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Medical Forum / Diseases and Disorders / Diabetes / March 2006

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Article: 36% of heart attacks are in diabetics!

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David - 04 Mar 2006 05:33 GMT
http://www.forbes.com/lifestyle/health/feeds/hscout/2006/03/03/hscout531268.html

Dave
gman99 - 04 Mar 2006 06:03 GMT
> http://www.forbes.com/lifestyle/health/feeds/hscout/2006/03/03/hscout531268.html

Buddy...you need to learn how to read. 36 % of diabetics suffered heart
attacks, not 36% of heart attacks are diabetic...
Alan S - 04 Mar 2006 06:28 GMT
>> http://www.forbes.com/lifestyle/health/feeds/hscout/2006/03/03/hscout531268.html
>
>Buddy...you need to learn how to read. 36 % of diabetics suffered heart
>attacks, not 36% of heart attacks are diabetic...

To put it in context:

"Fang's team analyzed New York City death records for people
35 and older from 1989 to 1991 and from 1999 to 2001. In the
decade that elapsed between these two periods, death rates
due to stroke, cancer and all other diseases declined. The
exception was the diabetes death rate, which increased by 61
percent.

Over that decade, the percentage of heart attacks among
people with diabetes increased from 21 percent to 36
percent. The total number of diabetics who had a heart
attack more than doubled -- from 2,951 to 6,048. While there
was an overall decline among the general population in days
spent in a hospital due to heart attack, diabetics showed an
increase of 51 percent."

Whichever way you look at it - it's wise for diabetics to
lead a lifestyle likely to reduce their risk of heart
problems.

Cheers, Alan, T2, Australia.
d&e, metformin 2x500mg
Signature

Everything in Moderation - Except Laughter.

Jenny - 04 Mar 2006 15:46 GMT
> Whichever way you look at it - it's wise for diabetics to
> lead a lifestyle likely to reduce their risk of heart
> problems.

Step one of which is NOT running diabetic blood sugar levels.

This is another one of those areas where there is no research, but if
heart attack risk varies directly with A1c, keeping the A1c in the
normal range, and as low in the normal range as possible, seems like the
very best thing any of us could do for ourselves.

Step two is to remember, that of all the ways you could go, a nice swift
heart attack is high on the list of GOOD ways. The alternatives are
cancer, COPD, Alzheimers, Parkinson's, MS, paralyzing stroke, and a host
of other "ways out"  that are a lot less attractive.

Sometimes the blessings we have to count are odd ones.

--Jenny

http://www.phlaunt.com/diabetes  Diabetes Info

http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood
Sugar Under Control
Alexander Arnakis - 04 Mar 2006 20:31 GMT
>Step one of which is NOT running diabetic blood sugar levels.
>
>This is another one of those areas where there is no research, but if
>heart attack risk varies directly with A1c, keeping the A1c in the
>normal range, and as low in the normal range as possible, seems like the
>very best thing any of us could do for ourselves.

The article doesn't break the diabetes down between Type 1 and Type 2.
I would think the risk of heart attack among Type 2's -- A1c's being
equal -- would be much higher than among Type 1's, because the high
serum insulin levels that result from insulin resistance are a factor
directly linked to heart attacks.

Ironically, pumping *more* insulin into the blood of Type 2's might
worsen the problem. Maybe, therefore, the preferred treatment should
rely more on diet, exercise, oral agents -- and above all weight loss
-- than on exogenous insulin.

I don't think A1c's tell the whole story here.
Greatime - 08 Mar 2006 07:50 GMT
>> Whichever way you look at it - it's wise for diabetics to
>> lead a lifestyle likely to reduce their risk of heart
[quoted text clipped - 20 lines]
>http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood
>Sugar Under Control

Pardon me but I don't understand why people don't seem to mention or
pay attention to saturated fat. Everywhere I see and hear in the
establishment (my endocrinologist, cardiologist, American Diebetic
Association, American Heart Association etc.) say that it is important
to keep saturated fat way down. That is why I seldom can find a recipe
anywhere for cake, cookies, ice cream etc. that I can eat. That
includes products sold in the stores as low carb. Can anyone explain
the lack of attention to this matter that seems to be common on
internet groups.

GT
Alan S - 08 Mar 2006 12:15 GMT
>>> Whichever way you look at it - it's wise for diabetics to
>>> lead a lifestyle likely to reduce their risk of heart
[quoted text clipped - 32 lines]
>
>GT

Hi GT

There is a reason for that. You've been misled.

I'm not an expert, but I'll try to put the point of view
that I formed by reading these newsgroups and many other
sources, and then acting on my distillation of that
information.  The nature of this newsgroup is that the
experts will promptly chime in and correct all of my
errors:-)

In my opinion ALL foods eaten to excess are bad for you.
However, where I differ with your "endocrinologist,
cardiologist, American Diebetic Association, American Heart
Association etc." is that I see very, very few foods as bad
for you in moderation. Where we would also differ is in the
definitions of moderation. Further, not eating adequately
from ALL the major food groups is just as bad for you. Like
the range on your lab reports - many items have a minimum as
well as a maximum; including fats, carbs and protein.

The difficulty is that all of those experts and
organisations have made the assumption for fifty years that
patients are too dumb to understand complex answers. Or they
assumed that we are like children who will eat the bad
things because we like them anyway, so by saying "no" they
really intended to reduce it, not delete it completely.  So
they made it simple. All fat is bad, and saturated fat is
worst. Grains are good, grains are carbohydrates - so eat
more starches, they are good for you. Protein is something
they got a bit vague about, so they tried to ignore it,
apart from muttered dire warnings that too much was bad for
the kidneys - without seeming to precisely define "too
much". Or noting that wasn't necessarily true if you had
healthy kidneys.

Unfortunately, like almost everything to do with the human
body - it just isn't that simple.

The folk you mention neglected to say that some fat is not
only necessary - but good for you. I won't get into all the
details on sat fats, mono-unsaturated fats, poly-unsaturated
fats, trans-fats (even some of those are OK - see the
current discussion). Others here can do that much better
than I.

Nor did they seem to notice that excessive carbs are bad for
you - and the level at which they become excessive is less
for a diabetic. Your meter will show you that for yourself.
Try a test tomorrow an hour after breakfast.

This has got too long. I'll let the others continue.

Let me put it this way. After I changed my breakfast from
cereal, bread, juice and toast to bacon and eggs (and
started testing and a few other things), I lost over fifty
pounds, reduced my HbA1c to under 6% from over 8%, dropped
triglycerides from 2.7(240) to under 1(90) and increased my
HDL from under 1(39) to 1.5(58). It's an old saying, but a
wise one and apt here: the proof of a pudding is in the
eating.

YMMV. Feel free to stick to your cereal; I'll continue to
eat the occasional pork chop, steak and chicken skin.

In moderation. Now it's time to have a scotch:-)

Cheers Alan, T2, Australia.
d&e, metformin 2x500mg
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I have no medical qualifications beyond my own experience.
Choose your advisers carefully, because experience can be
an expensive teacher.

Everything in Moderation - Except Laughter.

Quentin Grady - 08 Mar 2006 17:19 GMT
This post not CC'd by email
On Tue, 07 Mar 2006 23:50:09 -0800, Greatime
<realcotton222@yahoo.com> wrote:

>Pardon me but I don't understand why people don't seem to mention or
>pay attention to saturated fat. Everywhere I see and hear in the
[quoted text clipped - 3 lines]
>anywhere for cake, cookies, ice cream etc. that I can eat. That
>includes products sold in the stores as low carb.

G'day G'day Greatime,

> Can anyone explain the lack of attention to this matter that seems to be common on
>internet groups.
>
>GT

Interesting.  We observe the internet almost inadvertently because we
are part of it.  You obviously have.  I could offer you my explanation
yet I'm a the sort of bloke who is curious about the intent of posters
and about whose responsibility is to meet various needs.

You have observed the internet.  I know that because you have formed a
generalisation that it is COMMON for there to be a lack of attention
given to saturated fats which is less than the amount of attention you
commonly give to saturated fats.  OK, so I accept as a fact that you
think a lot about saturated fats. You have the word of many eminent
people in your life emphasizing that need to keep saturated fats "way
down."    Yet somehow you are wondering why so many other people don't
appear to be pushing that message with a fervour you think
appropriate.

How about a smorgasbord of possible reasons.  
You pick the one that makes you feel better.

Personally I don't believe there is a single reason.

1. People see statins as a the answer. Take the statin ... reduce the
risk of heart attacks. It's easier and less stressful for most people
to pop a pill than to change diet and obsess the way you appear to be
doing over food.  

2.  Many people think the saturated fat-cholesterol-heart attack
hypothesis chain is faulty. The steps might well be provable. The
chain rattles.

3.  Only one diet, the Portfolio diet has successfully produced
a lowering of cholesterol comparable with first generation statins.
It's key feature wasn't low saturated fat though it met that
requirement as did other diets which didn't do enough.
It's key feature was high soluble fibre foods.

4. Some intervention trials have produced 50% reductions in heart
attacks WITHOUT reductions in cholesterol levels.

5.  The WHI study showed low fat was a failed fad, at least for women
who started it in middle age.  It was done in earnest.  There were
over forty follow ups to ensure compliance. It was large, involving
about 50 thousand women. At eight years it was long.  Put simply when
it comes to proof, the sort of things all those eminent people should
be basing their recommendations it was Rolls Royce, gold standard
stuff and the best it could come up with was that it didn't do worse
than the feral Americans who have read the internet, read the diet
books, heard the words of wisdom of many diet gurus and escaped back
into the wild to carry on doing what they do.

Have I answered you question?  Maybe.  

The other maybe is that none of us can. You believe in low saturated
fat as the answer and although you haven't stated it as an aim you
might well like others to do so as well.  Unmet expectations,
especially if hidden, are the cause of many a relationship failure.

Well welcome to the world of inertia.

Those who believe will continue to believe and those who continue to
believe otherwise will continue to do that.

Best wishes in the wilds of the internet.
Signature

Quentin Grady       ^  ^  /
New Zealand,       >#,#< [
                   / \ /\    
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

Bill - 04 Mar 2006 06:51 GMT
>> http://www.forbes.com/lifestyle/health/feeds/hscout/2006/03/03/hscout531268.html
>
> Buddy...you need to learn how to read. 36 % of diabetics suffered heart
> attacks, not 36% of heart attacks are diabetic...

Actually, I think the statement is ambiguous. I does not make sense that over
1/3 of the diabetics in NYC had heart attacks between 1999 and 2001. And they
also claimed the percentage rose from 21% to 36%. It does not make sense that
diabetics have become almost twice as likely to have a heart attack during the
10 year period mentioned with all the new drugs, etc.

I think the article is just poorly written and what it is trying to say is
simply that there are significantly more diabetics in NYC than there used to
be. Also, this is causing significantly more problems.

It would have been good to have a few follow-up paragraphs on what to do about
it.

Bill
gman99 - 04 Mar 2006 12:48 GMT
> >> http://www.forbes.com/lifestyle/health/feeds/hscout/2006/03/03/hscout531268.html
> >
[quoted text clipped - 13 lines]
> It would have been good to have a few follow-up paragraphs on what to do about
> it.

There are significantly more diabetics everywherer...that is fact. That
is because the underlying risk, mainly obesity, has ballooned out of
control. It is a bit of a statistical catch 22....fewer non-diabetics
are having heart attacks because more non-diabetics are taking better
care of themselves. Those who do not take care of themselves are more
likley to become diabetic and after being diabetic their chances of
having a heart attack increases...a bit of a chicken and the egg...the
real problem, IMO, is obesity, not diabetes.
 
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