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How Low Blood Sugar is Too Low? New Evidence

Posted Jun 29 2012 12:00am

Some people avoid all carbs (that is, all bread, pasta, rice, etc.). Others advocate “safe starches”. No doubt wheat can be dangerous witness celiac disease (associated with a genetic difference). But I have noticed clear improvements in brain function (measured by arithmetic speed or something similar) after eating something sweet, such as pudding. None of this, unfortunately, helps answer the question: how low blood sugar is too low?

A new study makes more plausible the idea that really low levels of carbs may be bad for you:

A nested case-control study data set was generated from the cohort-study data set (n = 4140 type 2 diabetic outpatients) by sampling controls from the risk sets. Cases (n = 427) were compared with an equal number of controls chosen from those members of the cohort who were at risk for the same follow-up time of the case, matched for age (±3 years), sex, body mass index (BMI) (±2 kg m(-2)), duration of diabetes (±5 years), and Charlson’s Comorbidity Score (CCS) (±1). The main predefined analysis was the comparison of cases and controls for proportion of patients with each HbA1c class (<6.5%, 6.5-7.4%, 7.5-8.4% and ≥8.5%). During a mean follow-up of 5.7 ± 3.5 years, 427 deaths were recorded. The lowest risk of death was observed in the HbA1c 6.5-7.4% category; a lower HbA1c was associated with a non-significant trend towards a higher risk. The risk associated with a low (<6.5%) HbA1c was significantly greater in patients who were insulin-treated than in the rest of the sample.

The study is saying that diabetic patients in the HbA1c 6.5-7.4% category do not improve their health when given insulin that lowers their blood sugar even more. Their health may get worse.

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