Is tighter blood glucose control dangerous for people with Type 2 diabetes?


#1

Over the last few days there’s been a lot of news about the ACCORD trial and how tighter blood glucose control was ‘causing more deaths’ among folks with type 2 diabetes.

This news does not mean you should be changing how you control your
blood sugar. You should talk with your healthcare team before making
any changes in your treatment.



I posted about this on my blog last night and I just wanted to summarize a few points.

The participants had type 2 diabetes for at least 10 years and were at increased risk of cardiovascular problems for various reasons.

The trial was trying to determine how to better reduce cardiovascular ‘events’ - heart attack, stroke and so on… One group used a standard blood glucose control approach aiming for an A1C value between 7.0% and 7.9%. The other group used an intensive approach and aimed for an A1C value below 6.0%.

In the group using the standard approach 203 people died since the trial started. In the intensive group 257 people died over the same period. This is a 20% increased risk of death for those trying an intensive approach.

It’s not clear exactly what caused the additional deaths. It may have been because of what people did to reduce their blood glucose levels. But it could have been caused by other things. The deaths were because of heart attacks, cancer, and other reasons.

There’s a lot of useful information on the NHLBI questions and answers page. It’s really worth reading.



#2

I read the news too and I think it’s all FUD. Isn’t the point of research to find answers to questions? Isn’t the research incomplete until the questions are answered?

I plan to change nothing about my diabetes management ( well … maybe I need more exercise ). I have an A1C of 5.5 and I like it that way.


#3

I’m very very curious as to how much us T1’s can think of this as a possible issue. And how much did the folks in the trials (and others) who are below 6% experience hypos?? Very curious…personally, I’m still just aiming for below 7%