Even lower blood sugar levels advocated to avoid heart disease

Dec 22 2005

According to a researcher and diabetes expert, doctors with diabetic patients should be aiming for much lower levels of blood glucose than is currently suggested by the guidelines.

William Cefalu, M.D.,of the Pennington Biomedical Research Center, says the currently recommended blood-sugar levels are not low enough to avoid one of the major complications of diabetes, heart disease.

Referring to recently published research, Dr. Cefalu says that if the medical community believes long-term control of blood sugar levels can reduce the risk of cardiovascular disease, then a reassessment of the clinical goals may be needed.

The research shows that more aggressive control of blood sugar levels, by use of a more intensive insulin regimen, appears to help avoid long-term cardiovascular disease.

At present doctors on the advice of the American Diabetes Association, tell their patients with Type 1,(juvenile diabetes), and Type 2, (adult-onset diabetes), to maintain adequate long-term blood glucose control by achieving an A1c test of 7 percent.

This is a simple test commonly used by doctors in their office to determine blood sugar levels, and measures the amount of blood sugar attached to hemoglobin, a protein found in red blood cells.

A normal level is considered to be around 6-percent.

As new research reveals that long-term, more intensive control of blood sugar levels leads to far less cardiovascular disease, Cefalu believes the medical community should rethink its advice to patients.

Cefalu also suggests that because the effects on the cardiovascular system are seen in younger individuals with Type 1 diabetes compared to non-diabetic individuals, the blood-sugar levels for juveniles should be revised downward from the current guidelines of 8 percent for ages 6 through 12 and 7.5 percent for ages 13 through 19.

Cefalu says he recognises that these goals would be very difficult to achieve and that many physicians and patients are already struggling to meet the existing guidelines.

But he believes the data should not be ignored as many cases of heart disease could be avoided.

He says that the medical community needs better resources, new strategies, and a different attitude if they mean to improve and maintain blood sugar control in patients with Type 1 diabetes in order to see a reduction in the side effects.

The Pennington Biomedical Research Center is a campus of the Louisiana State University System and conducts both clinical and basic research.

It is the largest academically based nutrition research center in the world, with the greatest number of obesity researchers on faculty.

The Center has almost 600 employees who occupy several buildings on a 234-acre campus.

The research and Cefalu's remarks are published in this month's issue of the New England Journal of Medicine (NEJM).