Editor's note: This is a humorous post and is not intended to be taken literally.
The recent announcement of the results of the ACCORD study had diabetes experts buzzing.
The ACCORD study, whose preliminary results were reported several weeks ago, found that lowering blood glucose (BG) levels close to normal in older people who had type 2 diabetes and other cardiac risk factors resulted in more cardiac deaths. So that part of the study was dropped.
Most people were aghast. They've been telling people with diabetes for years that they should get their BG levels as close to normal as possible. And now it seemed as if that advice might kill them.
No one really knows why that ACCORD study results occurred. In fact, preliminary results from another study, the ADVANCE study, reported after the ACCORD results, showed just the opposite results. Those who lowered their BG close to normal levels (exactly the same, on average, as in the ACCORD study) had fewer cardiac deaths.
Some patients don't know what to do with their diabetes control now. Is normal too low? I don't think so, but in my opinion, these studies can come in awfully handy.
Imagine the following scenario. You're seeing your doctor, and the doctor suggests that you might get a little more exercise.
"Well, Doc," you reply. "I'd really love to. There's nothing I like more than leaping out of bed at 5 a.m. and running up a hill with 100-pound sandbags strapped to my back before I set out for work.
"But the thing is, I'm afraid if I do that now, my BG levels might approach normal and then I'd drop dead of a heart attack. You see, there's this randomized controlled study sponsored by the National Institutes of Health, reported in major medical magazines, that says I shouldn't get my BG levels too normal. And I know how much you love those randomized controlled studies sponsored by big medical associations because if you follow their recommendations, they protect you from lawsuits.
"So instead of running with those grain sacks, I'm forced to sit in front of the TV all day watching exciting golf matches."
Or imagine that you go out to lunch with your dietician. She orders the all-carbohydrate meal of pasta, white bread, meat-free sauce, soda, and a low-fat frozen-yogurt sweetened with a half ton of sugar, thereby qualifying for a gold star from the Food Pyramid creators. "But for you, because you have diabetes, I recommend the sparrow's tongue on rabbit food, with dressing-free salad and a glass of water for dessert."
You assure her that's exactly what you were planning to order. "But then I read about this randomized controlled study sponsored by the National Institutes of Health that said that getting your BG levels too normal might increase your risk of heart attack."
"So unfortunately, much though I was looking forward to that rabbit food and glass of water for dessert, I'm afraid I'm forced to order what you're having. Gotta get those BGs up!"
Or let's say your friend Hortensia has decided to move her 1000-volume library from one side of the street to the other. She's asked all her good friends to help.
You tell her, "Golly, Hortensia! There's nothing I'd like more than carrying heavy boxes of books across a busy street and then up three flights of stairs. But if I did that, my blood sugar might fall, and there's this randomized controlled study sponsored by the National Institutes of Health that said that getting your BG levels too normal might increase your risk of heart attack. You wouldn't want me to have a heart attack would you?"
Who knows if the ACCORD study or the ADVANCE study has produced the correct answer. But in the meantime, we can pick the one we want to support whatever it is we want to do.
I'd like to vote for hot fudge sundaes. Unfortunately, my intuition says to go with ADVANCE. As long as you don't get hypoglycemia, the lower the BGs, the better. Alas.
Other humor posts from Gretchen:
New Year, New You: Making resolutions you don't want to keep
De-stressing: Visualizing isn't so relaxing after all
Diabetes testing: Doughnut D1c and other assessments
Published On: February 24, 2008