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Aggressive Diabetes Therapy Lowers Death Risk, Study Finds
Date:2/6/2008

se [blood sugar levels are] high, if we try to drive it to normal, there may be harm," said Dr. Hertzel Gerstein, a principal ACCORD investigator, and a professor of medicine at McMaster University in Hamilton, Ontario, Canada.

The ACCORD researchers are currently analyzing their data to try to figure out why the intensively managed blood glucose group had a higher death rate, Gerstein added.

For the Steno-2 study, Pedersen and his colleagues randomly assigned 160 people with type 2 diabetes and persistent microalbuminuria to receive either intensive management or standard therapy. Microalbuminuria means that albumin -- a type of protein -- is spilling into the urine, which indicates that some kidney damage has already occurred. The average participant's age at the start of the study in 1993 was 55.

The goals for the intensive therapy group included an A1C level of 6.5 percent or lower, a fasting blood cholesterol level of 175 milligrams per deciliter, a fasting blood triglyceride level of less than 150 milligrams per deciliter, systolic blood pressure of less than 130 mm/Hg and diastolic blood pressure of less than 80 mm/Hg. In addition, regardless of blood pressure levels, those in intensive management were treated with angiotensin inhibitors -- commonly used blood pressure-lowering medications -- and daily low-dose aspirin.

"Although most of the patients didn't achieve the intensive targets, there was an absolute 20 percent different in the death rate compared to the conventional group," said Dr. Kirit Tolia, director of the Joslin Diabates Center at Providence Hospital in Southfield, Mich.

"Diabetes is a very serious disease that needs to be addressed in a very aggressive fashion, and that intervention needs to be multi-targeted," Tolia added.

Nearly 21 million Americans have diabetes, according to the U.S. Centers for Disease Control and Prevention, and their risk of death, particularly cardiova
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