Strict Sugar Controls in Diabetics benefit Kidneys but do not help the Heart

Rigorous control of blood sugar level in people with type 2 diabetes, does nothing to reduce the risk of heart attacks and strokes but it cuts the risk of kidney disease by 21 percent, according to the reports provided at the annual meeting of the American Diabetes Association.

Two large studies, involving about 21,000 people were separately conducted to see the effects of sugar control on the physiological systems of diabetics.

During intensive control of blood sugar, the level of hemoglobin A1c - a standard measure of blood sugar – should have been 6 percent to 6.5 percent, while a little loose control meant an A1C goal of around 7 percent to 7.9 percent.

At an average follow-up of 5 years, average A1c fell to 6.5 percent in the group that had thorough control compared with 7.3 percent in the standard group.

"The average difference in hemoglobin A1c during follow-up was 0.7%," said Dr. Anushka Patel of The George Institute for International Health in Sydney, Australia.

Too much control on sugar may lead to its deficiency in the blood, called hypoglycemia. The incidence of severe episodes of low blood sugar was 2.7 percent in the intensive glucose management group and 1.5 percent in the group receiving standard care. "However, the overall incidence was really quite low and there were no real sequelae, no evidence of chronic adverse events with hypoglycemia."

Cardiovascular diseases are responsible for 65 percent of deaths among people with Type 2 diabetes. Since diabetes is characterized by high levels of blood sugar, the popular belief held was that if people with diabetes could just get their blood sugar as close to normal as possible, their cardiovascular disease rate would be nearly normal as well.

However, according to researchers the only established method of avoiding complications in heart diseases is to give statins to control cholesterol, drugs to control blood pressure and aspirin to control blood clotting, and encourage people to lose weight and exercise. Patients should obtain moderate control of their blood sugar to protect against disease of eyes, kidney and nerves.

Earlier this year, researchers conducted a similar study and concluded that participants who were rigorously controlling their blood sugar actually had a higher death rate than those whose blood sugar control was less stern. These findings by the National Institutes of Health were disquieting as it was believed that death rate was declines with sugar control.

"We did not find any evidence of an increase in cardiovascular deaths or deaths from all causes," with intensive glucose management, Patel said after the recent study. The findings contradict the preceding research, which was halted early when it appeared that intensive glucose management was associated with an increased risk of death.

"There are some important differences in the two trials that may help explain the difference in results," Patel explained.

Although, cardiovascular system showed no improvement, the kidneys were found to benefit with controlling sugar and the rate of worsening renal disease among those with intense sugar control was 4.1 percent as compared with 5.2 percent among those with lesser control.

These benefits were seen as significant by some and modest by other researchers.