Intensive Control Does Work

David Mendosa Living With It Medical Journalist Living with Diabetes and Author of Fitness and Photography for Fun, www.mendosa.com/fitnessblog After earning a B.A. with honors from the University of California,... Send Message Subscribe: David Mendosa

Wednesday, May 27, 2009
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The study for the first time provided reliable evidence linking intensive blood glucose control with fewer heart attacks. Indeed, people with diabetes who maintain intensive, low blood glucose levels are significantly less likely to suffer heart attacks and coronary heart disease than those who followed standard treatment.

The intensive treatment group had a 17 percent reduction in heart attacks and a 15 percent reduction in coronary heart disease. In contrast to smaller studies which had suggested possible harm from better blood glucose control, those on intensive treatment did not suffer adverse effects on deaths from any cause.

Those of us with diabetes are at increased risk of heart disease, as I wrote here just a few days ago. We remain at high risk even when we reduce our risk by maintaining healthy blood pressure levels and keeping good lipid levels good.

"Previous studies have been inconclusive," Dr. Ray says. That leaves people with diabetes and their doctors "unsure as to whether maintaining lower blood sugar levels actually benefited the patients. Although additional research needs to be conducted, our findings provide insight into the importance of improving glucose levels which should include lifestyle changes as well as medication."

The five trials involved more than 33,000 people, including 1497 heart attack cases, 2,318 cases of coronary heart disease, and 1,227 strokes. Dr. Ray and his team analyzed A1C levels in assessing the possible risk of various heart conditions.

Interestingly, ACCORD was one of the five studies included in the new meta-analysis. The others were the UKPDS, ADVANCE, VADT, and PROactive.

"These findings emphasise the importance of detecting and treating diabetes as early as possible," Dr. Ray says, "thus preventing the chances of developing heart and circulatory disease. They reinforce the need for diabetic patients to achieve and maintain better control of blood sugars long-term as a means to reduce risk of heart disease."