Study: Patients Undergoing Intensive Glucose Control Should Take Caution

Study: Patients Undergoing Intensive Glucose Control Should Take CautionA new study suggests that people with type 2 diabetes who undergo intensive glucose-lowering treatments do not benefit from a reduction in the risk of deaths linked to cardiovascular problems, and that doctors should take caution when prescribing this form of treatment, HealthDay reports.

According to the news source, people who suffer from type 2 diabetes are already at an increased risk for cardiovascular disease and other microvascular complications, while intensive glucose-lowering treatment remains a widely used procedure for patients, even though research performed on the subject over the years has not been clear to show any benefits.

In the new study, which was led by Catherine Cornu, a researcher at the Clinical Investigation Center, investigators reviewed 13 studies comprised of 34,533 diabetes patients, 18,315 of whom were treated with the intensive glucose-lowering methods and 16,218 who were given standard treatments, the media outlet stated.

The study found that the intensive treatments did not reduce cardiovascular death or all-cause death in any significant way, but was linked to a twofold increase in risks associated with extremely low blood glucose levels, a term called severe hypoglycemia.

According to the National Library of Medicine, hypoglycemia is common among those with diabetes, and may occur when too much insulin is taken, not enough food has been eaten or an increase in exercise is not accompanied by an increase in food intake.

The researchers found that over a five-year period of treatment, in order to prevent one heart attack from occurring, 117 to 150 patients would need to undergo the intensive treatments, while 32 to 142 would need to be treated in order to prevent a single instance of microalbuminuria, and 15 to 53 patients would have to receive treatment to stave off one hypoglycemic event, the news outlet stated.

In the study, the authors included a warning that "intensive glucose-lowering treatment of type 2 diabetes should be considered with caution and therapeutic escalation should be limited."

Dr. Cornu and her colleagues released a statement along with the research, stating that their meta-analysis was consistent with previous research, suggesting intensive glucose lowering has a "modest at best" affect on cardiovascular health, and that the treatment is most likely less efficacious, and more difficult, than other procedures, such as lipid lowering and blood pressure control.

"A combined approach that targets glucose lowering, lipid lowering, and blood pressure control seems to be most beneficial, and available data also suggest a long-lasting beneficial effect on diabetes-related clinical events many years after an intensive regimen," the researchers said in their statement.

The report concludes by stating that a benefit-to-risk ratio of the treatments in the prevention of macrovascular and microvascular could not be determined, but that the harm that may be caused by a severe hypoglycemic event could very well counterbalance the possible benefits the treatment offers. The investigators intend to perform further double blind, randomized trials in a controlled setting to further develop the best therapeutic approach to those with type 2 diabetes.

According to the National Diabetes Information Clearinghouse, a subsection of the U.S. Department of Health and Human Services, type 2 diabetes is a disease which develops when the cells in the muscles, liver and fat cannot properly use insulin, a hormone made in the pancreas that helps process glucose in the blood into energy.

The disease is preventable by maintaining a healthy weight, proper diet and physical activity, although having a family history of obesity is a strong risk factor.