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Studies Differ on Benefits of Aggressive Blood Sugar Control
Date:6/7/2008

primarily kidney disease," lead researcher Dr. Anushka Patel, director of the Cardiovascular Division at the George Institute for International Health in Sydney, Australia, said during a teleconference Friday.

"There were no clear effects on macrovascular complications such as heart attack or stroke," Patel said. "Most importantly, using the strategy we employed for intensive glucose control, there was no increased risk of death."

In the study, 11,140 high-risk patients with type 2 diabetes either underwent intensive blood sugar control or standard treatment. By the end of the trial, most of the patients in the intensive care group were on several drugs, including insulin.

The ADVANCE researchers did not find any effect on cardiovascular disease between the two groups. The study also didn't find any increased risk of death for either group, unlike the second trial.

"These findings confirm what we already know -- that microvascular complications, and particularly kidney disease, is less with people whose blood sugar is intensively controlled," said Dr. Spyros Mezitis, an endocrinologist at Lenox Hill Hospital in New York City.

"This trial reassures us that we should be intensively controlling the blood sugar of patients so that we avoid microvascular complications," Mezitis added.

In the second study, called ACCORD (Action to Control Cardiovascular Risk in Diabetes), researchers found a 22 percent increased risk of death among patients receiving intensive blood sugar control, compared with those receiving standard treatment.

"In people with type 2 diabetes who are at high risk for cardiovascular disease, a therapeutic strategy that targets a blood sugar level below current recommendations increases mortality," ACCORD researcher Dr. Hertzel C. Gerstein, a professor in the Department of Medicine at McMaster University in Hamilton, Ontario, Canada, said during the teleconference.

"The reas
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