ALLERGY, RESPIRATORY
Asthmatics Who Quit Smoking May Reverse Lung Damage
New Spray Could Benefit Cystic Fibrosis Patients
Folic Acid Might Offer Allergy Relief
ALTERNATIVE MEDICINE
Spot light on Dani Antman New Lionheart teacher
Pharoah's Wine Jar Yields Medicinal Secrets
Memory Loss Help from Brain Supplement Prevagen
ANIMAL CARE
Beware of Dog Bites
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
'Comfort Dogs' Come to Emotional Rescue
BONES & JOINTS
Low Vitamin D Raises Women's Hip Fracture Risk
Barefoot Lifestyle Has Its Dangers
A Winning Strategy to Beat Spring Sporting Injuries
CANCER
Smoking Exposure Now Linked to Colon, Breast Cancers
Smokeout '08: The Perfect Time to Quit
Lifting Weights Can Ease Arm Swelling in Breast Cancer Survivors
CAREGIVING
High Rate of Rehospitalizations Costing Billions
Coordination Has Led to Quicker Heart Treatment
Omega-3 Fatty Acid May Help 'Preemie' Girls' Brains
CIRCULATORY SYSTEM
High Blood Fat Levels Common in Americans
Secondhand Smoke Quickly Affects Blood Vessels
Exercise May Blunt Salt's Effect on Hypertension
COSMETIC
New Genetic Links to Baldness Discovered
With Psoriasis, the Internet May Offer Hope
Health Tip: After Liposuction
DENTAL, ORAL
Good Oral Hygiene May Protect Against Heart Infections
Hormones May Be to Blame for Women's Cavity Rates
Periodontal Disease Impacts Whole Health
DIABETES
Drug May Not Help Diabetes-Related Eye Damage
Diabetes Linked to Cognitive Problems
Red-Grape Compound May Improve Diabetes
DIET, NUTRITION
Common Antioxidant Might Slow Parkinson's
Weight Loss Might Not Curb Knee Arthritis
Adding Garlic Might Cut Cancer Risk
DISABILITIES
Could Your Cell Phone Help Shield You From Alzheimer's?
Review Finds Marijuana May Help MS Patients
ENVIRONMENTAL HEALTH
Air Pollution Raises Risk of Heart Disease, Death
Household Chemicals May Affect Cholesterol Levels
Improved Fungicides May Be Easier on Environment
EYE CARE, VISION
Kids' Eye Injuries From Golf Clubs Rare But Severe
Autistic Children Make Limited Eye Contact
Hybrid Cars Pose Risk to Blind, Visually Impaired
FITNESS
Simple Exercise Precautions To Help Keep Baby Boomers Fit
Vigorous Exercise Can Cut Breast Cancer Risk
Fliers Can Keep Blood Clots at Bay
GASTROINTESTINAL PROBLEMS
Gum Chewing May Speed Colon Surgery Recovery
Intestinal Bacteria Trigger Immune Response
Olive Oil May Protect Against Bowel Disease
GENERAL HEALTH
Want to Stop Cancer? You Can, Experts Say
Hand-Washing Habits Still Need Improvement: Survey Says
Time to Remind Teens About Sun Protection
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Ski Helmets Encouraged for All
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
Magnet Therapy May Ease Hard-to-Treat Depression
E-Mailing Your Way to Healthier Habits
Save Your Aging Brain, Try Surfing The Web
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
An Apple a Day May Help Keep Heart Disease Away
Rheumatoid Arthritis a Threat to the Heart
Dark Chocolate May Lower Stroke Risk
INFECTIOUS DISEASE
Poor Restroom Cleaning Causes Cruise-Ship Sickness
Chinese 'Devil Dung' Plant Could Be a Swine Flu Fighter
Swine Flu Loves a Crowd
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Exercise Eases Obesity and Anger in Kids
Childhood Dairy Intake Boosts Bone Health Later On
Play Creatively as a Kid, Be a Healthier Adult
MEN'S HEALTH
Soy Linked to Low Sperm Count
Varicose Veins May Mask Larger Problem
The Dark Side of Vegetarianism
MENTAL HEALTH
Using the Mind to Heal the Heart
Daily dose of beet juice promotes brain health in older adults
A Simple 'Thank You' Brings Rewards to All
PAIN
Are We Exercising Pain Away? Not So Much.
Alleviating Rheumatoid Arthritis
Acupuncture, Real or Fake, Eases Back Pain
PHYSICAL THERAPY
PREGNANCY
Exercise As Well As Acupuncture, May Ease Polycystic Ovarian Syndrome
Prenatal Stress May Boost Baby's Asthma Risk
Before Conceiving, Take Folic Acid for One Full Year
SENIORS
Daily dose of beet juice promotes brain health in older adults
More Whole Grains May Mean Less Fat
Many Cancer Survivors Don't Adopt Healthy Lifestyle
SEXUAL HEALTH
SLEEP DISORDERS
Sleeping Could Help Women Lose The Baby Fat
Pay Attention to Signs That Say You're Too Fatigued to Drive
Moderate Aerobics May Ease Insomnia Symptoms
WOMEN'S HEALTH
Natural Therapies for Menopause
Woman in America Are Delaying Motherhood, Study Says
Caffeine in Pregnancy Associated With Low Birth Weight Risk
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Strict Blood Sugar Lowering Won't Ease Diabetes Heart Risk

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Dec. 17 (HealthDay News) -- Intensive lowering of blood sugar in people with poorly controlled type 2 diabetes does not have a significant effect on reducing cardiovascular events, such as heart attack and stroke, a new study finds.

"You can decrease cardiovascular events in patients with type 2 diabetes by good treatment of lipids [cholesterol], blood pressure and other cardiovascular risk factors," noted lead researcher Dr. William Duckworth, from the Phoenix Veterans Affairs Health Care Center in Arizona. "But among older patients whose risk factors are controlled, intensive glucose control does not add any significant benefit," he said.

That runs counter to the conventional wisdom on the issue, which holds that intensive lowering of blood sugar should reduce cardiovascular events.

"But it's never been proven," Duckworth said. And given the findings of the new study, "time and money may be better expended by doing more work on lipids, blood pressure, diet and exercise," he added.

The report was published in the Dec. 17 online edition of the New England Journal of Medicine.

For the study, called the Veterans Affairs Diabetes Trial (VADT), Duckworth's team randomly assigned almost 1,800 patients averaging 60 years of age to intensive blood sugar control or to standard blood sugar control. All of the patients had experienced suboptimal responses to treatment for type 2 diabetes.

During 5.6 years of follow-up, 264 of the patients receiving standard blood sugar control experienced a heart attack or stroke, died from heart disease, developed heart failure, had surgery for heart disease or had an amputation made necessary by poor circulation.

But so did 235 of the patients who received intensive blood sugar control.

Moreover, there was no difference between the groups in deaths from any cause or other complications from diabetes such as kidney and vision problems, the researchers found.

The value of intensive blood sugar control has become a highly debated topic, especially since two recent studies looking at the benefits of aggressively lowering blood sugar in people with type 2 diabetes came to different conclusions.

One study, the ADVANCE (Action in Diabetes and Vascular Disease) trial found a 21 percent reduced risk for kidney disease in patients on tight glucose control. On the other hand, the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial found a 22 percent increased risk of death for those on the stricter regimen.

Dr. David Nathan, a professor of medicine at Harvard Medical School and chief of the Diabetes Unit Medical Service at Massachusetts General Hospital in Boston, doesn't believe the new study adds much to the mix. And while dramatically lowering blood sugar may not have a benefit for cardiovascular disease, it does have a benefit in slowing or preventing other complications of diabetes, Nathan said.

"Neither study demonstrated a benefit for cardiovascular disease, and ACCORD was stopped early because of increased mortality in the intensive group," Nathan said. "The increased mortality in ACCORD suggests caution in aiming for very low blood sugar levels, which has been the American Diabetes Association's -- and my -- recommendation for years," he said.

"The bottom line here is that diabetes treatment aimed at blood sugar of less than 7 percent on blood sugar tests is of benefit for eye, kidney, and nerve disease, which was established by other studies, but probably underpowered in the VADT, but [it] may not benefit heart disease outcomes," Nathan said. "The VA study doesn't add much to the previously published studies, and it shouldn't be used to loosen the current recommendations," he said.

More information

For more about diabetes, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.



SOURCES: William Duckworth, M.D., Phoenix Veterans Affairs Health Care Center, Ariz; David Nathan, M.D., professor of medicine, Harvard Medical School, chief, Diabetes Unit Medical Service, Massachusetts General Hospital, Boston; Dec. 17, 2008, online edition, New England Journal of Medicine

Last Updated: Dec. 17, 2008

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