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Mr. Metabolism loves to follow new developments in diabetes research—in fact, that's one of the ways he makes his living. The following brief summaries give Mr. Metabolism's views on the Research Reports in the latest issue of DIABETES HEALTH.
Comment on Pentoxifylline
Ah, immunosuppression...desperation therapy for a desperate disease! Immunosuppression is justified only when the alternative is death, as in a kidney transplant. When the alternative is insulin injections, immunosuppression is not justified. The studies showing that the honeymoon can be extended by immunosuppression are regarded by sophisticated clinicians as academic curiosities. Mr. Metabolism thinks immunosuppressive therapy is a fad that will pass.
Comment on BGAT
The crash rate number implies that the vast majority of auto crashes by people with diabetes are caused by unawareness of hypoglycemia, a frightening idea. Over half of crashes by nondiabetics are caused by drunkenness. But 5/6 of the crashes involving people with diabetes are caused by hypoglycemia. Thus low blood sugar is more common than drunkenness in drivers with diabetes!
As they say, how you put your organ to use is more important than how big it is, but people with diabetes seem to be deficient in both departments. I am very skeptical of this report, but it could make sense if insulin is itself a growth hormone for the pancreas. Obviously people with diabetes have much lower levels of insulin in their pancreases because it is administered in the skin rather than being made in the pancreas. If the pancreas requires insulin from endogenous islets to maintain its size, then in a person with type I diabetes it would shrink. Just a speculation.
French Drinking Study
It seems to me that diabetes (obviously NIDDM) makes people want to drink rather than drink causing diabetes.
Very amusing. These sorts of studies usually turn out to be statistical artifacts that disappear following additional studies. The most common problem is that if you look at enough variables, one will correlate by chance—for instance, if you take a random group of 20 people and measure 20 random variables (for instance eye color, height, favorite composer) you could "prove" that blue eyed people who love Mozart are likely to get diabetes (which really occurred by chance). Thus a repeat at an independent center would be needed before I would even speculate about the cause.
0 comments - Mar 1, 1994
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