New recommendations for blood sugar control in people with type 2 diabetes issued by the American College of Physicians (ACP) may be confusing to health care providers and many of the 29 million Americans with the condition.
In a paper published in the Annals of Internal Medicine, the influential group argues that current guidelines can cause harm without providing significant benefits – a position opposed by the American Diabetes Association, which announced there will be no changes in its recommendations for tight blood glucose control in people with type 2 diabetes.
People with diabetes are encouraged to strive for a hemoglobin A1C score of 6.5 to 7 percent, but after reviewing existing research, the ACP determined that the burden of achieving these low levels – which often involves taking one or more medications – outweighs the benefits. Potential risks and side effects of tight glucose control include hypoglycemia, weight gain, digestive problems, congestive heart failure, joint pain, fractures, and fungal infections. Most patients should instead try to keep their A1C numbers between 7 and 8, says the ACP.