(10/09/02)
Patients with diabetes taking soy had improved control of
blood-sugar levels and a significant drop in LDL or "bad" cholesterol and
insulin resistance, suggesting a reduced risk of heart disease
Two
articles out last week say Thursday say both soy supplements and hormone
replacement therapy appear to improve risk factors for heart disease in women
with diabetes. But neither study examines whether the treatments prevent heart
attacks.
Studies in the journal Diabetes Care add to the debate over how postmenopausal
women can best reduce their risks for heart disease. "This is an area where we
have a great deal of data, none of it perfect, and people are trying to make
decisions based on it, which is not easy," says Eugene Barrett, professor of
medicine at the University of Virginia in Charlottesville and president-elect of
the American Diabetes Association.
In
one study, researchers at the University at Buffalo examined data on 2,786
postmenopausal women enrolled in the Third National Health and Nutrition
Examination Survey and found that those with diabetes and currently on hormone
replacement therapy had lower cholesterol and blood-sugar levels than those who
previously used or never used hormone supplements. Levels of certain blood
proteins associated with heart health also appeared better in women on hormone
therapy, the researchers report.
The finding seems to conflict with data from large clinical trials suspended
this summer after hormone replacement therapy was found not to improve heart
health and might even increase the risk of heart disease and stroke.
Carlos Crespo, lead author of the Buffalo study, says his study suggests that
women with diabetes who were not included in the halted trial might be among a
"segment of women who would be better off using" hormone therapy.
Barrett says that is not clear. "It may be that women on (hormones) see their
doctors more, take better care of themselves," he says. "It may not be because
they're on hormone therapy that their cholesterol is a bit lower."
In
the soy study, researchers at the Michael White Centre for Diabetes and
Endocrinology in Hull, England, gave 32 women with diabetes soy supplements or a
placebo for 12 weeks and found those taking soy had improved control of
blood-sugar levels and a significant drop in LDL or "bad" cholesterol and
insulin resistance, suggesting a reduced risk of heart disease.
Neither study looks at long-term outcomes,
Barrett says. "The best you could say is the soy didn't have deleterious
effects, as far as we could tell, but whether that's going to translate into
clinical benefits is not known." Of the hormone study, he says, "Biochemically,
it looked favorable." But other studies designed to isolate the effect of
hormone supplements from other factors "would suggest it's not so favorable."
The best advice, he says, is to talk to doctors about dietary changes or
medications to control blood pressure and blood sugars to lower the risk of
heart disease.
Source: Diabetes In Control Dot Com.