Frequent Blood Sugar Testing Slashes Heart Risks

A follow-up of diabetic patients who participated in a long-term study has shown that intensive glucose control in these patients lowered the risk of heart disease and stroke by about 50%. These results were reported in the December 22, 2005, issue of The New England Journal of Medicine.

"We see a greater reduction in cardiovascular events from intensive blood glucose control than from drugs that lower blood pressure and cholesterol,” said Saul Genuth, M.D., of Case Western Reserve University (Cleveland, OH, USA), who chaired the follow-up study, called the Epidemiology of Diabetes Interventions and Complications (EDIC) study.

The initial study examined the long-term benefits of prior intensive blood glucose control versus conventional control in patients with type 1 diabetes. The fact that the risk of heart disease is around 10 times higher in these patients makes the results even more impressive. The early follow-up showed that intensive glucose control can prevent or delay the eye, nerve, and kidney complications of type 1 diabetes. At the end of the study, HbA1c readings averaged 7% in the intensively treated group versus 9% in patients who had conventional treatment. Those findings led to a major shift in the way doctors manage patients with type 1 diabetes.

The long-term follow-up showed that intensive treatment not only reduced the development of heart disease but also produced long-lasting effects, even though the blood glucose levels of the group that was given intensive treatment had gradually risen to about 8%. Specifically, tight glucose control lowered the risk of a cardiovascular event by 42%, and the risk of a heart attack or stroke by 58%. Among the 1,375 volunteers still in the trial, those intensively treated had less than half the number of cardiovascular events that occurred in patients with conventional control.

"The benefits of intensive control strongly reinforce the message that this therapy should begin as early as possible and be maintained as long as possible,” noted Dr. Genuth.





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