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Living with Diabetes
Comment on ACCORD and ADVANCE Studies February 14, 2008
If you have been concerned about media coverage regarding recent studies and the controversy surrounding blood sugar control:
There have been conflicting reports in the media recently concerning the safety of strict blood sugar control in patients with diabetes and other risk factors for heart disease.
In one recent study, the ACCORD study, preliminary results suggest that a certain group of patients, those with diabetes and other conditions that put them at highest risk for heart disease, might be safer with less stringent control than previously thought.
The ACCORD study divided patients with longstanding Type 2 diabetes into 2 groups and compared cardiovascular risk between the group with tight control (Hemoglobin A1C goal of 6%) and those with less aggressive A1C lowering (7% range).
When the preliminary data suggested those with less aggressive blood sugar lowering might fare better that the other group, this part of the study was stopped and the patients reassigned to the higher A1C goal.
However, another large study, ADVANCE, refutes these findings, showing no increased risk of death with intensive blood sugar control.
It is important to realize that the analysis of the data of both of these studies hasn’t been completed yet, and won’t be until later this year.
The findings in ACCORD, should they prove to have merit, may only apply to the types of patients in that particular study (same age, same number of years with diabetes, 2 additional risk factors for heart disease, etc.)
It is also important to note that the A1C in the less aggressively controlled group averaged at 7.5%, which is very near the American Diabetes Association’s goal of < 7.0%.
The results of the ACCORD study do not apply to patients with Type 1 diabetes, formerly called juvenile diabetes, or those who are newly diagnosed or with a shorter history of diabetes.
Many other studies have shown tremendous decrease in the risk of the microvascular complications of diabetes (damage to nerves, kidneys, etc.) when the blood sugar is more aggressively controlled.
Until more is known, the medical community, including DiabetesAmerica™, recommends that no one change their treatment without talking to their doctor.
Individualization of treatment goals for your diabetes and medical history is and has always been the preferred approach at DiabetesAmerica™.
If you feel your diabetes treatment regimen needs review, please make an appointment with your DiabetesAmerica™ Care Team.
