Hyper-vigilance pays off for hyperglycemia

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When it comes to diabetes, the best medical practice has long been to try to control blood sugar. However, the evidence that such strict control helps improve the many adverse health effects in diabetic patients has been surprisingly and frustratingly scant. Now, though, an observational study seems to indicate that better glycemic control actually helps diabetes patients reduce their risk of various cardiovascular events, including death.

The new Swedish study was presented at the annual meeting of the American Diabetes Association. Led by a researcher from the University of Gothenburg in Sweden, the researchers analyzed data from the Swedish National Diabetes Register on over 18,000 patients ages 30 to 75 who had no history of cardiovascular disease. When analyzing patient outcomes, the researchers controlled for a wide variety of factors, including age, blood pressure, and diabetes duration. Those diabetics who were able to control their glucose better had a 45 percent lower risk of cardiovascular death. Such patients reduced their hemoglobin A1c levels by almost one percentage point, from about 7.8 to 7 percent (normal A1c level is less than 6 percent in most labs).

What s more, improved glycemic control led to similar reductions in both fatal and nonfatal coronary heart and cardiovascular disease events. The researchers thus concluded that treatment to lower glucose can help improve cardiovascular health in diabetic patients.

This is clearly important information for diabetic patients and the medical professionals who treat them, says ACSH s Dr. Ruth Kava. There is always a possibility of hypoglycemia (dangerously low blood sugar) when blood glucose is lowered, but these data suggest that the significant reduction in the risk of heart problems may be worth the increased risk of low blood sugar.