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Tight Blood Sugar Control May Not Harm Diabetics
Date:4/28/2010

Re-analysis of a landmark study refutes link between intensive therapy, higher death risk

WEDNESDAY, April 28 (HealthDay News) -- The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was abruptly halted in 2008 when researchers noticed an increase in deaths in the group of type 2 diabetics who were being intensively treated to bring their blood sugar levels down to near-normal levels.

Now, a new analysis of data from that study has concluded that a rapid lowering of blood sugar (glucose) levels was not the cause of the increased risk of mortality.

However, even though the researchers were able to exclude intensive diabetes management from their list of suspects, they still aren't clear what factors may have played a role.

"The original question underlying the study was, would rapid lowering of blood glucose be an explanation for the excess mortality rates?" said study author Dr. Matthew Riddle, a professor of medicine at Oregon Health and Science University in Portland.

"The answer was no. People who rapidly lowered their A1C didn't have excess deaths," Riddle said. In fact, "it was the ones who couldn't bring their A1Cs down that had increased mortality."

A1C is a test that can estimate two to three months of blood sugar control. The American Diabetes Association recommends that most people with diabetes try to maintain an A1C of 7 percent or less, which translates to an average blood sugar reading of about 154 milligrams per deciliter.

In the ACCORD trial, which included more than 10,000 people with type 2 diabetes, the intensive management group was trying to achieve an A1C level of less than 6 percent, which is a normal level. Most people with type 2 diabetes have significantly higher A1C levels, according to background information in the study.

The reason lowering A1C is important is that other studies have shown that for each 1 percent increas
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