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Soy
and HRT Improves Risk Factors for Heart Disease in Women with
Diabetes
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.
If
your patients are having a problem paying for their medications go to www.diabetesmeds.org
and download the application that will allow them to get all of their
medications for 10 dollars or less for a 90 day supply.
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