February 22, 2008

How low should blood glucose go?

How low should blood glucose go? Recent news from two large studies in people (~ 10,000 each) with type 2 diabetes—the ACCORD and ADVANCE trials—raised this question…yet again. Perspective is pertinent! It’s well known that managing type 2 diabetes is not only about blood glucose control. It’s also about treating blood pressure (goal: <130/80) and blood lipids (LDL: <100 or less) to into the healthy zone.

The recent studies: The ACCORD (Action to Control Cardiovascular Risk in Diabetes) study, according to the NHLBI, the NIH division that conducted the study, “The death rates in both the standard and intensive groups were lower than seen in similar populations in other studies.” Learn more.

The ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation) study (conducted outside the U.S.) concluded: “no evidence of an increased risk of death among those patients receiving intensive treatment to lower blood glucose (sugar).” Learn more.

The body of evidence, including these recent results, underscore the importance of controlling glucose, blood pressure and lipids for health. Unfortunately many people with type 2 diabetes are either not yet diagnosed or not under good control. Though it is clear that many people with type 2 diabetes will require medications to get and keep their blood glucose, blood pressure and lipids in target zones; healthy eating with diabetes, shedding pounds as needed and being physically active, often underutilized treatment tools, also go a long way towards helping people achieve these targets to stay healthy and alive.