Diabetes Study

Caduceus

Shared on Thu, 02/07/2008 - 09:58
From the AP Wire:
The government abruptly halted aggressive treatment in a major study of diabetes and heart disease after a surprising number of deaths among patients who pushed their blood sugar to super-lows — findings that call into question a growing movement in diabetes care.

Wednesday's move doesn't affect health guidelines for most Type 2 diabetics, but it raises concern about a particularly vulnerable group: Patients at especially high risk of heart attack or stroke.

Instead, the NIH took the rare step of halting part of the study 18 months early — citing 257 deaths among aggressively treated patients compared to 203 among diabetics given more standard care.

Ironically, the death rate was well below what doctors usually see in Type 2 diabetics, probably due to the extra care and monitoring they received as part of the research.

Moreover, the aggressively treated patients suffered about 10 percent fewer heart attacks overall than their counterparts, said Dr. William Friedewald of Columbia University, who helped monitor the study.

So for now, the NIH's message: Diabetics with heart disease shouldn't strive for near-normal glucose, but to a level long described as optimal for all diabetics — around 7 on a measurement scale known as the A1C.

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From my perspective, most standard care will remain unchanged.   This study of aggressively lowering the blood sugars to below non-diabetic levels obviously increases risk for patients.  I look forward to seeing more conclusions that have been drawn from the data, especially breaking out of high risk groups.

Comments

J-Cat's picture
Submitted by J-Cat on Thu, 02/07/2008 - 10:27
I don't understand why they would push their glucose levels to below normal. I am hypoglycemic: when I get sugar lows it is a *horrible* feeling. It's like being drunk, but not int he good way... in the I think I'm going to fall over way.
Caduceus's picture
Submitted by Caduceus on Thu, 02/07/2008 - 10:32
What I've seen states they didn't think it was "hypoglycemic" levels of treatment. We'll know more when the data is fully collected.
Ag3nt_Or4ngE's picture
Submitted by Ag3nt_Or4ngE on Thu, 02/07/2008 - 10:45
I too am anxious to see more data. God love the people who let science experiment with thier body's. I know a lot are at points of desperation in their disease processes or has nothing to lose, but thank you for giving what you got left to further find treatments and cures for generations to come. Good post Caduceus.
Caduceus's picture
Submitted by Caduceus on Thu, 02/07/2008 - 11:06
Interestingly, the most medical research is done on children with cancer. Almost every child that is diagnosed is placed (with parental consent) into study groups because with the most years in front of them, it makes the most sense to try and make strides in that area.
CapnHun's picture
Submitted by CapnHun on Thu, 02/07/2008 - 11:43
My favorite type of family doctor is the kind that keeps up with all the studies but treats his/her patients in general about 10 years behind the curve. That way all the medical 'mistakes' get left out.
TANK's picture
Submitted by TANK on Thu, 02/07/2008 - 11:54
The problem with aggressive treatments like that is it's extremely hard to manage. You need to have your day planned and know how much energy you're going to be expending when, when you're eating, when you're taking your meds and how long those meds affect your glucose absorbtion. The problem with constantly going hypo is that eventually your body stops producing the warning signs of being shakey, sweaty, light headed and what happens is you just pass out with no warning. So while very tight control of your glucose is necessary to avoid complications, being too aggressive can be just as harmful and deadly as not being aggressive enough. They need to make some type of watch type meter that is mointors glucose in realtime without having to stop and tak ea blood sample. They used to have a watch type device but that project was cancelled, the lag was about 20 minutes (so what it showed on the screen was what your glucose was 20 minutes ago). But honestly, this is what htye need to go to for really tight control. Another thing that could help is something like an insulin pump that also monitors and can dispense insuline as needed. The way i'd invision such a device working is you set the range you want your glucose to be within. Then you connect it to yourself somehow (probably 2 needles on the back side, one to inject and one to draw). Then every 5 minutes it takes a glucose sample and if the reading is higher than your range, it dispenses insulin on a scale, say 2 units for every 10 points you're over. As you go through your day, it keeps monitoring to see . if you get hypo then an alarm can sound telling you your trend is downwards and you should eat. Hell, this thing could have a 3rd vile of glucose and a 3rd needle on it and could inject glucose into you if needed as well. I don't know how something like that goes about being designed but i can't believe it hasn't been designed yet.

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