treatment and controlling glucose with higherdoses of medication did not improve the chances of preventing kidneyfailure.
Since the results are cloaked behindthe veil of money, I am not able to determine what procedures wereused and what combinations of medications, if any, were used. Thewrite up about the research hides much information that could be ofvalue. I will say this as I think it could be true also. Theresearch did not reach the conclusion desired so they salvagesomething and explain the minimum to justify the study.
Since insulin is not mentioned or anyother medication by name, it is difficult to give any reliability tothis study. My interpretation is that this is again junk science andbecause the results were not what they wanted, we the patients learnnothing. If they had mentioned the medications by name and reallytried to inform us, we may have learned which medications are uselessfor treating end-stage renal problems. I also have to believe thatinsulin was not part of the study and only oral medications wereconsidered.
Since before the ACCORD study, stackingoral medications seems to be the only way to do studies. With theexception of Metformin which slows the release of glucose from theliver, oral medications work on the pancreas to produce more insulinand this means a quicker demise of the pancreas because it cannotcontinue to force out insulin as it is asked to do. Yet, this seemsto be the only topic for research.
Therefore, I think it is time thatstudies are required to have a insulin control group to compare theresults of oral medications against to see which gives the mostefficient treatment. Then maybe the studies could have more meaningand give people with type 2 diabetes some actual comparisons fordetermining which treatment to use. Granted, some additional testingwould be required of the pancreas before and after the study todetermine the amount of insulin the pancreas is capable of producing.
This could also open new analysis forconsideration as this is seldom mentioned in any of the current orrecent studies. Who knows, we could have many study participantsthat are producing small amounts of insulin and incapable of moreinsulin production. This could produce misleading results for anystudy if these are the people participating in the study producesmall amounts of insulin and the people in the control group canproduce greater quantities of insulin. The reverse scenario wouldproduce even more inflated results which the study wants. Yet thisis something seldom seen even in studies given wide publication andnot put behind a wall of money.
If it is the desire to prevent thegeneral public from analyzing the study, then there needs to be astandard criteria published that will let the public know that theseprocedures were followed. Until this is done, we need to beskeptical of most studies and how much we should rely on theiraccuracy. Oral diabetes medications have their place and studyunder different scenarios is needed; however, a group within anystudy needs to be using insulin for a more accurate comparison.