Last Updated: 2005-06-02 12:02:21 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The cholesterol-lowering drug Lipitor, known generically as atorvastatin, reduces cardiovascular events in people with type 2 diabetes and high blood pressure, a study shows.

The findings confirm that regardless of "cholesterol level at baseline, the use of atorvastatin by patients with type 2 diabetes and hypertension reduces adverse cardiovascular events by about a quarter," Dr. Neil R. Poulter of Imperial College, London, told Reuters Health.

In light of these results and other data, Poulter added, "physicians really need to find a good reason why not to include a statin as part of routine treatment for all patients with type 2 diabetes."

The investigator and his and colleagues examined data from a large trial that included more than 10,000 hypertensive patients with no history of coronary heart disease, but at least three cardiovascular risk factors.

The researchers focused on the 2532 participants who had diabetes at the start of the study. The subjects, who did not have very high cholesterol levels, were randomly assigned to take Lipitor or an inactive placebo.

After 3 years, there were 116 (9 percent) major cardiovascular events such as heart attacks or procedures such as coronary bypass surgery in the Lipitor group and 151 (12 percent) in the placebo group -- a significant reduction -- the researchers report in the journal Diabetes Care.

The team concludes that it seems reasonable to prescribe statin therapy routinely for people with diabetes, particularly older patients and those with a long duration of diabetes.

SOURCE: Diabetes Care, May 2005.


Low-Carb Diet Helps Diabetics Quickly Shed Pounds

Last Updated: 2005-03-14 17:00:25 -0400 (Reuters Health)

By Alison McCook

NEW YORK (Reuters Health) - After eating only traces of carbohydrates for 2 weeks, 10 obese patients with Type 2 diabetes lost an average of 3.6 pounds, suggesting that a low-carbohydrate diet works in the short-term, according to study findings released Monday.

Although participants could eat as much protein and fat as they wanted during the diet, they averaged 1,000 fewer calories each day, which was probably the key factor in their weight loss, the lead author told Reuters Health.

The low-carbohydrate diets or the Atkins diet work in the short term because followers "lose weight, and the reason they do is because they eat less," said Dr. Guenther Boden of Temple University in Philadelphia.

Boden cautioned that the two-week diet was "very drastic." People were allowed to eat only 20 grams of carbohydrates per day -- practically no carbohydrates, he said. "There's no way you could stick to this for any length of time."

Consequently, Boden noted that for people who want to lose a little bit of weight -- perhaps 20 pounds -- it makes more sense to cut carbohydrates to "a reasonable amount."

During the study, Boden and his team asked 10 obese people with Type 2 diabetes -- the most common form of the disease -- to follow their usual diets for 7 days, and then cut out practically all carbohydrates for the next 14 days.

While eating their usual diets, people consumed approximately 3100 calories each day. During the 14-day diet, however, they averaged only 2100 calories per day, and lost almost 4 pounds in 2 weeks.

Boden explained that the amount of calories people ate on the low-carb diet matched what they should eat, based on their height. "By taking the carbs away, they adjusted their excessive caloric intake to a normal caloric intake, spontaneously," he said.

As a result, he suggested that there may be something in carbohydrates that fuels appetite, given that that was the only factor that changed in the experiment.

Cutting carbs appeared to also help normalize diabetics' blood sugar, so much so that some patients had to reduce their diabetes medication, Boden added. "For diabetics, you get an additional benefit," he said.

The authors also carefully measured how many calories people burned on daily activities while on the different diets, and found they did not increase their expenditures while eating low-carb fare. Changes in water weight also did not explain the weight loss, the authors report in the Annals of Internal Medicine.

Boden said that he and his colleagues did not accept any financial backing from Atkins Nutritionals, the well-known promoter of the low-carbohydrate diet.

In an accompanying editorial, Dr. George A. Bray, of the Pennington Biomedical Research Center in Baton Rouge, notes that previous research has shown low-carb dieters tend to initially lose more weight than other dieters, but those differences vanish after one year.

If one diet could "cure" obesity, researchers would have discovered it by now, given the amount of time they've spent investigating the subject, Bray adds.

All diets limit food choices, he notes. "I am thus not convinced that one diet has any more value than another -- they all have value," Bray writes.

SOURCE: Annals of Internal Medicine, March 15, 2005.