Doctors aggressively pushing down blood sugar levels in diabetic patients have found their treatment appears to increase deaths in high risk patients. This finding could call into question the entire approach to treating these patients.
The ACCORD trial of 10,000 type 2 diabetics was supposed to continue for 18 months more but the National Institutes of Health pulled the plug after 257 patients whose blood sugar was intensely lowered died, compared with 203 patients who received standard care.
“A thorough review of the data shows that the medical treatment strategy of intensively reducing blood sugar below current clinical guidelines causes harm in these especially high-risk patients with type 2 diabetes. Though we have stopped this part of the trial, we will continue to care for these participants, who now will receive the less-intensive standard treatment,” says Elizabeth Nabel, director of the NIH National Heart, Lung, and Blood Institute (press release).
Experts are keen to stress that lowering blood sugar levels is beneficial to diabetes but the new results mean it is unclear how low you should go. “It’s profoundly disappointing. This presents a real dilemma to patients and their physicians. How intensive should treatment be? We just don’t know,” says Richard Kahn, chief scientific and medical officer for the American Diabetes Association (Washington Post).
“It’s confusing and disturbing that this happened. For 50 years, we’ve talked about getting blood sugar very low. Everything in the literature would suggest this is the right thing to do,” says James Dove, president of the American College of Cardiology (NY Times).
The Seattle Times also quotes Dove: “Everything else has suggested, for 50 years or more, that tight control was good. We’ve got half a century of literature that is put on the back burner right now by one study.”
More
Background details and implications from the American Diabetes Association
Press briefing prepared remarks PDF
Image: diabetic patient / Punchstock