Intensive Control of Blood Sugar in Diabetics Is Questioned
February 17th, 2008 | by David Reiner, M.D. | 
The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health has stopped one treatment within a large, ongoing North American clinical trial of diabetes and cardiovascular disease 18 months early due to concerns about a higher risk of death seen in a trial called the ACCORD trial. Prior studies suggested that reducing blood sugar to levels found in non-diabetic adults may reduce the rate of cardiovascular diseases among those with diabetes. However, a randomized clinical trial was needed to determine whether that hypothesis is accurate.
The ACCORD findings are important, but will not change therapy for most patients with type 2 diabetes. Few patients with high cardiovascular risk like those studied in ACCORD are treated to blood sugar levels as low as those tested in this study, to levels of hemoglobian A1C of less than 6.0. However, this study data contradicts findings of another large ongoing trial called the Advance trial. This trial which is still in progress, and is twice as large as the ACCORD trial, was recently scrutinized because of these findings. They are using the same aggressive target levels for blood sugar lowering and did not find any evidence of danger at all in their study. This study is more than 99% complete.
At the present time, most medical professionals are not sure how to interpret the findings of this study, and are not recommending any changes in diabetes management at the present time.
Reference: National Institute of Health Press Release February 6, 2008.
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