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Rigorous Blood Sugar Control Doesn't Reduce Risk of Heart Trouble in Diabetics, Research Shows

Posted Oct 02 2008 3:12pm

Note from Connie: It's intriguing to learn how, contrary to what many experts had long thought, intense blood-sugar reduction drug therapy doesn't significantly reduce the incidence of heart disease in type 2 diabetics, according to new research in theNew England Journal of Medicine. Jennifer Moore brings you details about this study and another.

Another study, also published in the NEJM, found that while intensive blood-glucose control therapy reduced kidney disease in its subjects, it didn't significantly effect the incidence of " macrovascular events" -- that is, heart attack, stroke, or loss of blood supply to the limbs (which can lead to amputation if it's severe). This research from Australian scientists also found that the intensive medication regimen increased the rate of severe hypoglycemia amongst patients.

These findings from the ACCORD and ADVANCE trials caused a stir earlier in 2008 (read this blog's take on them both here and here ).

So what should we make of all of this? A pair of editorials accompanying these studies ( here and here ) provide some insights.

But a third article, written by Harlan M. Krumholz, M.D., and Thomas H. Lee, M.D., gets to the crux of the matter: "Lifestyle interventions may have few risks," they write, "but we cannot assume the same for drugs — and drug-related risks are not always known or appreciated....ACCORD, ADVANCE, and other   recent studies remind us that practice is complex and that ultimately   we need to understand a strategy's effects on people, not just   on surrogate end points."

Clearly, treating type 2 diabetes can be complicated, so it seems that a person's best bet is to reduce the chance of getting the disease in the first place, via a healthy diet and plenty of exercise.

Thanks to New York Times' reporter Gina Kolata for the tip on this surprising news, which was also covered by the AP, Reuters, USA TODAY, and WebMD.

Jennifer Moore for SUGAR SHOCK! Blog

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