December 21st, 2011


When to use RX for Diabetes

Comment on the diabetes "megatrials" from Leszek Czupryniak, President of the Polish Diabetes Professional Association:

The results, as you must have heard and you probably might remember, have been conflicting. In some of the studies, intensive glycemic control provided some benefit, especially in terms of microvascular complications. In other trials, especially in the ACCORD study, intensive glycemic control was clearly detrimental in terms of increasing the risk for macrovascular complications.

The first interpretation of these results was basically unfavorable toward intensive diabetes control. And we diabetologists were afraid for a while that perhaps what we were trying to do on an everyday basis was actually harming our patients. However, by looking in more detail at the results -- and this is the issue largely discussed these days in Dubai -- now we know that one [patient with] diabetes is not equal to another [patient with] diabetes. We should no longer adopt one target for [the whole] diabetes population; we should be able to differentiate among patients.

In my opinion -- but not only mine, it has been a shared view during this meeting -- the final interpretation of these studies is rather striking, because now we clearly know that intensive diabetes control is absolutely beneficial for subjects who have just diabetes with no complications, who are relatively young, and who have had diabetes for a shorter time, less than 5 years.

Montana Mountains

New EPA limits on Mercury Emissions Balanced by Particulate Increase

The EPA's new rule is a compromise between public health and corporate profits. Nothing comes for free. Particulates cause increased cardiovascular and respiratory disease and have neurological effects as well. The new rule is called MATS: Mercury and Air Toxics Standards. Obama can't get anything done through congress, but he is still working his evil socialist ways via agencies designed to protect public interests. I for one appreciate some attention given to public health: better to have some reasonably devised limits than to simply let industry poison us for greater profit, even if we WANT the product of that industry.

The EPA proposal incorporates three separate limits: one for mercury, a second for acid gases and a third for particulate matter, which is used to target emissions of metals such as chromium, selenium and cadmium.

In its March proposal, it said the regulation could prevent 17,000 premature deaths from toxic emissions. Today it lowered that estimate to 11,000, according to the statement. Jackson said improved estimates for benefits from a rule to combat pollution across state borders leaves the mercury standard with fewer toxics to remove.

The changes announced today include easing off on mandatory controls for particulate matter, dispatching with pollution caps when plants are starting up or shutting down, and allowing companies greater leeway to average mercury emissions across units. Those changes will save utilities about $1 billion annually, EPA said in a fact sheet.

For more:

For the rule straight from the EPA: