Tight Glucose Control Decreases Chance of Heart Attack in Diabetics

June 3, 2009

Dr. Randall Wong

As a retinal specialist regularly involved with the treatment of diabetics, I read with interest a report in Lancet, that tight glucose control decreases the chance of heart attack, but not stroke or over all mortality. Researchers reported that those patients with lower serum glucose were noted to have a reduced rate of nonfatal myocardial infarction and coronary heart disease events.

Interestingly, the risk of stroke and overall mortality was not reduced. The research was based on the findings of a meta-analyses of five prospective trials involving over 33,000 patients. The results also indicate that tighter sugar control is not as effective in reducing mortality as is lowering LDL cholesterol or lowering blood pressure.

These findings fuel the ongoing debate as to the best way to treat Type II diabetics. Associated with tighter control, researchers found that a higher incidence of having a hypoglycemic event and these patients also gained more weight.

Obviously, diabetes continues to prove to be a very complicated disease. It is much more than just controlling the sugar as we eye doctors know. Suggestions regarding diet and exercise continue to get more confusing. As with the recommendations with ARMD, we just really won’t know until prospective, randomized trials are performed.