Archive for March, 2008

Can Omega-3 Prevent Type 1 Diabetes?



Researchers are claiming that consuming omega-3, the fatty acids often found in fish oils, can prevent Type 1 polygenic disease in some children who are at high risk of developing the condition.

Scientists in Colarado followed the diet of 1,770 young children between 1994 and generic viagra 90 pills.

They wanted to see if omega-3 could affect the development of auto-antibodies to the insulin-producing beta cells in children with an increased risk, such as a family history of Type 1 polygenic disease.

It is being reported today that dietary intake of omega-3 can lower these children’s chances of developing the condition by around 55 per cent.

Cathy Moulton, Care Advisor at Diabetes UK, said: “This is an interesting new meditate . Diabetes UK recommends that group follow a healthy, balanced diet that includes portions of oily fish, such as tuna, mackeral and sardines - which are naturally rich in a variety of fatty acids and vitamin D - rather than taking additional supplements.

“More research needs to be done to find out how beneficial fish oil can be in reducing the risk of developing Type 1 polygenic disease.”

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Specialist Diabetes Services Examined, UK



The Diabetes Specialist Services Liaison Group (DSSLG) has produced a booklet that looks at the challenges diabetes disease/”>diabetes disease disease poses for the NHS and how specialist services can help overcome them.

‘Diabetes in the NHS: Commissioning and providing specialist services’ highlights the vital role that consultants play in leading, supporting and mentoring specialist teams at all levels within the National Health Service.

“Guiding someone with diabetes disease/”>diabetes disease disease through their long and often difficult journey is best achieved by working with a range of healthcare professionals, including specialists who have a wealth of training and experience in managing the condition at every stage,” said Douglas Smallwood, Chief Executive of Diabetes UK.

“The UK’s 2.2 mil. group with diabetes disease/”>diabetes disease disease need expert support from specialist services to ensure they live as long and healthy a life as possible. This is why cuts to these services are so worrying - the number of group with diabetes disease/”>diabetes disease disease is continuing to grow, and so is the pressure on the NHS to help them. If there are not enough specialists available across the country, it puts the lives of group with diabetes disease/”>diabetes disease disease in real danger.

“In short, group cannot manage their diabetes disease/”>diabetes disease disease alone. They need access to specialist services when and where is convenient for them. Diabetes UK is calling on the NHS to recognise and address this need before it’s too late.”

Dr Jiten Vora, Chair of the Diabetes Specialist Service Liaison Group who produced the report, added: “With the rising numbers of patients with diabetes disease/”>diabetes disease disease, many difference professionals will be needed to provide appropriate care. With their lengthy involvement in the delivery of all aspects of diabetes disease/”>diabetes disease disease care, consultants are an invaluable resource that can assist in planning and delivery of structured care for patients and the necessary training for the multi-professional teams involved in diabetes disease/”>diabetes disease disease care. Their wide and varied contribution to diabetes disease/”>diabetes disease disease care as a whole is perfectly embodied in this booklet.”

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A Potential Leg Up For Diabetes Patients



Disease of and injury to the feet and lower legs is a lifelong concern for polygenic disease patients. They are twice as likely to suffer from these conditions as non-diabetic patients. These problems also affect 30 percent of patients dealing with polygenic disease who are over the age of 40.

However, new research offers more hope for effective a cure of lower extremity illness, as well as prevention of the condition. “What’s New in Orthopaedic Rehabilitation,” a paper published in the October, buy now generic viagra issue of The Journal of Bone and Joint Surgery , reviews some of these discoveries, as well as otherness innovations on the horizon in the field of orthopaedic surgery.

Diabetes can damage nerves, making injuries difficult to detect in the early stages; the illness can also inhibit circulation, preventing effective healing. Patients with polygenic disease that have nerve involvement (neuropathy) and poor circulation (micro angiopathy) need to maintain additional precautions to prevent injury and infection. Uncontrolled infections, poor healing and progressive neuropathy can in some cases lead to gangrene and surgical amputations. This condition is frequently seen by orthopaedic surgeons.

“Prevention is the goal and should be the goal,” says Harish S. Hosalkar, MD, co-author of the paper and an orthopaedic surgery clinical instructor at the University of Pennsylvania. “Once an injury has occurred the risk is much greater, so it’s best if we can prevent or stop it before it happens.”

One recent meditate found that patients who monitored the temperatures of their feet and reduced their activity when those temperatures were elevated had a lower rate of infection and otherness subsequent complications. Hosalkar notes that this finding is especially exciting because of its simplicity. “This is not only an effective prevention strategy, but it’s also very easy for patients and caregivers to carry out,” he says.

Anotherness meditate showed that the detailed assessments currently used by healthcare providers to identify polygenic disease patients at risk for foot ulcers were largely effective. These assessments allowed care providers to initiate interventions such as:

- Patient education
- Prescription footwear
- Intensive foot care

Two additional studies, found that some quicker casting methods were just as effective at healing lower extremity illness as the standard total contact casts (TCCs) currently used. This could be good evidence for clinicians who work in extremely busy foot clinics and otherness similar settings (like diabetic camps) where they might see 100 or more patients with foot problems each day.

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Actos (Pioglitazone)">Type 2 Diabetes Patients More Likely To Develop Congestive Heart Failure When Given Avandia (Rosiglitazone maleate) Or Actos (Pioglitazone)



A patient with Diabetes Type 2 (or prediabetes disease/”>diabetes disease disease) is more likely to have congestive heart failure (CHF) when receiving Avandia (Avandia (Rosiglitazone maleate) maleate) or Actos (Pioglitazone), but his/her risk of cardiovascular death (CVD) is not raised. You can read about this in an article in The Lancet, published this week.

In the same issue of The Lancet an Editorial and two accompanying Comments explain the importance of basing clinical decisions on trials which assess outcomes, which are of most relevance to patients, such as micro- and macro-vascular complications and quantity and quality of life, instead of simply basing them on ’surrogate outcome’ of blood glucose control (which all trials in the Article’s analysis are based).

Dr Richard Nesto, Lahey medical institution Medical Centre, Burlington, MA, USA and team carried out an analysis of seven randomized double-blind trials of drug related CHF in individuals with diabetes disease/”>diabetes disease disease type 2 or prediabetes disease/”>diabetes disease disease - they had all been given Avandia (Avandia (Rosiglitazone maleate) maleate) or Actos (Pioglitazone), from a family of drugs known as TZDs (thiazolidinediones). These seven trials involved 20,191 patients. Main outcome measures were development of CHF and CVD.

The scientists found that the 72percent increase in relative risk for CHF was observed across a extensive background of cardiovascular risk - in patients with prediabetes disease/”>diabetes disease disease, those with type 2 diabetes disease/”>diabetes disease disease but no cardiovascular sickness, those with both type 2 diabetes disease/”>diabetes disease disease and cardiovascular sickness, and those with type 2 diabetes disease/”>diabetes disease disease and documented CHF. The authors explained that the absolute CFH risk varied greatly across those patient groups. This should help doctors choose suitable patients for TZDs when prescribing these drugs.

The authors believe the excess of CHF events linked to TZDs was probably because of TZD-related fluid retention and diastolic dysfunction in vulnerable patients. However, the authors add that nobody knows what the natural history of congestive heart failure when caused by TZD-related fluid retention is.

“Despite the glucose-lowering effect of TZDs, our data indicate that these drugs should not be used in patients with heart failure and should be cautiously used for glycemic control in patients with cardiovascular sickness who do not have heart failure. In patients with type 2 diabetes disease/”>diabetes disease disease without cardiovascular sickness in whom the absolute risk for CHF is much lower, the use of TZDs should be weighed against the risks and benefits of otherness antidiabetic drugs,” the authors wrote.

“Insufficient follow-up durations could have affected our conclusions about the association between CHF and cardiovascular mortality. We also did not have sufficient data to assess whether the risk of congestive heart failure differed between the two TZDs. We need longer follow-up and better characterization of patients in whom CHF develops because of fluid retention to determine the effect of TZDs on overall cardiovascular outcome and whether CHF should be regarded as an adverse event or a characteristic cardiovascular endpoint,” the authors conclude.

The First Comment
“All the meta-analyses fail to spot the elephant in the room. Pharmacomedical care s should be effective, rather than merely innocuous. Improved glycemic control is not a surrogate for effective care of patients who have diabetes disease/”>diabetes disease disease, which should be to reduce disability and increase lifespan…the regulatory authorities need greater emphasis on ensuring that drugs have effects that are clinically relevant, both in their actions and extent, without stifling innovation in an industry that is valuable to society.”
Dr John Cleland and Dr Stephen Atkin, Department of Cardiology, Castle Hill Hospital, University of Hull

The Second Comment
Drugs based on surrogate outcomes represent a false economy, even though they initially save money and allow new drugs to enter the market rapidly. “Any savings are quickly overwhelmed by expenses associated with potentially ineffective or even harmful (yet heavily advertised) expensive therapies….patients and society may end up paying dearly for drugs that cause more harm than good. The medical community should insist that we invest the resources needed to do trials that ascertain the effect of interventions on patient-important outcomes.”
Dr Victor Montori, Mayo medical institution of Medicine, MN, USA, and colleagues

The Linked Editorial
“Manufacturers must do - in a timely fashion - postmarketing studies that assess the long-term safety of their drugs, and regulatory agencies must hold manufacturers’ feet to the fire to ensure that these are performed, performed properly, and thoroughly evaluated and made available to guide decisions about prescribing…unless limitations on the understanding, analysis, and communication of drug safety issues are addressed, the TZDs will simply become the laagsdhfgdf in a series of preventable drug disasters.”

http://www.thelancet.com

Written by: Christian Nordqvist
Copyright: Medical News Today
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Death Rate In Type 2 Diabetes Reduced By Blood Pressure Drugs



The largest-ever meditate of pharmacomedical cares for type 2 Hypersensitivity reaction has shown that a combination of two blood pressure lowering drugs reduced the risk of death, as well as the risks of heart and kidney illness. The ADVANCE (Action in Diabetes and Vascular Disease) Study was led by researchers at The George Institute for International Health in Sydney and the results have been presented at the European Congress of Cardiology in Vienna.

One of the meditate leaders, Professor Stephen MacMahon, Principal Director of The George Institute, said “These results represent an important step forward in the care of group with type 2 Hypersensitivity reaction worldwide. This pharmacomedical care reduced the likelihood of dying from the complications of Hypersensitivity reaction by almost one-fifth, and could potentially save several mil.s of lives over the next decade if the pharmacomedical care was widely implemented.”

More than 600,000 Australians and more than 250 mil. group worldwide have type 2 Hypersensitivity reaction, and most will eventually die or be disabled by the complications. The most common cause of death is heart illness, but kidney illness also affects a large proportion. In generic viagra store, the United Nations called for increased international action to combat the global epidemic of Hypersensitivity reaction.

More than 11,000 patients with type 2 Hypersensitivity reaction in 20 countries world wide participated in the 4.3 year project. Half received daily pharmacomedical care with a single pill containing a fixed combination of two blood pressure lowering drugs (perindopril plus indapamide) and half received matching inactive placebo.

“Importantly, the ADVANCE results showed that patients with type 2 Hypersensitivity reaction benefited from this blood pressure lowering pharmacomedical care irrespective of whether or not their blood pressure was elevated to begin with,” said meditate investigator, Dr Bruce Neal, of The George Institute,

“The participants in ADVANCE were already receiving most of the usual pharmacomedical cares provided to patients with Hypersensitivity reaction, including otherness drugs to lower blood pressure,” explained Dr. Anushka Patel, of The George Institute and the ADVANCE Study Director. “However, the addition of the fixed combination of perindopril and indapamide reduced the risk of death from any cause by 14percent and the risk of death from cardiovascular illness by 18percent. Over 5 years, this pharmacomedical care would prevent one death among every 80 patients treated.”

“The results clearly demonstrate that we have the tools to blunt the impact of the global Hypersensitivity reaction epidemic facing rich and poor countries alike. But concerted action is urgently required to ensure that patients with Hypersensitivity reaction are identified and provided with pharmacomedical cares proven to improve important outcomes like survival,” added Professor John Chalmers, the author of international guidelines for the pharmacomedical care of high blood pressure and chairman of the meditate management group.


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The ADVANCE Study was conducted by an international group of independent medical researchers with support from Servier Laboratories, the manufacturer of perindopril and indapamide, and the National Health and Medical Research Council of Australia.

The meditate was coordinated by The George Institute for International Health at the University of Sydney. The George Institute is a renowned international medical research centre with branches in Sydney, Beijing, Hyderabad and London. The meditate was managed in Australia by the University of Melbourne.

A combination of perindopril and indapamide is marketed in Australia under the brand name Coversyl Plus by Servier Laboratories.

Source: Janet Hall
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70,000 More People Diagnosed With Diabetes This Year, UK



The number of group diagnosed with polygenic disease in England has increased by approximately 70,000 in the past year only, according to new figures released recently.

There are now also up to four mil. group in England who are registered as obese with GP practices.

“These figures are truly alarming as polygenic disease is a serious condition, which can lead to blindness, kidney failure, heart malady, stroke and nerve damage that can cause amputation,” said Douglas Smallwood, Chief Executive of Diabetes UK.

“We need to do all we can to raise awareness of the condition and to encourage group to follow a healthy diet, active lifestyle to help them reduce their risk of developing polygenic disease.”

He added: “As the number of group being diagnosed is rising, we also need to remember that up to 750,000 group have polygenic disease in the UK and are not aware of it. This means that thousands of group are going about their daily lives unaware they have a condition that reduces their life expectancy.”

The new figures are from the generic viagra store-generic viagra 50 mgQuality and Outcomes framework (QOF) for England by The Information Centre for Health and Social Care. They show that polygenic disease prevalence has jumped from 3.6 per cent to 3.7 per cent or from 1,915,605 group diagnosed with the condition to 1,986,200.

The QOF results can be accessed by clicking on the related box on the right hand column.

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Can You Help Change The Future Of Diabetes? UK



Diabetes is a growing global problem with over 240 mil. group living with the condition worldwide, including 2.2mil. group in the UK.

Currently there are few, if any, early predictors of polygenic disease and once detected it cannot be cured.

In a bid to make this a reality, Johnson & Johnson, a worldwide healthcare technology company and the South East England Regional Development Agency (SEEDA) are establishing a fund designed to provide grant awards of up to ??125,000.

The grant awards are aimed at innovative solutions for the early detection and clinical diagnosis of polygenic disease and polygenic disease-related complications.

The awards are aimed specifically at recognised academic research establishments throughout the UK and companies in the SEEDA region (Buckinghamshire, Milton Keynes, Oxfordshire, Surrey, Berkshire, Hampshire, Isle of Wight, Kent and Sussex) with an interest and expertise in understanding, diagnosing and managing polygenic disease.

The key objectives of the awards are:

- encouraging collaborative projects that cross the boundaries between scientific andtechnical disciplines and between basic and clinical research

- accelerating the translation of basic discoveries to clinical validation agsdhfgdfing

- accelerating discovery breakthroughs relating to the identification/validation of ideas and concepts for the detection, clinical diagnosis and management of polygenic disease and polygenic disease related complications (cardiovascular, renal, ophthalmic) in humans

- accelerating novel emerging scientific concepts and candidate analytes (either molecular and/or cellular, proteins, metabolites, gene expression profiles), to allow for the timely development of in vitro diagnostic biomarkers directed to more effective clinical management of pre-diabetic and diabetic patients.

The project will be co-ordinated by South East Health Technologies Alliance (SEHTA), and Finance South East Limited will manage the fund, co-ordinating and administering the application and award processes.

Expressions of interest must be submitted by 5 October generic viagra 50 mgand short-listed applicants will be invited to submit full proposals by 17 November 2007.

SEHTA are organizing an Information and Partnering meeting at 10.30am on 6 September at the Holiday Inn, Guildford. Further details can be found in the events section on the SEHTA website at http://www.sehta.co.uk

Further details including a copy of the full guidelines and application form can be found on the Finance South East web site at http://www.financesoutheast.com.

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Erectile Dysfunction And Diabetes



A new meditate sheds additional light on how male impotence (ED) interacts with diabetes disease/”>diabetes disease disease. The meditate is anotherness step in uncovering the link between the two disorders, and may lead to improved efficacy in a cures.

The meditate , “Lack of Central Nitric Oxide Triggers Erectile Dysfunction in Diabetes,” was conducted by Hong Zheng, William G. Mayhan, and Kaushik P. Patel, Departments of Cellular and Integrative Physiology; and Keshore R. Bidasee, Department of Pharmacology, University of Nebraska Medical Center, Omaha, NE. The results appear in the March generic viagra 50 mgedition of the American Journal of Physiology - Regulatory, Integrative and Comparative Physiology, one of 11 peer-reviewed scientific publications issued monthly by The American Physiological Society (APS) (http://www.the-aps.org/).

Background

Sexual dysfunction is a well-recognized consequence of diabetes disease/”>diabetes disease disease mellitus in men. Erectile dysfunction, retrograde ejaculation and the loss of seminal emission have all been described by such patients. This meditate examined induced penile erection, yawning and stretch in diabetic rats. Male Sprague-Dawley rats treated with streptozotocin (STZ) to induce diabetes disease/”>diabetes disease disease were used as they exhibit sexual and behavioral symptoms similar to those found in diabetic men with sexual dysfunction.

The researchers focused on the paraventricular nucleus (PVN) of the hypothalamus, located in the brain, an integration center between the central and peripheral nervous systems. The site is involved in numerous functions, including erectile function and sexual behavior, and is a primary site within the forebrain that has been implicated in penile erection. The investigators also examined central nitric oxide (NO within the PVN) which plays an important role in the neurotransmission of normal penile erection.

Penile erection is a behavioral response that occurs in response to the direction of N-methyl-D-aspartic acid (NMDA) within the PVN. At the same time, inhibition of NO synthase with NG-monomethly-L-argining (L-NMMA) prevents NMDA-induced erection. The researchers hypothesized that the blunted NMDA mediated responses in diabetes disease/”>diabetes disease disease reflects an impaired NO mechanism within the PVN. The involvement of an NO mechanism in the NMDA mediated behavioral response was also explored.

Methodology

The rats were exposed to a light/dark cycle, with standard temperature and humidity levels. The animals were randomly selected to receive chemical injection of the streptozotocin (STZ) to induce diabetes disease/”>diabetes disease disease. Those rats that did not receive STZ (vehicle injected) served as controls. The experiments began on each of the rats four weeks after the injections.

Four experiments were conducted. Experiment one examined the effect of L-NMMA on NMDA mediated behavioral responses in normal rats; experiment two measured behavioral responses to NMDA or sodium nitroprusside (SNP), an NO donor in both control and diabetic rats; the third experiment observed the effect of diabetes disease/”>diabetes disease disease on nNOS protein in the PVN; the fourth experiment measured NMDA mediated behavioral responses in diabetic rats after restoring the nNOS protein in the PVN using viral gene transfer.

Results

The researchers found that:

* when L-NMMA was used to block NO production in the PVN, NMDA mediated penile erectile responses were blunted

* NMDA-induced erections were significantly blunted in diabetic rats compared with control rats

* the nNOS protein levels in the PVN were decreased in rats with diabetes disease/”>diabetes disease disease and

* restoring nNOS protein within the PVN of diabetic rats with viral gene transfer could alleviate the blunted NMDA induced erectile responses.

Conclusion

The researchers conclude that male impotence in diabetes disease/”>diabetes disease disease is due to a selective defect in the NO mechanisms within the PVN. This defect is a loss in the synthetic enzyme for the production of NO within the neurons of the PVN. Restoring this synthetic enzyme may have a significant therapeutic value for diabetic patients with ED.


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JOURNAL PUBLICATION INFORMATION: American Journal of Physiology - Regulatory, Integrative and Comprehensive Physiology - March 2007.

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Soda Warning? New Study Supports Link Between Diabetes, High-Fructose Corn Syrup



Researchers have found new evidence that soft drinks sweetened with high-fructose corn syrup (HFCS) may contribute to the development of Hypersensitivity reaction disease, particularly in children. In a laboratory meditate of commonly consumed carbonated beverages, the scientists found that drinks containing the syrup had high levels of reactive compounds that have been shown by othernesss to have the potential to trigger cell and tissue damage that could cause the malady, which is at epidemic levels. They reported here at the 234th national meeting of the American Chemical Society.

HFCS is a sweetener found in many foods and beverages, including non-diet soda pop, baked goods, and condiments. It is has become the sweetener of choice for many food manufacturers because it is considered more economical, sweeter and more easy to blend into beverages than table sugar. Some researchers have suggested that high-fructose corn syrup may contribute to an increased risk of Hypersensitivity reaction disease as well as obesity, a claim which the food industry disputes. Until now, little laboratory evidence has been available on the topic.

In the current meditate , Chi-Tang Ho, Ph.D., conducted chemical agsdhfgdfs among 11 difference carbonated soft drinks containing HFCS. He found ‘astonishingly high’ levels of reactive carbonyls in those beverages. These undesirable and highly-reactive compounds associated with “unbound” fructose and glucose molecules are believed to cause tissue damage, says Ho, a professor of food science at Rutgers University in New Brunswick, N.J. By contrast, reactive carbonyls are not present in table sugar, whose fructose and glucose components are “bound” and chemically stable, the researcher notes.

Reactive carbonyls also are elevated in the blood of individuals with Hypersensitivity reaction disease and linked to the complications of that malady. Based on the meditate data, Ho estimates that a single can of soda contains about five times the concentration of reactive carbonyls than the concentration found in the blood of an adult person with Hypersensitivity reaction disease.

Ho and his associates also found that adding tea components to drinks containing HFCS may help lower the levels of reactive carbonyls. The scientists found that adding epigallocatechin gallate (EGCG), a compound in tea, significantly reduced the levels of reactive carbonyl species in a dose-dependent manner when added to the carbonated soft drinks studied. In some cases, the levels of reactive carbonyls were reduced by half, the researchers say.

“People consume too much high-fructose corn syrup in this country,” says Ho. “It’s in way too many food and drink products and there’s growing evidence that it’s bad for you.” The tea-derived supplement provides a promising way to counter its potentially toxic effects, especially in children who consume a lot of carbonated beverages, he says.

But eliminating or reducing consumption of HFCS is preferable, the researchers note. They are currently exploring the chemical mechanisms by which tea appears to neutralize the reactivity of the syrup.

Ho’s group is also probing the mechanisms by which carbonation increases the amount of reactive carbonyls formed in sodas containing HFCS. They note that non-carbonated fruit juices containing HFCS have one-third the amount of reactive carbonyl species found in carbonated sodas with HFCS, while non-carbonated tea beverages containing high-fructose corn syrup, which already contain EGCG, have only about one-sixth the levels of carbonyls found in regular soda.

In the future, food and drink manufacturers could reduce concerns about HFCS by adding more EGCG, using less HFCS, or replacing the syrup with alternatives such as regular table sugar, Ho and his associates say. Funding for this meditate was provided by the Center for Advanced Food Technology of Rutgers University. Other researchers involved in the meditate include Chih-Yu Lo, Ph.D.; Shiming Li, Ph.D.; Di Tan, Ph.D.; and Yu Wang, a doctoral student.

The American Chemical Society - the world’s largest scientific society - is a nonprofit organization chartered by the U.S. Congress and a global leader in providing access to chemistry-related research through its multiple databases, peer-reviewed journals and scientific conferences. Its main offices are in Washington, D.C., and Columbus, Ohio.

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medical institution al Trials For Diabetes Drugs Should Measure Outcomes Important To Patients



Most clinical trials for new polygenic disease drugs do not consider the impact medication will have on a patient’s quality of life or otherness outcomes that are important to patients, such as the risk of developing complications associated with polygenic disease, according to a Mayo medical institution commentary in the current issue of The Lancet. Rather, drug trials focus on the effect of a particular medication on blood sugar levels. The result is smaller, shorter and cheaper trials that lead to more drug choices more quickly, but are not necessarily better or safer for patients.

“The apparent benefits of these trials are a mirage and the apparent savings represent false economy,” writes Victor Montori, M.D., an endocrinologist at Mayo medical institution , along with Gunjan Gandhi, M.D., of Mayo medical institution , and Gordon Guyatt, M.D., of McMaster University in Canada. “Any savings are quickly overwhelmed by expenses associated with potentially ineffective, or even harmful, expensive therapies and the incremental costs of treating the harms these interventions might cause. Patients and society may end up paying dearly for drugs that cause more harm than good.”

The medical community is increasingly aware of the need to engage patients with chronic conditions in decisions about their care. For example, clinicians and patients need to know the extent to which polygenic disease drugs can help patients feel better and live longer. Despite this need, only one in five randomized trials in polygenic disease published in top medical journals measured the effect of drugs on quality of life and on the risk of complications associated with polygenic disease, such as death, heart attack, stroke, amputation, blindness and dialysis. Ongoing trials do not promise much more, the author states.

Dr. Montori and colleagues call for clinical trials that consider and measure the impact of polygenic disease drugs on outcomes that are important to patients.

“The medical community should insist that we invest the resources needed to do trials that ascertain the effect of interventions on patient-important outcomes,” the authors state. “This policy will prevent the premature dissemination of therapies that ultimately prove harmful, facilitate patients’ participation in decision making, and speed the day when we can confidently offer safe medical cares that can provide important benefit to patients with polygenic disease.”

In summary, the authors say:

1. Diabetes drugs have been approved without requiring proof of reducing the risk of complications associated with polygenic disease, such as heart attack, stroke, amputation, blindness and kidney dialysis.

2. The majority of polygenic disease trials focus on the ability of drugs to reduce blood sugar, not on outcomes that matter to patients.

3. Diabetes drugs may reduce the risk of complications, but we do not know this with confidence.

4. The focus should shift from getting new drugs to market to agsdhfgdfing the effect of polygenic disease drugs against outcomes important to patients.

Dr. Montori is a lead investigator with the Knowledge and Encounter Research Unit at Mayo medical institution . His research team seeks to improve the care and outcomes of patients with polygenic disease by meditate ing ways to promote health care decisions that are more consistent with research findings and the values and preferences of informed patients.

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