February 08, 2008	Friday	Muharram 29, 1429

CHICAGO: Conventional thinking among doctors who treat people with type-two diabetes has been the lower the blood sugar levels, the better.

Many doctors are now taking a second look.

A massive study of diabetics with a high risk of heart disease known as ACCORD has found that lowering blood sugar levels to what is considered normal for healthy people proved deadly for some, researchers said.

Older patients who underwent intensive therapy to reach that level had higher rates of death than a group of patients in the same study who were treated more conservatively.

“The study was designed asking the question if you really control blood sugar, do you actually prevent death?” said Dr Faramarz Ismail-Beigi of the University Hospitals Case Medical Center in Cleveland, Ohio, one of the study’s researchers.

“I think in the intensive group, the answer is no. It doesn’t prevent heart attacks and stroke,” he said in a telephone interview.

Ismail-Beigi said the study participants have answered an important question for millions of patients around the world with type-two diabetes, a disease marked by high blood sugar that can lead to a host of complications including heart attacks and stroke.

“We know how to manage the disease safely and better at less expense,” Ismail-Beigi said. He said it would have taken a huge amount of resources to move type-two diabetics to the lower, normal blood sugar range, a measure known as hemoglobin A1c.

Patients in the intensive treatment group of the ACCORD study were aiming for an A1c level of six per cent or below. They achieved an average of 6.4 per cent, whereas the more conservative treatment group had A1c levels of about 7.5 per cent.

“We can move millions of people into this zone with a certain amount of resources,” Ismail-Beigi said. To move them all down to 6, you would need five to 10 times more resources.

“In terms of public health, it makes a huge difference.” Dr James Dove, president of the American College of Cardiology, said the study was a bit unsettling.

“I think it offers some concern and caution,” Dove said in a telephone interview. —Reuters