Avandia Safety

Avandia (a Type 2 Diabetes Medication) Update
Last week, an FDA advisory panel voted to keep Avandia available in the United States. Three medical associations have told people who take the medication to continue to take it unless they are told to stop by their health care team or physician. The Endocrine Society, American Diabetes Association, and the American Association of Clinical Endocrinologists warned that stopping the medication can cause high levels of glucose in the blood, which may lead to the exacerbation of long-term diabetes complications. Please talk to your physician about Avandia if you take this medication.

Using A1c as a Diagnosis Tool in the African-American Population
Another study in Endocrinology Today, written by David S.H Bell, MD, found that the A1c test may show ethnic inconsistencies between the percentages reported and glycemic burden for African-Americans diagnosed with type 2 diabetes.

The researchers from the University of Tennessee Health Science Center studied 234 African-American and Caucasian people who had a parent with type 2 diabetes but who did not have the disease at the time of testing.

Participants were given a fasting glucose tolerance test along with the A1c test. The African-American participants were found to have significantly higher A1c test scores than the Caucasian participants who were matched for BMI, waist circumference, age, insulin resistance, and beta cell function.

Because of the significantly higher A1c scores in the African-American population, the researchers suggested that physicians should use caution using this test for diagnosing either pre-diabetes or type 2 diabetes in the African-American population.

Another study done at Emory University by David Zeimer et al which was reported in the Annals of Internal Medicine (2010; 152:770-777) reported that A1c scores were 0.13% and 0.21% higher in African-American participants with normal glucose tolerance.

In pre-diabetes, the A1c were 0.26% and 0.30% higher. These researchers recruited over 3,000 participants for their study and concluded that using the A1c for diagnosis of type 2 diabetes or pre-diabetes in African-American patients should not be a part of any assessment until the factors that affect these differences are better understood.

Why You Should Eat Whole Grains: They Reduce the Risk of Type 2 Diabetes
Current research continues to tout the benefits of eating a diet high in fiber from whole grains and low in saturated fats.

To further emphasize this, we bring you an article from the Archives of Internal Medicine (2010; 170(11):961-969) titled "White Rice, Brown Rice, and the Risk of Type 2 Diabetes in US Men and Women." It was written by Q. Sun, MD, ScD et al, and they examined the effect of processed rice using information from the Health Professionals Follow-up Study and the Nurses' Health Study I and II.

They looked at diet, lifestyles, and reported diseases in 39,765 men and 157,463 women. After accounting for confounders like age, lifestyle, and other dietary risk factors, the researchers found that consuming 5 or more servings of white (processed) rice per week verses less than 1 serving per month brought a higher risk of type 2 diabetes.

On the other hand, eating at least 2 servings of brown rice a week lowered the risk of type 2 diabetes. That means that substituting the same amount of brown rice for white rice resulted in a lowering of 16% in the risk factor for developing type 2 diabetes.

The researchers also looked at replacing the same amount of food with other whole grains, and that lowered the type 2 diabetes risk factor by 36%. The researchers concluded that the substitution of whole grains in the diet rather than eating processed foods like white rice can have a significant effect on preventing type 2 diabetes.

Read the abstract here.

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