Damage may already be done in advanced diabetes

NEW YORK (Reuters Health) - For men with long-standing, poorly controlled diabetes, intensive efforts to regulate glucose levels have little effect on rates of heart attacks or stroke, complications such as eye damage, or death, according to a report published Wednesday.

Previous studies indicated a delayed benefit from intensive glucose control in young patients with type 1 diabetes, but recent studies in older patients with more advanced disease failed to detect any advantages to more aggressive treatment, the researchers explain in their online report in the New England Journal of Medicine.

The current study included 1791 military veterans with long-standing type 2 diabetes and high A1C readings — a measure of long-term glucose levels. Half the subjects were randomly assigned to intensive treatment, with the goal of reducing their A1C by 1.5 percentage points compared with the standard-therapy group.

During the 7.5-year trial, average A1C levels were 8.4 percent in the standard group and 6.9 percent in the intensive group, Dr. William Duckworth, at the Phoenix VA Health Care System in Arizona, and fellow investigators report.

However, there was no significant difference between groups in the primary outcomes — time to occurrence of heart attack, stroke, death from cardiovascular causes, heart failure, vascular disease requiring surgery, inoperable coronary disease, or amputation due to gangrene.

Moreover, mortality rates and the incidence of serious complications, major kidney impairment, and nerve damage were similar with the two treatments.

“Intensive glycemic control earlier in the disease course may produce benefit,” Duckworth’s team suggests. For advanced diabetes, however, treating high blood pressure and high cholesterol levels and other risk factors would seem to be the best approach to reducing heart-related illnesses and deaths.

SOURCE: New England Journal of Medicine, January 8, 2009, online December 17, 2008.

Source

--------------------------------------------------------------------------------------------
Related Posts:


NEW YORK (Reuters Health) - Following gestational diabetes, a type of diabetes that developments during pregnancy and usually goes away after pregnancy, treatment with metformin or intensive lifestyle interventions can prevent or delay diabetes from becoming permanent in the postpartum period, new research shows. Lead author Dr. Robert E. Ratner at Medstar Research Institute in Hyattsville,

Full Post: Metformin can prevent postpartum diabetes
--------------------------------------------------------------------------------------------

NEW YORK (Reuters Health) - For people who have type 2 diabetes, a low-glycemic index diet is significantly better than a high-fiber diet for keeping blood glucose levels down, researchers report Glycemic index, or GI, refers to how rapidly a food causes blood sugar to rise. High-GI foods, like white bread and potatoes, tend to spur

Full Post: Diabetes control better with low-glycemic diet
--------------------------------------------------------------------------------------------

CHICAGO (Reuters) - Genes that increase the risk of heart disease in the general population carry an even greater risk of heart trouble in diabetics, U.S. researchers said on Tuesday. The findings may help better identify which diabetics are at risk for heart disease and could lead to new treatments, they said. “Coronary artery disease is one

Full Post: Genes that raise heart risks amplified in diabetics
--------------------------------------------------------------------------------------------

By David Douglas NEW YORK (Reuters Health) - Intensive control of high blood pressure (hypertension) leads to improved pregnancy outcomes in women with type 1 diabetes and kidney disease, Danish researchers report in the journal Diabetes Care. “Diabetic women with kidney involvement have an increased risk of complications in pregnancy leading to preterm delivery,” lead investigator Dr.

Full Post: Blood pressure control key for diabetic pregnancy
--------------------------------------------------------------------------------------------

NEW YORK (Reuters Health) - Good metabolic control and intensive insulin treatment doesn’t normalize the onset of menstruation, which is usually delayed in girls with type 1 diabetes compared with girls without the disease, study findings confirm. Dr. Paolo Pozzilli, at Universita Campus Bio-Medico, in Rome, and colleagues compared the age at onset of menstruation among

Full Post: Diabetes control doesn’t normalize menstruation

Site Navigation

Most Read

Search