ALLERGY, RESPIRATORY
Air Pollution May Raise Blood Pressure
Keep Asthma, Allergies at Bay for the Holidays
Overweight Moms More Likely to Have Asthmatic Kids
ALTERNATIVE MEDICINE
Relaxation Tapes or Mozart Lower Blood Pressure
Acupuncture May Trigger Natural Painkiller
Massage Therapy Helps Those With Advanced Cancer
ANIMAL CARE
Beware of Dog Bites
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
Animals Respond to Acupuncture's Healing Touch
BONES & JOINTS
Gene Plays Key Role in Clubfoot
Low Vitamin D Raises Women's Hip Fracture Risk
Rheumatoid Arthritis Hits Women Harder
CANCER
Supplement Hampers Thyroid Cancer Treatment
More Americans Urged to Get Cancer Screenings
Asthmatics Who Quit Smoking May Reverse Lung Damage
CAREGIVING
Early Exercise Boosts Outcomes for ICU Patients
Falls Are Top Cause of Injury, Death Among Elderly
ER Less Likely to Diagnose Stroke in Younger Folks
CIRCULATORY SYSTEM
Firefighters Have Narrower-Than-Normal Arteries, Study Finds
Bye, Bye Back Fat?
Salt Boosts Blood Pressure in High-Risk Patients
COSMETIC
Study Evaluates Laser Therapies for Hair Removal
Contact Lenses Boost Kids' Self-Image
The Acne Drug Accutane More Than Doubles Depression Risk
DENTAL, ORAL
Hormones May Be to Blame for Women's Cavity Rates
Holistic Dentistry-My View
Obesity Boosts Gum Disease Risk
DIABETES
Findings Challenge Tight Glucose Control for Critically Ill Patients
Out-of-Control Blood Sugar May Affect Memory
Brown Rice Bests White for Diabetes Prevention
DIET, NUTRITION
For Fitness, Cutting Calories May Not Be Enough
Is Your Refrigerator Getting Enough Attention For Your Raw Food Success?
Occaisonal Dieting May Cut Breast Cancer, Study Says
DISABILITIES
Could Your Cell Phone Help Shield You From Alzheimer's?
Review Finds Marijuana May Help MS Patients
ENVIRONMENTAL HEALTH
Freckles, Moles May Indicate Risk for Eye Cancer
City Kids Find the Breathin' Is Easier Elsewhere
Former Inmates at Increased Risk for High Blood Pressure
EYE CARE, VISION
Nutrient-Rich Diet Lowers Risk of Age-Related Eye Disease
Ordinary Chores Cause Half of All Eye Injuries
High Temps Degrade Contact Lens Solution: Study
FITNESS
The 3LS Wellness Program for Reversing Chronic Symptoms and Creating Lasting Health
Football Can Shrink Players
Diet, Exercise May Slow Kidney Disease Progression
GASTROINTESTINAL PROBLEMS
Bowel Prep Harder on Women Than Men
New Guidelines Issued for Management of IBS
HRT Use Raises Risk of Stomach Trouble
GENERAL HEALTH
'Soda Tax' Wins Health Experts' Support
New Options Offered for Sleep Apnea
Why Am I So Tired? Could It Be Low Thyroid?
HEAD & NECK
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
'Cell Phone Elbow' -- A New Ill for the Wired Age
Subway Defibrillators Save Lives
Using Light Therapy to Silence Harmful Brain Activity
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Dark Chocolate May Lower Stroke Risk
Small Cuts in Salt Intake Spur Big Drops in Heart Trouble
Coffee Is Generally Heart-Friendly
INFECTIOUS DISEASE
Grapefruit Compound Inhibits Hepatitis C Virus
Swine Flu Now Reported in All 50 States
Dry Weather Boosts Odds of Flu Outbreaks
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
More Calcium And Dairy Products in Childhood Could Mean Longer Life
Frequent Feedings May Be Making Babies Fat
Stomach Germ May Protect Against Asthma
MEN'S HEALTH
More Vitamin C May Mean Less Chance of Gout
Physical Activity May Prolong Survival After Colon Cancer
Lots of Sex May Prevent Erectile Dysfunction
MENTAL HEALTH
Using the Mind to Heal the Heart
Estrogen May Help Men's Hearts
Daily dose of beet juice promotes brain health in older adults
PAIN
Acupuncture, Real or Fake, Eases Back Pain
Tai Chi May Help Ease Fibromyalgia
Alleviating Rheumatoid Arthritis
PHYSICAL THERAPY
PREGNANCY
Music of Mozart Soothes the Preemie Baby
Acupuncture May Ease Depression During Pregnancy
Obesity May Affect Fertility in Young Womene
SENIORS
Money May Matter, Health-Wise, in Old Age
High-Impact Activity May Be Good for Old Bones
Video Gaming Just Might Fight Aging
SEXUAL HEALTH
SLEEP DISORDERS
Daylight Savings: Not a Bright Time for All
Lose Weight, Sleep Apnea May Improve
Meditation May Help Put Primary Insomnia to Bed
WOMEN'S HEALTH
Varicose Veins May Mask Larger Problem
Natural Childbirth Moms More Attuned to Babies' Cry
Natural Oils Help Lower Body Fat For Some
Add your Article

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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