Navigation Links
Tight Blood Sugar Control in Older Diabetics May Not Reduce Heart Risk

By Kathleen Doheny
HealthDay Reporter

TUESDAY, June 29 (HealthDay News) -- Intensive control of blood glucose levels does not reduce the odds of cardiovascular disease for those with long-term type 2 diabetes who are at risk of heart problems, as researchers have known. But it may have some other benefits, a new analysis suggests.

Strict control of blood sugar in a certain group of patients may slow progression of eye disease and help kidney and peripheral nerve health, the researchers found.

The new study is the latest analysis from the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial.

The study results, like the previous research, apply only to a certain group of people with diabetes, said study lead author Dr. Faramarz Ismail-Beigi, professor of medicine at Case Western Reserve University and University Hospitals of Cleveland.

"The trial fundamentally is on older adults, average age 60, who had diabetes 10 years on average," he said. "All are type 2." Because they have had the disease for 10 years, typically the disease has progressed, he said. The 10,251 participants had either a history of heart disease or two or more risk factors for it.

The study compared intense blood sugar control -- A1C values of less than 6 percent -- with standard, 7 to 7.9 percent, control. A1C levels reflect blood sugar levels over the preceding three months. Under 6 percent is viewed as normal; diabetics are often advised to keep it at around 7.

The study results, published online June 29 in The Lancet, were to be presented Tuesday at the American Diabetes Association annual meeting, in Orlando, Fla.

Study participants were assigned to either intensive glucose-control therapy or standard therapy. When it was found that those in the intensive group had an increase in deaths, the study was stopped in February 2008, and all participants were switched to the standard group for the remainder of the five-year follow-up, which ended in June 2009.

In this new analysis, the researchers looked at kidney, eye and nerve problems. The intensive therapy did not reduce the risk of problems such as advanced kidney or eye complications. But it did delay the onset of albuminuria, protein in the urine, which is associated with renal failure, and some eye complications and nerve problems.

But those on tight control also gained more weight and were at risk for very low blood sugar, the study found.

The researchers concluded that: "The observed benefits associated with intense glycaemia management should be weighed against higher total and cardiovascular-related mortality, weight gain, and severe hypoglycaemia in patients at high risk of cardiovascular disease."

"A target of 6 percent or less with present strategies seems imprudent," the researchers wrote.

In a commentary accompanying the study in The Lancet, Dr. Ronald Klein of the University of Wisconsin School of Medicine and Public Health, Madison, noted the three-fold increase in severely low blood sugar found in those on intensive therapy. Technological improvements are needed, he said, to normalize blood sugar without causing it to drop dangerously low.

It's not surprising that no benefits were found for all complications, Klein said. "The study didn't really go long enough," he said, to observe the protective effect of intensive therapy on some complications.

Even so, he added, it's still crucial to control blood sugar -- perhaps just not as intensively as researchers previously thought necessary.

Other researchers in a subgroup of the ACCORD study reported online June 29 in the New England Journal of Medicine that tight glucose control helped reduce the progression of retinopathy, a common complication of diabetes that can cause blindness.

Looking at 2,856 study participants, the subgroup researchers found that the rates of progression of diabetic retinopathy were 7.3 percent with intensive therapy but 10.4 percent with standard therapy. Retinopathy was also less likely to progress in those who got intensive cholesterol-lowering treatment, but intensive blood pressure control had little effect on the eye disease, the researchers said.

In an editorial accompanying the study in the journal, Dr. Barbara Klein, also of the University of Wisconsin, Madison, said the subgroup study adds valuable information about the effect of blood sugar on retinopathy and points to the need for further study of the value of cholesterol-lowering drugs.

More information

To learn more about eye complications of diabetes, visit the American Diabetes Association.

SOURCES: Ronald Klein, M.D., Ph.D., professor, Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison; Barbara Klein, M.D., M.P.H., professor, University of Wisconsin School of Medicine and Public Health, Madison; Faramarz Ismail-Beigi, M.D., professor of medicine, Case Western Reserve University, University Hospitals of Cleveland, Ohio; The Lancet, June 29, 2010, online New England Journal of Medicine, June 29, 2010, online

Copyright©2010 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Tight Blood Sugar Control May Not Harm Diabetics
2. FDA Tightens Oversight of Home Medical Devices
3. IBM Enterprise CloneDR Helps Enterprises Transform Bloated COBOL into Clean, Tight, and Maintainable Code
4. FDA Tightens Controls on Anemia Drugs
5. Tight Blood Sugar Control May Raise Risk of Death
6. Tighter Blood Sugar Control Not Best for Some Diabetics
7. Insulin Pump With Blood Sugar Sensor May Improve on Injections
8. Sensor and insulin pump results in better blood-sugar control in all age groups with diabetes
9. Blacks Seem More Vulnerable to Deadly Blood Infection
10. Filtering donor blood reduces heart, lung complications
11. Mothers high blood sugar in pregnancy is linked to childrens reduced insulin sensitivity
Post Your Comments:
(Date:11/25/2015)... ... November 25, 2015 , ... “While riding the bus, I ... Bronx, N.Y. “I thought there had to be a convenient and comfortable way to ... The PROTECTOR enables disabled individuals to safely travel during cold or inclement weather. In ...
(Date:11/25/2015)... , ... November 25, 2015 , ... ... (PHA) announces the nation’s Periwinkle Pioneers, individuals and groups responsible for advancing care ... disease. The Periwinkle Pioneers, nominated by the public, will receive special recognition throughout ...
(Date:11/25/2015)... ... November 25, 2015 , ... ... philanthropic seniors, is resulting in a way for homeless people to have a ... have launched a new initiative whereby they are repurposing plastic bags into sleeping ...
(Date:11/25/2015)... ... November 25, 2015 , ... Since its launch in 2012, ... adult stem cell therapies to patients with chronic degenerative medical conditions. Now, the ... Registered Trademark (RTM). , Organizations are required to hold a registered trademark in ...
(Date:11/24/2015)... ... November 25, 2015 , ... Genesis Chiropractic Software ... software creates an agreement between the practice owner and the patient that automatically ... notification, and projections. Click here to learn more. , ...
Breaking Medicine News(10 mins):
(Date:11/24/2015)... FRANCISCO , Nov. 24, 2015  Thanks to ... Dignity Health St. Mary,s Medical Center,s Sister Diane Grassilli ... breast imaging capabilities in San Francisco ... an anonymous friend, stepped forward with a gift of ... for Breast Digital Mammography with Tomosynthesis and Whole Breast ...
(Date:11/24/2015)... Colo. , Nov. 24, 2015  Array ... that its Chief Executive Officer, Ron Squarer ... Healthcare Conference in New York.  The public is ... webcast on the Array BioPharma website.Event:Piper Jaffray Annual ... , Wednesday, December 2, 2015Time:1:30 p.m. Eastern Time ...
(Date:11/24/2015)... HOUSTON, TX and VANCOUVER, Nov. 24, 2015 /PRNewswire/ ... EPI; NASDAQ: EPIX ) announced today that the ... clinical study of EPI-506 as a treatment for metastatic ... States and Canada.  --> ... --> In the Phase 1/2 clinical trial, ...
Breaking Medicine Technology: