Weekly Health Update:
"A critical weekly review of important new research findings for health-conscious readers..."
By, Robert A. Wascher, MD, FACS
Updated: 12/12/2010
The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author. Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.
Welcome to Weekly Health Update
“A critical weekly review of important new research findings for health-conscious readers”
METFORMIN, DIABETES AND DEATH
Metformin is a diabetes medication that is of great interest to me, and to other cancer specialists, because of intriguing research data suggesting that it may reduce the risk of cancer occurrence and cancer recurrence in people with diabetes. (Diabetes is, itself, a risk factor for certain types of cancer, including one of the most lethal of all cancers, pancreatic cancer.)
Metformin has been shown to be particularly beneficial in reducing the risk of death due to the complications of diabetes in overweight and obese patients, who are especially prone to developing diabetes. However, there has been some concern regarding the potential safety of metformin in patients with preexisting cardiovascular disease and kidney disease, and so this first-line diabetes medication has not been extensively prescribed to diabetic patients with these diseases. (Somewhat ironically, cardiovascular disease and kidney disease are, themselves, known complications of diabetes.) For this reason, the clinical research study that I will be discussing in today’s column is especially important to the estimated 24 million patients in the United States, alone, who have diabetes, and to the hundreds of thousands of diabetic patients who have already developed cardiovascular disease and kidney disease in the US.
This newly published study, which appears in the current issue of the Archives of Internal Medicine, reports on the results of the massive Reduction of Atherothrombosis for Continued Health (REACH) Study, which included 19,691 patients with documented diabetes. (The researchers involved in the REACH Study have been following this huge number of patient volunteers since they enlisted in the study between December 2003 and December 2004.)
The findings of this very large prospective public health study validate the findings of smaller prior clinical studies. In this study, diabetic patients with cardiovascular disease were significantly less likely to die during the course of this study if they took metformin instead of other diabetes medications (or no diabetes medication at all). The patients in this study who took metformin were 24 percent less likely to die when compared to the diabetic patients who did not take metformin. Among patients with congestive heart failure, which has until recently has been considered a contraindication to taking metformin, the use of metformin was associated with a 31 percent reduction in death due to all causes. Moreover, patients with other health conditions that have previously thought to preclude diabetes treatment with metformin also appeared to benefit from metformin in this study. Diabetic patients with cardiovascular disease who were older than 65 years were 23 percent less likely to die if they took metformin, while patients with decreased kidney function (estimated creatinine clearance of 30 to 60 ml/minute) experienced a whopping 36 percent decrease in the risk of death if they took metformin.
As this was an observational study (i.e., there were no randomized groups of patients, and there was no placebo-control group), it should be urgently followed with a prospective, randomized, placebo-controlled clinical research study to confirm these highly important clinical findings. Taken together, however, the findings of this pivotal public health study are certain to eventually expand the number of patients with diabetes who will be considered eligible to receive metformin!
For a complete discussion of metformin as a potential cancer prevention agent, as well as other important evidence-based approaches to cancer prevention, order your copy of my new book, A Cancer Prevention Guide for the Human Race,now! For the price of a cheeseburger, fries, and a shake, you can purchase this landmark new book, and begin living an evidence-based cancer prevention lifestyle today!
On Thanksgiving Day, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com Top 100 Bestseller’s List for Kindle e-books!
I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month. (As of 9/16/2010, more than 1,000,000 health-conscious people have logged onto Weekly Health Update so far this year!) As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.
Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity
Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author
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Copyright 2007 - 2010
Robert A. Wascher, MD, FACS
All rights reserved
Dr. Wascher's Archives:
12-12-2010: Metformin, Diabetes and Death
12-5-2010: Vitamin D and Depression
11-28-2010: Mammograms Save Lives in Women with Family History of Breast Cancer
11-14-2020: Low Dose Aspirin Reduces Colorectal Cancer Risk
11-7-2010: Coffee, Tea, Caffeine and Brain Cancer Risk
10-28-2010: Diet and Lifestyle Habits that Decrease Colorectal Cancer Risk
10-21-2010: The Silent Epidemic of Surgeon Burnout and Depression
10-14-2010: Gum Disease (Gingivitis) and Breast Cancer Risk
10-7-2010: Hormone Replacement Therapy (HRT) and Breast Cancer Risk
10-3-2010: Mammograms Between 40 and 49 Years of Age
9-26-2010: Vitamin D, Cardiovascular Disease, Cancer, and Death
9-19-2010: Fruits and Vegetables Improve Memory
9-12-2010: Low-Carb Diet and Risk of Death
9-5-2010: Non-Compliance with Hormonal Therapy for Breast Cancer and Risk of Death
8-29-2010: New Treatment for Irritable Bowel Syndrome (IBS)
8-22-2010: Lactoferrin Reduces Abdominal (Visceral) Obesity
8-15-2010: Blueberries, Obesity, Diabetes and Metabolic Syndrome
8-8-2010: High LDL Cholesterol in Young Adults and Heart Disease Risk in Middle Age
8-1-2010: Physician Error
7-25-2010: Obesity and Cancer Risk
7-18-2010: Vitamin D Reduces Risk of Cognitive Decline & Dementia
7-11-2010: All Forms of Hormone Replacement Therapy (HRT) Increase Breast Cancer Risk
7-4-2010: Irritable Bowel Syndrome: Cause Discovered?
6-27-2010: Soy, Curcumin & Prostate Cancer Risk
6-20-2010: Green Tea Epicatechin Reduces Heart Damage & CHF
6-13-2010: Diacylglycerol (Diglyceride) Oil Reduces Obesity
6-6-2010: Important New Advance in the Breast Cancer Treatment: Intraoperative Radiation Therapy
5-30-2010: Medical Research Studies & “Spin”
5-23-2010: Soy & Curcumin Reduce Prostate-Specific Antigen (PSA)
5-16-2010: Coffee & the Risk of Death from Heart Disease & Cancer
5-9-2010: Soy Foods & Stomach Cancer Risk
5-2-2010: Chemotherapy for Breast Cancer & Memory Loss
4-25-2010: Smoking, Teenagers & Tobacco Company Advertising
4-18-2010: Coffee Improves HDL Cholesterol Levels
4-11-2010: Cruciferous Vegetables, Soy & Breast Cancer Risk
4-4-2010: Avodart (Dutasteride) & Prostate Cancer Prevention
3-28-2010: Aspirin & Breast Cancer Survival
3-21-2010: Obesity, Alcohol & Liver Disease
3-14-2010: Nuts, Diet & Obesity
3-7-2010: Walnuts, Cholesterol, LDL & Triglycerides
2-28-2010: Soy Isoflavones & Recurrent Prostate Cancer
2-21-2010: Testosterone Supplements in Frail Elderly Men
2-14-2010: Pancreatic Cancer Risk, Sodas & Juice
2-7-2010: Vitamin D, Cardiovascular Disease & Death
1-31-2010: Concord Grape Juice Improves Memory
1-24-2010: Mozart, Music, Babies & Health
1-17-2010: Breast Cancer, Physical Therapy & Lymphedema
1-10-2010: Prevention of Surgical Site Infections (SSIs) after Surgery
1-3-2010: Ginkgo Biloba, Memory & Cognitive Health
12-20-2009: CT Scans & Cancer Risk
12-13-2009: Soy Isoflavones Decrease Breast Cancer Recurrence Risk
12-6-2009: Salt (Sodium) Intake, Stroke & Cardiovascular Disease
11-29-2009: Exercise & Prostate Cancer Risk
11-22-2009: Genistein (Soy Isoflavone) & Prostate Cancer
11-15-2009: Breast Cancer Treatment & Chronic Pain
1-8-2009: Vitamin D & Breast Cancer Risk
11-1-2009: Exercise & Prostate Cancer Risk
10-25-2009: HPV Virus & Risk of Breast Cancer
10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)
10-11-2009: Vitamin D & Falls in the Elderly
10-4-2009: Surgery, NSQIP, Complications & Death
9-27-2009 Stress, Heart Disease, Exercise & Death
9-20-2009: Vitamin D & Colorectal Cancer Survival
9-13-2009: H1N1 Swine Flu Update
9-7-2009: Green Tea, Aging & Lifespan
8-30-2009: Irritable Bowel Syndrome (IBS), Diet & Fiber
8-23-2009: Update on Prostate Cancer and Cryotherapy
8-16-2009: Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors
8-9-2009: Breast Cancer Recurrence, Death & Vitamin D
8-2-2009: Honesty, Dishonesty & Brain Function
7-26-2009: Coronary Artery CT Scans & Cancer Risk
7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer
7-12-2009: Breast Cancer & Metformin (Glucophage)
7-5-2009: Prostate Cancer & Green Tea
6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)
6-21-2009: Red Yeast Rice, Statins & Cholesterol
6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)
6-7-2009: Diet, Soy & Breast Cancer Risk
5-31-2009: Diet and Prostate Cancer Risk
5-24-2009: Diabetes, Glucose Control & Death
5-17-2009: Drug Company Marketing & Physician Prescribing Bias
5-10-2009: Hemorrhoids & Surgery
5-3-2009: Statin Drugs & Blood Clots (Thromboembolism)
4-26-2009: Are We Really Losing the War on Cancer?
4-19-2009: Exercise in Middle Age & Risk of Death
4-12-2009: Can Chronic Stress Harm Your Heart?
4-5-2009: Does PSA Testing for Prostate Cancer Save Lives?
3-15-2009: Depression, Stress, Anger & Heart Disease
3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children
3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children
2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer
2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones
2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum
1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?
1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors
1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure
12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps
12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection
12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome
12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival
11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk
11-23-2008: Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk
11-9-2008: Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level
11-2-2008: Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk
10-26-2008: Smoking & Quality of Life
10-19-2008: Agent Orange & Prostate Cancer
10-12-2008: Pomegranate Juice & Prostate Cancer
10-5-2008: Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer
9-28-2008: Publication & Citation Bias in Favor of Industry-Funded Research?
9-21-2008: Does Tylenol® (Acetaminophen) Cause Asthma?
9-14-208: Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke
8-23-2008: Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles
2-23-2008: Universal Healthcare Insurance Study; Glucosamine & Arthritis
2-3-2008: Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer
1-12-2008: Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer
12-31-2007: Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?
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