Thanks for the support. I consider myself widely read and I have insititutional access to many sources, unfortunately, as you are probably aware, Diabetes Care does not allow free access to its most recent articles. I wish the ADA would support patients by providing free access as other journals have done, but what can I say, the ADA has its priorities.
When I disagreed with my endo on the ACCORD I have to give him credit for at least asking me to support my claim. In response, I emailed him the following:
Endochrine Today "ACCORD: Intensive glucose control not to blame for excess mortality", June 10, 2009 on the ADA 69th Scientific session
“HbA1c was associated with hypoglycemia but not in the relationship we expected,” said Denise Bonds, MD, MPH, project officer for ACCORD at the National Heart, Lung and Blood Institute, National Institutes of Health.
Severe hypoglycemia was associated with higher risk for death in both treatment groups but a lower risk in the intensive group vs. standard group (HR=1.28 vs. HR=2.87). Further, risk for hypoglycemia was lower in the intensive control group who achieved the target goal faster compared with the standard group (HR=0.86 vs. HR=0.72). Importantly, hypoglycemia did not account for overall mortality findings.
“Hypoglycemia was felt to play no role in most deaths,” Bonds said. Few deaths occurred within 90 days of a documented episode of severe hypoglycemia.
He did not respond to the email and has not provided further claims, but he is still "resistant." While I think you are right that everyone applauds a motivated patient, many doctors have difficulty with well informed and decisive diabetics and even more so deferring to the patient as the primary authority leading the treatment of the condition. And if anything, I have to admit, I can be a difficult patient.