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10/11/12

How Intense Should Blood Sugar Control Be in Type 2 Diabetes


How Intense Should Blood Sugar Control be in Type 2 Diabetes and How Do Doctors Measure Blood Sugar Control in Diabetes?


A Study Published in 2011 Said That While Blood Sugar Control is Very Important Very Intensive Glycemic (Blood Sugar) Control did not seem to Reduce Mortality Beyond a Shadow of A Doubt and was Associated with Severe Low Blood Sugar





Control of blood sugar in people with diabetes is very important.The American Diabetic Association “Standards of Medical Care in Diabetes” recommends lowering HbA1c to <7.











Doctors know that people with diabetes must work to keep their blood sugars normal and that high blood sugars are associated with eye, heart, kidney and circulation and foot problems. The billion dollar question is how low should sugars be?




Doctors searched the medical literature for studies of the benefits of very tight control of blood sugar. The idea is if tight control of blood sugars is known to be beneficial than maybe very tight control of blood sugar is even better. The doctors tried to combine the results of 14 studies with a technique called meta-analysis.



In this Large Meta-Analysis Intensive Glycemic Control Did Not Reduce Mortality and was Associated with an increased Risk of Severe Hypoglycemia


Their meta-analysis did not demonstrate beyond a shadow of a doubt that super intense control of blood sugars had these extra benefits and they did find evidence of dangerous low blood sugar (hypoglycemia).


"We found evidence to refute the suggestion that intensive compared with conventional glycaemic control reduces all cause mortality with a relative risk reduction of 10% or more. We found insufficient information to confirm or exclude a 10% relative risk reduction in cardiovascular mortality and non-fatal myocardial infarction with intensive glycaemic control. We found insufficient evidence for a reduction in risk of composite microvascular complications, retinopathy, and nephropathy. Conversely, we confirmed a 30% increase in relative risk of severe hypoglycaemia with intensive compared with conventional glycaemic control. Accordingly, treatment and choice of a glycaemic target for patients with type 2 diabetes need to take both harms and benefits into account."

  • Intensive glycaemic control for patients with type 2 diabetes: systematic review with meta-analysis and trial sequential analysis of randomised clinical trials