Navigation Links
Tight Blood Sugar Control May Raise Risk of Death
Date:1/26/2010

Guidelines should be revised to include a low limit for glucose levels, researchers say

TUESDAY, Jan. 26 (HealthDay News) -- Very tight blood sugar control may raise the risk of premature death in people with type 2 diabetes, with the risk even higher among patients taking insulin, a new study reveals.

The study authors, from Cardiff University School of Medicine in Wales, suggest revising diabetes guidelines to include a low threshold for blood sugar levels in addition to the well-known upper thresholds.

But other experts familiar with the study said the issue is still up for debate and that diabetics should by no means abandon their efforts to lower blood sugar whether it be through medication, insulin or lifestyle changes, but should avoid efforts to go too low if possible.

"The first thing you want to avoid almost no matter what is low blood sugar. If you're driving and you have hypoglycemia, you can get in a car wreck," said Dr. Daniel Bessesen, professor of medicine at the University of Colorado Denver and chief of endocrinology at Denver Health Medical Center. "[But] this doesn't completely change the ballgame." And few people actually achieve the really low levels that seemed to cause problems in this study, he added.

It has been widely believed for years that keeping blood glucose levels as close to normal as possible will minimize both microvascular complications (affecting the eyes, kidneys and limbs) and macrovascular complications, such as heart attack and stroke.

And the mantra for blood sugar for all this time was "go lower."

But the new findings, published online Jan. 27 in The Lancet and funded by Eli Lilly and Co., are not the first to suggest a downside to lower glucose levels.

Two earlier studies found that, when taken too far, efforts to lower glucose levels might not help and could even kill people with type 2 diabetes.

The Cardiff researchers looked back at almost 28,000 people with type 2 diabetes who were taking a combination of metformin (known as Glucophage and other brand names) and a class of drugs known as sulphonylureas.

Another 20,000 individuals were taking insulin.

Risk of death for individuals with the lowest blood sugar levels (median HbA1c of 6.4 percent) was 52 percent higher than those with a 7.5 percent HbA1c. Meanwhile, those with the highest blood sugar levels over time had a risk of death 79 percent higher than the control group, which had the lowest mortality rate.

Actual causes of death were not outlined and the study was only a retrospective one, two factors giving the study less weight than a randomized controlled trial.

The heightened danger among those taking insulin might be explained by the fact that these patients generally are sicker, said Dr. Mary Ann Banerji, professor of medicine and director of the diabetes treatment center at the State University of New York Downstate Medical Center in New York City.

They also tend to be older, Bessesen said.

And it may not be an issue of how low you go as much as how you get there, said Dr. James Underberg, clinical assistant professor of medicine at New York University Medical School.

Different diabetes drugs act in different ways and have different effects on low blood sugar, he said.

Ultimately, Underberg said, "it goes back to what doctors are doing every day, fitting the guidelines to the individual."

And individuals should probably be aiming for blood sugar levels in the range of 7, Banerji said. And that is pretty tough for most people to do, she added.

Dr. Richard Bergenstal, president of medicine and science for the American Diabetes Association (ADA), said: "We need to individualize the A1c target. I don't think the message should be now everybody should be at 7.5 because that was at their sweet spot. The ADA has it pretty close to 7 -- if we can do that safely. So if you can't get to 7 and need to be at 7.5 because of hypoglycemia, then that's what you should do."

More information

The American Diabetes Association has more on type 2 diabetes.



SOURCES: James Underberg, M.D., clinical assistant professor of medicine, New York University Medical School, New York City; Mary Ann Banerji, M.D., professor of medicine and director, diabetes treatment center, State University of New York Downstate Medical Center, New York City; Daniel Bessesen, M.D., professor of medicine, University of Colorado Denver and chief of endocrinology, Denver Health Medical Center; Richard Bergenstal, M.D., president, medicine and science, American Diabetes Association; Jan. 27, 2010, The Lancet, online


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Acupuncturists Relocation Tightens Relationship With Fertility Clinic
2. Prominent Farmington Plastic Surgeon Uses Two New Non-Surgical Procedures to Tighten Skin and Remove Fat
3. Tighter tummies: A new way to combat weight gain
4. Tight Backpack Straps Cut Blood to Shoulders, Arms
5. New approach to cancer: Find most tightly controlled genes
6. USCIS Tightens Vaccination Requirements
7. No Need to Forego Nutrition in Tight Economic Times
8. Accent Dual Mode Skin Tightening Laser is Latest Offering from Juva Skin Center
9. Healthy Eating and Good Nutrition Go Hand-in-Hand in Tight Economic Times
10. A better mesh: Researchers tighten bodys protective coating
11. Health and Wellness Programs in a Tight Economy
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/4/2016)... ... May 04, 2016 , ... Cirius, a provider of cloud-based ... Secure Messaging platform, which includes secure, private messaging, large file sharing, secure e-signatures, ... of patents around innovative features for securing, tracking, and controlling messages for organizations ...
(Date:5/4/2016)... ... May 04, 2016 , ... Somnoware Healthcare ... today announced it has secured $9 million in Series A funding led by ... investment will be used by Somnoware to further fulfill its mission to connect, ...
(Date:5/4/2016)... Palm City, Florida (PRWEB) , ... May 04, ... ... providers of cold therapy products, announced today the introduction of the innovative newly ... for post operative hip replacement patients. The plush design enhances comfort and enables ...
(Date:5/4/2016)... ... 04, 2016 , ... a2z, Inc. is pleased to announce ... for Enterostomal Therapy (CAET) will be utilizing powerful and innovative technology solutions to ... exhibitors for the 2016 WOCN Society & CAET Joint Conference—which is the largest ...
(Date:5/4/2016)... ... May 04, 2016 , ... Washington Wellness Center today ... central New Jersey residents. What started out as an idea to provide a ... integrated approach to healthcare. , Developed by Dr. David Swanekamp, Chiropractic Physician , ...
Breaking Medicine News(10 mins):
(Date:5/3/2016)... 4, 2016 Global Insulin ... profiling 09 key companies and supported with 272 ... in-depth study on the current state of the ... the industry including definitions, classifications, applications and industry ... provided for the international market including development history, ...
(Date:5/3/2016)... 3, 2016 ACME Markets, ... and Delaware County Councilman Dave White ... in all ACME pharmacies across ... Control and Prevention (CDC), naloxone has saved 26,463 lives nationwide over ... Delaware County were authorized to administer naloxone ...
(Date:5/3/2016)... May 3, 2016 Pharmaceutical giant ... million to a woman who says its talc-based powder ... Gloria Ristesund $5 million in compensatory damages ... (Logo: http://photos.prnewswire.com/prnh/20160330/349511LOGO ) , This ... the company. In February, the same court awarded $72 ...
Breaking Medicine Technology: