article on loweringblood sugar

[Guest guest]

I got this from today's USA Today:

Rapid lowering of blood sugar not linked to deaths

By Brophy Marcus

Intensively lowering blood sugar levels is still the best treatment for most

patients with type 2 diabetes, according to a new analysis of a study

released

last year that suggested death rates were higher for some people who did

just that.

When scientists took a closer look at previous results of one of the largest

ongoing diabetes studies, called ACCORD, to discover why death rates were

higher

among some type 2 patients who participated in the intensive blood

glucose-lowering arm of the research, they found that aggressively lowering

A1C levels

was not to blame for the increased mortality rates.

The short answer is that no, rapid lowering of blood glucose does not

correlate with increased death, " says Riddle, professor of medicine

at Oregon

Health and Science University, lead author of a paper in this week's

Diabetes Care.

If anything, it's the other way around, say Riddle and other ACCORD

researchers.

People with the lowest A1C levels were those who had the lowest mortality, "

says endocrinologist and study investigator Kendall, chief scientific

and medical officer of the American Diabetes Association. He says those with

a higher A1C, despite intensive treatment, were more likely to die.

For years, medical experts who treat diabetes have debated over how best to

manage the disease to stave off long-term health complications, including

cardiovascular,

nerve and kidney damage. Most believe making lifestyle changes -- improving

diet and exercise -- and an aggressive medication plan early on achieve that

goal. But when some ACCORD patients had higher mortality rates, the

intensive control theory came into question.

Though the latest evaluation didn't find a " smoking gun " that explains more

deaths in some participants, Riddle says in his paper, weight gain,

depression

or poor adherence to the treatment plan could play a role.

We need to make efforts to learn more about the subgroup at risk, " Riddle

says.

I think unseen episodes of severe low blood sugar -- hypoglycemia -- could

be occurring and leading to more deaths, too, " says Serge Jabbour, professor

of medicine in the division of Endocrinology, Diabetes & Metabolic Diseases

at Jefferson Medical College in Philadelphia.

Sicker, older diabetes patients also could have other health factors that

lead to more deaths, says Zonszein, director of the Clinical Diabetes

Center

at Montefiore Medical Center in the Bronx.

Bottom line in diabetes is we have to be aggressive early in the disease, "

Zonszein says. Intervening too aggressively, too late, is of benefit but of

much

less impact.