Navigation Links
Strict Blood Sugar Lowering Wont Ease Diabetes Heart Risk

Blood pressure, cholesterol control may be type 2 diabetics' best bet, researchers say

WEDNESDAY, Dec. 17 (HealthDay News) -- Intensive lowering of blood sugar in people with poorly controlled type 2 diabetes does not have a significant effect on reducing cardiovascular events, such as heart attack and stroke, a new study finds.

"You can decrease cardiovascular events in patients with type 2 diabetes by good treatment of lipids [cholesterol], blood pressure and other cardiovascular risk factors," noted lead researcher Dr. William Duckworth, from the Phoenix Veterans Affairs Health Care Center in Arizona. "But among older patients whose risk factors are controlled, intensive glucose control does not add any significant benefit," he said.

That runs counter to the conventional wisdom on the issue, which holds that intensive lowering of blood sugar should reduce cardiovascular events.

"But it's never been proven," Duckworth said. And given the findings of the new study, "time and money may be better expended by doing more work on lipids, blood pressure, diet and exercise," he added.

The report was published in the Dec. 17 online edition of the New England Journal of Medicine.

For the study, called the Veterans Affairs Diabetes Trial (VADT), Duckworth's team randomly assigned almost 1,800 patients averaging 60 years of age to intensive blood sugar control or to standard blood sugar control. All of the patients had experienced suboptimal responses to treatment for type 2 diabetes.

During 5.6 years of follow-up, 264 of the patients receiving standard blood sugar control experienced a heart attack or stroke, died from heart disease, developed heart failure, had surgery for heart disease or had an amputation made necessary by poor circulation.

But so did 235 of the patients who received intensive blood sugar control.

Moreover, there was no difference between the groups in deaths from any cause or other complications from diabetes such as kidney and vision problems, the researchers found.

The value of intensive blood sugar control has become a highly debated topic, especially since two recent studies looking at the benefits of aggressively lowering blood sugar in people with type 2 diabetes came to different conclusions.

One study, the ADVANCE (Action in Diabetes and Vascular Disease) trial found a 21 percent reduced risk for kidney disease in patients on tight glucose control. On the other hand, the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial found a 22 percent increased risk of death for those on the stricter regimen.

Dr. David Nathan, a professor of medicine at Harvard Medical School and chief of the Diabetes Unit Medical Service at Massachusetts General Hospital in Boston, doesn't believe the new study adds much to the mix. And while dramatically lowering blood sugar may not have a benefit for cardiovascular disease, it does have a benefit in slowing or preventing other complications of diabetes, Nathan said.

"Neither study demonstrated a benefit for cardiovascular disease, and ACCORD was stopped early because of increased mortality in the intensive group," Nathan said. "The increased mortality in ACCORD suggests caution in aiming for very low blood sugar levels, which has been the American Diabetes Association's -- and my -- recommendation for years," he said.

"The bottom line here is that diabetes treatment aimed at blood sugar of less than 7 percent on blood sugar tests is of benefit for eye, kidney, and nerve disease, which was established by other studies, but probably underpowered in the VADT, but [it] may not benefit heart disease outcomes," Nathan said. "The VA study doesn't add much to the previously published studies, and it shouldn't be used to loosen the current recommendations," he said.

More information

For more about diabetes, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

SOURCES: William Duckworth, M.D., Phoenix Veterans Affairs Health Care Center, Ariz; David Nathan, M.D., professor of medicine, Harvard Medical School, chief, Diabetes Unit Medical Service, Massachusetts General Hospital, Boston; Dec. 17, 2008, online edition, New England Journal of Medicine

Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Restricting Blood Flow May Help Heart Bypass Patients
2. FDA Seeks to Regulate Complementary and Alternative Medicine; Products Such as Vegetable Juice Could Be Restricted for Medical Use
3. Vitamin Relief Brings Needed Nutrition to School District Resurrecting After Katrina
4. Researchers Pinpoint Link Between Caloric Restriction and Longevity
5. Fingertip Formulary Restrictions(TM) Provides Unprecedented Access to Real- Time Managed Care Restrictions Data
6. Cancer Doctors Across America Stunned at Governments Ruling Restricting Anemia Management Protocols for Cancer Patients, Call Ruling Interference in Practice of Medicine
7. New transfusion rules restrict donations from previously pregnant women
8. Autism Speaks Applauds Supreme Court Decision Upholding Families Right to Challenge IEPs Without First Trying Out School District Proposed Placement
9. Food restriction increases dopamine receptor levels in obese rats
10. Government restrictions on weight loss surgeries limit access for poor, underinsured patients
11. AstraZeneca Response to November 2, 2007 Ruling In Re: Pharmaceutical Industry Average Wholesale Price Litigation, MDL No. 1456, U.S. District Court, District of Massachusetts
Post Your Comments:
Related Image:
Strict Blood Sugar Lowering Wont Ease Diabetes Heart Risk
(Date:11/25/2015)... , ... November 25, 2015 , ... On November 25, ... center for the Narconon network, announced the release of a new cutting edge recovery ... Narconon organization has been working with drug- and alcohol-addicted individuals with the purpose to ...
(Date:11/25/2015)... Crystal Lake, IL (PRWEB) , ... November 25, 2015 , ... ... pleased to announce a recent successful appellate decision obtained by Attorneys Francisco J. Botto ... the case Adcock v. Illinois Workers’ Compensation Comm’n, 2015 IL App (2d) 130884WC. , ...
(Date:11/25/2015)... ... November 25, 2015 , ... Smiles by Stevens is pleased ... moderate facial wrinkling. While many patients are aware of the benefits of Botox® in ... delivers to those suffering with discomfort, soreness, and pain as a result of Jaw ...
(Date:11/25/2015)... (PRWEB) , ... November 25, 2015 , ... Beddit® has ... Beddit Classic sleep tracking systems. The new app features a more intuitive SleepScore™ that ... understand how well you slept. The SleepScore is created by a proprietary algorithm. Beddit ...
(Date:11/25/2015)... Livonia, MI (PRWEB) , ... November 25, 2015 , ... ... at Presence Resurrection Medical Center (RMC) in Chicago, IL, UV Angel is evaluating the ... the medical and surgical intensive care units (totaling 30 beds) from May 2014 through ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... , November 26, 2015 ... Juntendo universitetssjukhus ser potential att använda ... magnetresonansbilder (MR-bilder) för patienter med multipel ... ett forskningsavtal med SyntheticMR AB för att ... forskningsprojekt på sjukhuset. Med SyMRI kan man ...
(Date:11/26/2015)... 26, 2015 ... adds "Global Repaglinide Industry 2015 ... on China Repaglinide Market, 2010-2019" reports ... and information to its online business ... . --> ...
(Date:11/26/2015)... DUBLIN , November 26, 2015 /PRNewswire/ ... the addition of the "Radioimmunoassay Market ... User (Hospital, Pharmaceutical Industry, Academics, Clinical Diagnostic ... - Global Forecast to 2020" report ... ) has announced the addition of the ...
Breaking Medicine Technology: