ALLERGY, RESPIRATORY
Traffic, Dust Linked to Asthma in Kids
Air Pollution May Raise Blood Pressure
Know Your Asthma Triggers
ALTERNATIVE MEDICINE
Acupuncture Eases Breast Cancer Treatment Side Effects
Could Chinese Herb Be a Natural Viagra?
Fish Oil's Benefits Remain Elusive
ANIMAL CARE
Safe Toys for Dogs
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
'Comfort Dogs' Come to Emotional Rescue
BONES & JOINTS
Soccer's a Winner for Building Bone Health in Girls
Rheumatoid Arthritis a Threat to the Heart
Rheumatoid Arthritis Rising Among U.S. Women
CANCER
Poor Women Seem to Be Skipping Breast Cancer Drugs
Vitamin D Good for Breast Cancer Patients
Asthmatics Who Quit Smoking May Reverse Lung Damage
CAREGIVING
Coordination Has Led to Quicker Heart Treatment
Many Alzheimer's Caregivers Admit to Abusive Behavior
Health Tip: Benefitting From Adult Day Care
CIRCULATORY SYSTEM
Exercise May Blunt Salt's Effect on Hypertension
Smog Tougher on the Obese
Walk 100 Steps a Minute for 'Moderate' Exercise
COSMETIC
Get Sugared!.... Its a sweet choice for hair removal
What to Do If You Have Unsightly Veins
Study Evaluates Laser Therapies for Hair Removal
DENTAL, ORAL
Sports Drinks May Be Tough on Teeth
Mom's Vitamin D Levels Affect Baby's Dental Health
A Sweet Way to Shield Baby's Teeth
DIABETES
Strict Blood Sugar Lowering Won't Ease Diabetes Heart Risk
Treatment for Type 2 Diabetes Updated
Vitamin K Slows Insulin Resistance in Older Men
DIET, NUTRITION
Fatty Acid in Olive Oil Wards Off Hunger
Eating Vegan or Raw-Vegan at Regular Restaurants
Soluble Fiber, But Not Bran, Soothes Irritable Bowel
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
Home Renovations by Affluent Families Can Unleash Lead Threat
Main Ingredients in Household Dust Come From Outdoors
EYE CARE, VISION
Thyroid Problems Boost Glaucoma Risk
Sports Eye Injuries Leading Cause of Blindness in Youths
Guard Kids' Eyes Against Long-Term Sun Damage
FITNESS
As Temperature Plummets, It's Still Safe to Exercise
Mom and Baby Alike May Benefit From Exercise
Occupational Therapy Plus Exercise Benefits Osteoarthritis
GASTROINTESTINAL PROBLEMS
Japanese Herbals May Ease Gastro Woes
Peppermint Oil, Fiber Can Fight Irritable Bowel
Bowel Prep Harder on Women Than Men
GENERAL HEALTH
More Single Women Are Having Babies
Music Therapy For Prehistoric Man?
Eat Light - Live Longer
HEAD & NECK
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
E-Mailing Your Way to Healthier Habits
'Cell Phone Elbow' -- A New Ill for the Wired Age
Subway Defibrillators Save Lives
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Whole Grains Lower Risk of Heart Failure
Vigorous Exercise Cuts Stroke Risk for Men, Not Women
Potassium-Rich Foods May Cut Stroke, Heart Disease Risk
INFECTIOUS DISEASE
Bacterial Infections May Succumb to Honey
Older Adults May Have Some Immunity to Swine Flu
The HPV Vaccine: Preventative Medicine or Human Sacrifice?
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
3 Home Habits Help Youngsters Stay Slim
Scorpion Anti-Venom Speeds Children's Recovery
Safety Should Be Priority for Those Involved in Kids' Sports
MEN'S HEALTH
Sunlight May Help Protect Men From Kidney Cancer
Exercise May Prevent Prostate Cancer: Study Shows
Noise Hurts Men's Hearing More, Study Shows
MENTAL HEALTH
Eight Spiritual Universal Principles in the Art of Practice
How to Attack Holiday Stress Head-On
Have a Goal in Life? You Might Live Longer
PAIN
'Cell Phone Elbow' -- A New Ill for the Wired Age
Tai Chi May Help Ease Fibromyalgia
Are We Exercising Pain Away? Not So Much.
PHYSICAL THERAPY
PREGNANCY
Heart Defects in Newborns Linked to Antidepressants
Sugary Colas Tied to Gestational Diabetes
Acupuncture May Ease Depression During Pregnancy
SENIORS
Mediterranean Diet Plus Exercise Lowers Alzheimer's Risk
Keeping Mentally Active Seems To Keep The Brain Active
The Juice From Beetroots May Boost Stamina
SEXUAL HEALTH
SLEEP DISORDERS
Pay Attention to Signs That Say You're Too Fatigued to Drive
Moderate Aerobics May Ease Insomnia Symptoms
Daylight Savings: Not a Bright Time for All
WOMEN'S HEALTH
Pre-Pregnancy Weight Linked to Babies' Heart Problems
How Much Fish to Eat While Pregnant?
Most Women With Osteoporosis Unaware of Raised Fracture 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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