We have been preaching tight control of glucose in patients with diabetes for a number of years. We believed that it made a major difference. We were right!
Diabetes Study Verifies Lifesaving Tactic
A 17-year federal study has finally answered one of the most pressing questions about diabetes: Can tight control of blood sugar prevent heart attacks and strokes?
The answer, reported today in The New England Journal of Medicine, is yes. Intense control can reduce the risk by nearly half.
And, the study found, the effect occurred even though the patients had only had a relatively brief period of intense blood sugar control when they were young adults. Nonetheless, more than a decade later, when they reached middle age, when heart disease and strokes normally start to appear, they were protected.
The study involved those with Type 1 diabetes, which usually arises in early in life and involves the death of insulin-secreting cells.
“This is truly an important study,” said Dr. Robert Rizza, a professor of medicine at the Mayo Clinic and the president of the American Diabetes Association. “And I usually don’t say that,” he added.
One could argue that we only know that this is true for type I diabetes, and thus we do not have the evidence to push as hard with type II diabetes. That reasoning is (in my opinion) flawed. (see previous rant)
But the result also gives rise to questions: Does the same effect occur in people with Type 2 diabetes, which usually occurs later in life and involves an inability to respond to insulin? And why would tight control of blood sugar for one brief period have such a pronounced effect later?
Dr. Fradkin said she expected that the results would hold for Type 2 diabetes. Another large federal study is addressing that question, she noted, but it is already known that tight control of blood sugar in Type 2 diabetes protects against nerve, kidney and eye damage, just as it does with Type 1 diabetes.
In addition, a study in Britain hinted, though it did not demonstrate, that Type 2 diabetics who kept their blood sugar low had less heart disease and fewer strokes.
