Tight Glucose Control Disappoints
Reported January 09, 2009
(Ivanhoe Newswire) — In a new study that compared standard and more intense glucose control in veterans with type 2 diabetes, researchers found a more tightly controlled regimen didn’t make a significant difference when it came to cardiovascular problems.
One group of veterans received standard glucose control and another group received therapy with the goal of keeping hemoglobin levels 1.5 percent lower than in the standard group.
Intensive therapy did not delay cardiovascular events significantly compared to standard therapy. There were also no significant differences between the two groups when it came to death rates. In fact, the number of sudden deaths in the intensive-therapy group was three-times that of the standard-therapy group, and more people who received intensive therapy experienced severe adverse events.
Intensive therapy had no significant impact on a patient’s progression to eye problems like diabetic retinopathy or macular edema, or on a patient’s development of neuropathy.
“Intensive glycemic control earlier in the disease course may produce benefit, especially if severe hypoglycemia is avoided,” study authors wrote. “For now, appropriate management of hypertension, dyslipidemia and other cardiovascular risk factors appears to be the most effective approach to preventing cardiovascular morbidity and mortality.”
More than 60 percent of all patients with type 2 diabetes die of cardiovascular disease, and even more have serious complications.
SOURCE: New England Journal of Medicine, 2009;360:129-139