Lowering Blood Sugar Drops Heart Risks, Too
Finding contradicts reports of increased likelihood of harm

(HealthDay News) -- Although there's been some debate about whether tight blood sugar control can reduce the chances of heart disease, a study from The Lancet found that when people with type 2 diabetes achieved excellent control of their blood sugar level, their risk for heart disease dropped by about 15 percent.

"We show that if you lower glucose measures by something called HbA1c by 0.9 percent over five years, you reduce heart attacks by 17 percent and fatal and nonfatal heart attacks by 15 percent," the study's lead author, Dr. Kausik Ray, a senior clinical research associate from the University of Cambridge, told HealthDay. HbA1c is a measure of how much sugar is in the blood on average over two to three months. It's sometimes simply called A1c.

The study also found that there was "no excess risk of death in contrast to earlier claims," according to Ray. "There have been claims recently by doctors that lowering glucose to less than 7 percent could be harmful," he explained. "We disprove that in the largest study to date."

People with diabetes have an increased risk for heart disease and strokes, according to the U.S. National Diabetes Information Clearinghouse, a service of the National Institutes of Health. In addition to keeping blood sugar levels low, people with diabetes often need to aggressively manage blood pressure and cholesterol levels. In fact, they're advised to have blood pressure and cholesterol level targets that are even lower than for the general population. NIH experts say that people with diabetes should keep their blood pressure below 130/80 mmHg and their LDL ("bad") cholesterol under 100 milligrams per deciliter (mg/dL). HDL ("good") cholesterol should be above 40 mg/dL in men and above 50 mg/dL in women.

Ray and his colleagues gathered data from five studies, involving more than 33,000 people. Almost 1,500 people had heart attacks, another 2,318 had coronary artery disease and 1,127 people had strokes during the course of the studies. A total of 2,982 people died.

After reviewing A1c levels, the researchers found that those with better levels had a lower heart disease risk.

The intensively treated groups in the studies achieved average A1c levels of 6.6 percent, compared with 7.5 percent for standard treatments. People without diabetes generally have A1c levels from 4 to 5.9 percent.

Those with lower A1c levels reduced their risk for heart attacks by 17 percent, the study found.

Dr. Theodore Mazzone, chief of the endocrinology, diabetes and metabolism section at the University of Illinois at Chicago, stressed that "people with type 2 diabetes are at greatly increased risk for heart attack."

"We do know that treating them with statins and controlling their blood pressure can have a significantly beneficial effect for reducing this risk," Mazzone told HealthDay. "But even after that, there still is residual incremental risk compared to non-diabetic patients."

On the Web

To learn more about how people with diabetes can prevent heart disease, visit the American Diabetes Association.

SOURCES: HealthDay News; Kausik Ray, M.D., senior clinical research associate, University of Cambridge, England; Theodore Mazzone, M.D., professor, medicine, and chief, section of endocrinology, diabetes and metabolism, University of Illinois at Chicago; May 23, 2009, The Lancet; U.S. National Diabetes Information Clearinghouse (www.diabetes.niddk.nih.gov)
Author: Serena Gordon
Publication Date: May 31, 2010
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