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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.

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