Past research has demonstrated that tight control of blood glucose levels can help people with type 1 diabetes the ones who must use insulin to avoid some of the negative health consequences of the disease. A new study, published recently in The Lancet, extends the benefits of tight control to patients with type 2 diabetes the more common type usually associated with obesity and overweight.
As part of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, Dr. Hertzel C. Gerstein of the Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada, and colleagues from the ACCORD study group, investigated whether strict control of blood glucose levels could reduce the risk of heart disease in patients with type 2 diabetes. They followed the health status of about 10,250 adults (40-79 years old) who all had established type 2 diabetes. On average, their levels of glycated hemoglobin (HbA1c) were over 8 percent. Glycated hemoglobin is an indication of long-term (2-3 months) control of blood glucose levels, and the aim of standard therapy is to keep that number below 7 percent.
Participants in the study were randomly assigned to either standard therapy or intensive therapy. The goal of the intensive therapy was an HbA1c of 6 percent or less, while that for people in the standard therapy group was 7 percent or less. The investigators followed participants while they received active treatment, which ranged from 3 to 7 years, and for an additional 1 to 2 years after that.
More intensive treatment resulted in fewer heart attacks during active treatment the risk was lower by about 20 percent compared to that in the standard treatment group. The researchers concluded Raised glucose concentration is a modifiable risk factor for ischaemic heart disease in middle-aged people with type 2 diabetes and other cardiovascular risk factors.
ACSH s Dr. Ruth Kava added These results are important, as they support the benefit of tight control of blood glucose in people with type 2 diabetes. Of course, such control must be monitored carefully since there is also a risk of hypoglycemia (low blood sugar)which can be dangerous. However, decreasing the risk of heart attacks is certainly worth the extra attention that must be paid to keep HbA1c levels at or below 6 percent.