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.