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Diabetes Study Partially Halted After Deaths by Gina Kolata.

Executive summary: Maintaining an A1C of 7 leads to a reduced risk of death compared to maintaining an A1C of 6 or less, for people averaging age 62 who have had diabetes about 10 years and are on meds and/or insulin.

Excerpts:
For decades, researchers believed that if people with diabetes lowered their blood sugar to normal levels, they would no longer be at high risk of dying from heart disease. But a major federal study of more than 10,000 middle-aged and older people with Type 2 diabetes has found that lowering blood sugar actually increased their risk of death, researchers reported Wednesday.
[...]
Dr. John Buse, the vice-chairman of the study’s steering committee and the president of medicine and science at the American Diabetes Association, described what was required to get blood sugar levels low, as measured by a protein, hemoglobin A1C, which was supposed to be at 6 percent or less.

“Many were taking four or five shots of insulin a day,” he said. “Some were using insulin pumps. Some were monitoring their blood sugar seven or eight times a day.”

They also took pills to lower their blood sugar, in addition to the pills they took for other medical conditions and to lower their blood pressure and cholesterol. They also came to a medical clinic every two months and had frequent telephone conversations with clinic staff.

Those assigned to the less stringent blood sugar control, an A1C level of 7.0 to 7.9 percent, had an easier time of it. They measured their blood sugar once or twice a day, went to the clinic every four months and took fewer drugs or lower doses.
[...]
the drug Avandia, suspected of increasing the risk of heart attacks in diabetes, did not appear to contribute to the increased death rate.
I am on a fat-accepting diabetes list (which seems to be down at the moment) where a lot of people are into very tight control, keeping their A1C in the 5-6 range. I tend to argue for a more relaxed approach, and I keep my A1C in the 6-7 range. I'm relieved to find evidence that my approach has some validity for one population.

Comments

( 9 comments — Leave a comment )
krasota
Feb. 8th, 2008 09:59 pm (UTC)
In my extended family, those with insulin pumps tend to not watch their diet at *all* and just randomly adjust their pump settings (often without checking their blood sugar). Needless to say, they have the most issues.

My grandmother watched her diet strictly, but also kept her blood sugar lower than necessary. It was an age-old habit--my great-grandmother liked having quiet daughters and insulin made that easy, so they grew up pretty much constantly hypoglycemic. And she did die of diabetes-related complications . . . after living with the disease for over 50 years. She may still be here if she hadn't overdone it with the insulin. I think there's something to be said for moderation.
webmaven
Feb. 9th, 2008 03:47 am (UTC)
Hmm. I wonder if they can disambiguate between the low blood-sugar per-se and the tighter control as causes. Maybe what caused the higher death rate was simple anxiety.
firecat
Feb. 9th, 2008 03:57 am (UTC)
Stress is very hard on the health in a few ways, plus it raises blood sugar, so I don't know that any anxiety involvement is necessarily "simple."
pir_anha
Feb. 9th, 2008 04:52 pm (UTC)
Re: Diabetes news
when reading that, i was immediately wondering in how far stress affected the "tighter control" group. they sound like their blood glucose levels might've been a major anxiety source (frequent phone calls to clinic staff?).

when i was measuring my blood glucose 3-4 times a day i felt mildly obsessive and stressed about it already. if i did it 7-8 times i'd probably be preoccupied with it all day, and fidget about it constantly.
firecat
Feb. 9th, 2008 05:42 pm (UTC)
Re: Diabetes news
Yep, I think that stress and anxiety are definitely involved in the finding. Stress and anxiety avoidance is precisely the reason I am more relaxed about my A1C control. I dunno if it will increase my lifespan but at least it will improve the quality of the lifespan I have.
innerdoggie
Feb. 11th, 2008 07:31 pm (UTC)
Re: Diabetes news
My grandma had diabetes, so I wonder whether I might get it as well. I worry if I do, how will I keep up with the blood sugar levels without ending up with an eating disorder or OCD?

Sounds like your moderate approach is a very good one.
firecat
Feb. 11th, 2008 07:35 pm (UTC)
Re: Diabetes news
I worry if I do, how will I keep up with the blood sugar levels without ending up with an eating disorder or OCD?

It ain't easy. I hope you don't get it.
mjlayman
Feb. 9th, 2008 08:05 pm (UTC)
Diabetes is one of the three most common secondary diseases for renal patients and I intend not to get it (already have hypertension and glaucoma). Thanks for the study info; I hope I never need it!
firecat
Feb. 9th, 2008 10:09 pm (UTC)
Me too!
( 9 comments — Leave a comment )

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