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HowToPreventHeartDisease.com |
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How Lowering Blood Sugar Can Increase Risk of Death from Heart Disease? Diabetes has been known to be a risk factor of heart disease. So when one is diagnosed with diabetes, he or she will naturally be put on medication so that the blood sugar could be brought down to the normal level. However, this might actually increase his or her risk of death from heart disease, according to the finding of a study by the American Diabetes Association in February 2008 on more than 10,000 middle-aged and older people with Type-2 diabetes. The study showed that an intensive program to lower blood sugar actually increased risk of death. Methods used in the study, known as Accord (for Action to Control Cardiovascular Risk in Diabetes), were very different from the techniques employed by most doctors and patients to manage blood sugar levels. Moreover, the patients in the study were typically far sicker than many people living with diabetes today. Researchers admitted that the intensity of the program used in the study was far beyond what is commonly used in clinical practice. Yet, they still maintained that doctors should reconsider their emphasis on lowering blood sugar at all costs. This is because there are also other factors influencing the overall health of patients with diabetes. In fact, a separate study published in The New England Journal of Medicine in February 2008 showing that a 3-pronged approach of managing blood sugar, blood pressure and cholesterol, together with taking low doses of aspirin, actually prolonged the lives of people with diabetes. The study also pointed out that the patients who benefited the best did not reach the very low blood sugar levels (the aim of the Accord study), but just slightly above the normal levels.
The Accord study showed that patients who were randomly assigned to reduce their blood sugar levels to nearly normal had 54 more deaths than those whose levels were less rigidly controlled. The patients were in the study for an average of 4 years, and investigators eventually had to stop the intense program and relocate all of them to the less intense group. By lowering blood sugar alone could not protect one from dying sooner, as indicated by the study. This would mean that while managing blood sugar is important, controlling blood pressure and cholesterol are equally paramount. For patients with newly diagnosed diabetes, keeping their blood sugar levels as close to normal as possible through healthy eating and exercise would still benefit. But for patients with history of heart attack and other risk factors, inability to get their blood sugar to normal levels should not make them feel guilty. What they need to do is to get their blood pressure and cholesterol controlled, and their blood sugar appropriately managed, instead of aggressively pushing down the blood sugar. The prevailing practice is to prescribe diabetic patients with 2 or 3 medications to help them manage their blood sugar levels. However, many patients in the Accord Study were asked to take multiple drugs and insulin shots, to adhere to strict diets, and to regularly meet counselors and doctors who monitored them. As there is no single medical treatment was prescribed, doctors just employed whatever possible treatments appeared to work best for each individual patient. The researchers admitted that they would have to re-examine the data on those who died to find out pattern, if any, which might explain why patients had worse result in the intense treatment group. Meanwhile, they suspected that these patients might be sicker to begin with, or it might because of the number of drugs used, or the pace at which their blood sugar dropped. Undoubtedly, the intense treatment required a great deal of effort from the patients. It could therefore be the stress of the treatment itself arising from the fact that it was exceedingly difficult for any of the patients to achieve the targeted blood sugar levels. Many diabetics would simply feel stressed when they were unable to lower to their targeted blood sugar levels set by their doctors.
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