ALLERGY, RESPIRATORY
Keep Asthma, Allergies at Bay for the Holidays
Herbal Remedy Could Halt Peanut Allergy
Know Your Asthma Triggers
ALTERNATIVE MEDICINE
Acupuncture May Trigger Natural Painkiller
When Healing Becomes a Commodity
38% of U.S. Adults Use Alternative Treatments
ANIMAL CARE
Separation Anxiety, Canine-Style
Safe Toys for Dogs
Animals Respond to Acupuncture's Healing Touch
BONES & JOINTS
Exercise Key Player in Knee Replacement Recovery
Human Ancestors Put Best Foot Forward 1.5M Years Ago
Low Vitamin D Raises Women's Hip Fracture Risk
CANCER
Yoga Eases Sleep Problems Among Cancer Survivors
Occaisonal Dieting May Cut Breast Cancer, Study Says
Physical Activity May Prolong Survival After Colon Cancer
CAREGIVING
High Rate of Rehospitalizations Costing Billions
Injected Medication Errors a Major Problem
3 Steps Might Help Stop MRSA's Spread
CIRCULATORY SYSTEM
Bad Marriages Harder on Women's Health
Salt Boosts Blood Pressure in High-Risk Patients
Obesity Linked to Heart Failure Risk
COSMETIC
Study Evaluates Laser Therapies for Hair Removal
New Genetic Links to Baldness Discovered
Health Tip: After Liposuction
DENTAL, ORAL
Gum Disease Might Boost Cancer Risk
A Sweet Way to Shield Baby's Teeth
Dental Implants Need More Work Than Root Canals
DIABETES
Out-of-Control Blood Sugar May Affect Memory
Study Shows Turmeric May Prevent Type 2 Diabetes
Brown Rice Bests White for Diabetes Prevention
DIET, NUTRITION
Eating your way to Good Health
Mercury in Fish Linked to High Blood Pressure
Successful Weight Loss Shows Unique Brain Patterns
DISABILITIES
Could Your Cell Phone Help Shield You From Alzheimer's?
Review Finds Marijuana May Help MS Patients
ENVIRONMENTAL HEALTH
Greener Neighborhoods Mean Slimmer Children
Household Insecticides May Be Linked to Autoimmune Diseases
Ozone Pollution Taking Toll on American Lives
EYE CARE, VISION
Too Much Sun, Too Few Antioxidants Spell Eye Trouble
Clues Found to Brain Mechanism Behind Migraines
'Blind' Man Navigates Obstacle Course Without Error
FITNESS
Study Shows Exercise Shields Against Osteoporosis
Occupational Therapy Plus Exercise Benefits Osteoarthritis
Any Exercise Good After a Heart Attack
GASTROINTESTINAL PROBLEMS
New Guidelines Issued for Management of IBS
Traditional Nonsurgical GERD Treatments Not Impressive
Soothing Imagery May Help Rid Some Kids of Stomach Pain
GENERAL HEALTH
Tai Chi May Help Ease Fibromyalgia
More Calcium And Dairy Products in Childhood Could Mean Longer Life
Heavy Alcohol Use Linked to Cancer
HEAD & NECK
Ski Helmets Encouraged for All
Many Children Will Outgrow Headaches
Zen May Thicken Brain, Thwart Pain
HEALTH & TECHNOLOGY
Imaging Sheds Light on How Acupuncture Works
E-Mailing Your Way to Healthier Habits
The Internet Is Becoming One-Stop Shopping for Health Help
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Rheumatoid Arthritis a Threat to the Heart
Shedding Light on Why Omega-3 Fatty Acids May Help the Heart
Cherry-Enriched Diet Cut Heart Risks in Rats
INFECTIOUS DISEASE
The HPV Vaccine: Preventative Medicine or Human Sacrifice?
Swine Flu Is Now a Pandemic Says W.H.O.
Swine Flu Loves a Crowd
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Mom's Extra Pregnancy Pounds May Raise Child's Heart Risks
Many Children Will Outgrow Headaches
Wood Fires Can Harm the Youngest Lungs
MEN'S HEALTH
More Vitamin C May Mean Less Chance of Gout
Vigorous Exercise Cuts Stroke Risk for Men, Not Women
Physical Activity May Prolong Survival After Colon Cancer
MENTAL HEALTH
Psychotherapy Can Boost Happiness More Than Money
Chocolate a Sweet Pick-Me-Up for the Depressed
Eight Spiritual Universal Principles in the Art of Practice
PAIN
Acupuncture, Real or Fake, Eases Back Pain
Are We Exercising Pain Away? Not So Much.
'Cell Phone Elbow' -- A New Ill for the Wired Age
PHYSICAL THERAPY
PREGNANCY
Sleeping Could Help Women Lose The Baby Fat
Sugary Colas Tied to Gestational Diabetes
Alternative Treatments May Boost IVF Success
SENIORS
The Juice From Beetroots May Boost Stamina
Daily dose of beet juice promotes brain health in older adults
Seniors Cope With Sleep Loss Better Than Young Adults
SEXUAL HEALTH
SLEEP DISORDERS
Meditation May Help Put Primary Insomnia to Bed
Moderate Aerobics May Ease Insomnia Symptoms
Exercising Throat Muscles May Relieve Sleep Apnea
WOMEN'S HEALTH
Caffeine in Pregnancy Associated With Low Birth Weight Risk
Most Women With Osteoporosis Unaware of Raised Fracture Risk
Pre-Pregnancy Weight Linked to Babies' Heart Problems
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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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