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Thu, Jun-12-08, 08:20
Diabetes study finds hope in low blood sugar
Louise Hall Health Reporter
June 8, 2008
The Age Australia
AUSTRALIAN and North American medical researchers are heading for a conflict that may leave millions of diabetes sufferers worldwide in the dark on how best to treat their disease.
The way people manage diabetes could change following a landmark Australian-led study which found that dramatically reducing blood sugar levels slashes the risks of complications and death.
The ADVANCE (Action in Diabetes and Vascular Disease) study of 11,140 people found lowering glucose levels well below current standard practice could help prevent kidney and cardiovascular disease, complications that will kill most of the 250million people affected by the global epidemic of type 2 diabetes.
ADVANCE chief investigator Professor Stephen MacMahon, from the George Institute for International Health at Sydney University yesterday told the American Diabetes Association Conference in San Francisco that intensively lowering the hemoglobin A1c level - a marker of blood glucose control - to the level of a person without diabetes was not only safe, but cut the number of deaths. Safety fears halted a similar US-led trial - ACCORD (Action to Control Cardiovascular Risk in Diabetes) - in February because of a slight increase in deaths in the trial's patients.
Professor MacMahon said the contradictory results of the ACCORD study, which are sure to spark heated debate when presented to the conference on Tuesday, could be explained by the speed of the treatment.
"Our approach was to lower blood glucose levels gradually by slowly adding medication and, only if absolutely necessary, adding insulin, which we found produced benefits not risks," he said. "In the US they used a very aggressive treatment program using high levels of insulin and a range of other drugs quickly."
The ADVANCE randomised trial, conducted in 20 countries, aimed to reduce levels of hemoglobin A1c to 6.5percent or below in half the participants using a range of methods including insulin and gliclazide, a drug taken orally.
The other half received the standard treatment to match the current recommended A1c target of 7 to 7.9percent.
Researchers found those who intensively lowered their glucose levels had a 10percent reduction in the risk of serious and disabling diabetes complications and, in particular, cut their risk of kidney disease by 20percent.
The study found a 1.2percent increase in the likelihood of experiencing hypoglycaemia - a dramatic fall in blood sugar levels, resulting in dizziness, confusion and even loss of consciousness.
Source: http://www.theage.com.au/news/health/diabetes-study-finds-hope-in-low-blood-sugar/2008/06/07/1212259179201.html
Louise Hall Health Reporter
June 8, 2008
The Age Australia
AUSTRALIAN and North American medical researchers are heading for a conflict that may leave millions of diabetes sufferers worldwide in the dark on how best to treat their disease.
The way people manage diabetes could change following a landmark Australian-led study which found that dramatically reducing blood sugar levels slashes the risks of complications and death.
The ADVANCE (Action in Diabetes and Vascular Disease) study of 11,140 people found lowering glucose levels well below current standard practice could help prevent kidney and cardiovascular disease, complications that will kill most of the 250million people affected by the global epidemic of type 2 diabetes.
ADVANCE chief investigator Professor Stephen MacMahon, from the George Institute for International Health at Sydney University yesterday told the American Diabetes Association Conference in San Francisco that intensively lowering the hemoglobin A1c level - a marker of blood glucose control - to the level of a person without diabetes was not only safe, but cut the number of deaths. Safety fears halted a similar US-led trial - ACCORD (Action to Control Cardiovascular Risk in Diabetes) - in February because of a slight increase in deaths in the trial's patients.
Professor MacMahon said the contradictory results of the ACCORD study, which are sure to spark heated debate when presented to the conference on Tuesday, could be explained by the speed of the treatment.
"Our approach was to lower blood glucose levels gradually by slowly adding medication and, only if absolutely necessary, adding insulin, which we found produced benefits not risks," he said. "In the US they used a very aggressive treatment program using high levels of insulin and a range of other drugs quickly."
The ADVANCE randomised trial, conducted in 20 countries, aimed to reduce levels of hemoglobin A1c to 6.5percent or below in half the participants using a range of methods including insulin and gliclazide, a drug taken orally.
The other half received the standard treatment to match the current recommended A1c target of 7 to 7.9percent.
Researchers found those who intensively lowered their glucose levels had a 10percent reduction in the risk of serious and disabling diabetes complications and, in particular, cut their risk of kidney disease by 20percent.
The study found a 1.2percent increase in the likelihood of experiencing hypoglycaemia - a dramatic fall in blood sugar levels, resulting in dizziness, confusion and even loss of consciousness.
Source: http://www.theage.com.au/news/health/diabetes-study-finds-hope-in-low-blood-sugar/2008/06/07/1212259179201.html