Moderation Is Key
Scientists in the UK have discovered that contrary to the classic medical approach to diabetes, it's important not to be too aggressive when bringing down blood sugar. It seems that lowering blood sugar levels too far is just as risky as allowing levels to stay high. These researchers suggest moderation is the key to diabetes treatment as in so many other facets of life.
During the course of the trial, the Cardiff University research team also discovered that those who suffer from type 2 diabetes and used insulin to get their blood sugar levels down to almost normal had a mortality rate of 50% higher than for those who were treated with an oral drug combination such as metformin and sulphonylurea. But according to the results of this large study, which was published in The Lancet, a medical journal, the scientists feel this is due to the fact that those type 2 diabetics requiring insulin treatment tended to be older and more ill than those on the oral drug regimen.
The results of the study suggest that oral drugs are the best way to increase the diabetic's sensitivity to insulin, and that in combination with a sensible diet and exercise, may be the wisest and safest method for controlling blood sugar levels in type 2 diabetics. The researchers believe that doctors should try to keep their patients on such a treatment plan for as long as possible. Study author Craig Currie commented that the study is likely to raise some eyebrows, "Conventionally, doctors have always been told to drive down (blood sugar levels) as low as possible. It will come as a major surprise to many doctors that taking people down too far appears to be quite risky."
Currie says that the study findings on insulin need not cause physicians or their patients to take any urgent action, but that patients should make an appointment to speak to their doctors over the next few weeks to talk about the issue. The Cardiff study is just one more of several recent studies that weigh whether aggressive therapeutic measures with the aim of achieving near normal levels of blood sugar might prevent the high risk for heart attacks and strokes in diabetics. One such study sponsored by the U.S. government, ACCORD, was discontinued in February of 2008 when it was found that the mortality rate in diabetics with heart problems was 20% higher in those who received aggressive treatment.
In the Cardiff study, researchers correlated the mortality rate with blood sugar levels in some 48,000 participants over the age of 50 in treatment for type 2 diabetes. The data was taken from the UK General Practice Research Database from the period of 1986 through November 2008. Patients at either extreme for blood sugar levels had an increased risk for mortality. Those at the high end of the scale had an increased death risk of 79% while those at the low end of the scale had an increased risk for death of 7.5%. In those taking insulin, the risk was 49% higher than in those on oral medications. The researchers also spotted a possible link between insulin use and cancer progression, which tallies with the results of an earlier study.