July 1, 2015 – Intensive Glucose Control

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Anchor lead:  Is there any benefit to aggressively lowering blood glucose in people with diabetes?  Elizabeth Tracey reports

How low should blood sugar go to control the many consequences of diabetes, especially cardiovascular problems?  For many years the thought was the tighter the control the better, but now a decade of data offers a contrary view.  Rita Kalyani, a diabetes expert at Johns Hopkins, describes the research.

Kalyani: At the end of an average of ten years of follow up the intensive group had a significantly lower risk of a major cardiovascular event, it was reduced by about 17% but they did not have a significant reduction in cardiovascular mortality or total mortality. What these results suggest is that there was a persistence of that initial intensive glucose lowering, what we call metabolic memory, that persisted even after the intensive treatment was discontinued, even after 10 years.   :30

Kalyani says this study underscores the need to take a personalized approach to blood sugar control in those with diabetes, taking into account other conditions and medications to maximize benefit.  At Johns Hopkins, I’m Elizabeth Tracey.