Rethinking blood glucose control...
Is it true that the lower the blood glucose in diabetic patients, the better? Maybe not. A major study has found that high risk diabetic patients actually do worse with intensive control of their blood glucose.
Over 10,000 North American diabetics with cardiovascular disease or risk factors were randomised into two groups. One group had standard diabetes care with the aim of keeping their glycated haemoglobin (HbA1c) at 7-7.9%, the other group had intensive treatment to get their HbA1c below 6%.
Surprisingly, intensive glucose control increased mortality and didn't reduce cardiovascular disease or risk factors compared with standard glucose control. High risk diabetic patients may therefore be harmed by intensive lowering of their blood glucose.
Source: Evidence-Based Medicine 2008;13:169; doi:10.1136/ebm.13.6.169