That's all well and good. My point was (and remains) that type-II diabetes, unless progressed to a hypothetically advanced state which probably doesn't occur in reality, doesn't involve a total lack of beta cell function. It may involve - most likely, as an effect rather than a cause - impaired beta cell function, with which pioglitazone helps, but that's not the same as complete lack of function. In fact, even type-I diabetics show chemical reaction to sugar intake; I, for example, show almost-normal c-peptide response. Unfortunately, the problem is that it doesn't precipitate any insulin production.
IanKennedy wrote:So by one of their chosen methods of calculating IR there was no change in either group. I'm now extremely interested to find out what happens if they use the HOMA model (the standard method) of calculating IR. This does not mean the drug didn't prevent diabetes, just that they may be wrong about the method by which it worked.
The glucose-tolerance may show that lack of effect because there was no testing done on diabetics; further, I'd call a 602-person experimental group statistically unsound. I also don't recall (though I've been chasing a two-year-old around while perusing this) reading about the size of a control group that was taken at the same pre-diabetic state and treated with lifestyle changes before the onset of diabetes.
IanKennedy wrote:Interestingly the difference in FPG (fasting plasma glucose, ie glucose levels in the blood when you haven't eaten for about 10 hours) start out about 7% lower in the active group vs the placebo group after one year. However, by 3 years, the difference is down to about 2%. Equally the two hour values also show the same pattern. This suggests that the effect of the drug is falling off over time, again, indicating a delay of progression rather than a cure. It would seem that it may buy you about 5 years.
Probably. It is possible, though, that the body can adapt over time to allow for more normal essential glucose production in the liver, "through" the effects of the drug as it were. Lord knows that my pre-prandial morning serum glucose is creeping up and up on average; while the long-acting insulin I take is in general effective, and right at the limit of where my dosage can be without causing rampant hypoglycemic reactions, essential glucose production has began to adapt to it and creep up to non-treated levels.
"We've been over this. We don't shoot first and ask questions later."
"Of course! We never ask questions."