Intensive glucose control in type 2 diabetes can have adverse effects

November 15, 2017

The common approach of intensive glucose control to achieve low blood sugar targets in type 2 diabetes can increase the risk of mortality, finds a study by Cardiff University.

Looking at routine data from over 300,000 people in the UK, collected between 2004 and 2015, researchers found that lower levels of glycated haemoglobin--typically regarded as being good diabetes control - were associated with increased mortality risk, compared to moderate levels, especially in conjunction with intensive treatments that could cause hypoglycaemia.

Professor Craig Currie from Cardiff University's School of Medicine said: "Treatment guidelines generally recommend therapeutic strategies that aim for low levels of glucose control, on the understanding that it reduces risk of macrovascular complications such as coronary artery disease and stroke. Contrary to this belief, our findings show persuasively that there is an association with increased mortality risk and what is considered to be good glucose control, or low HbA1c."

The findings of the study also suggest that neither randomised trials nor observational studies have been able to demonstrate a consistent pattern of association between levels of glucose control and adverse outcome, without any explanation as to why. Thus, the optimal target for glucose control in patients with type 2 diabetes remains uncertain. Furthermore, the pattern of mortality in relation to glucose control differed in relation to differing types of diabetes drugs. Of most concern was an increase in mortality risk in those with 'good control' with type 2 diabetes who were treated with insulin and other glucose lowering drugs that induce hypoglycaemia.

Professor Currie said: "Serious questions remain about the safety of some glucose lowering drugs, with scientific evidence and opposing opinions being largely ignored."
-end-
The study 'The impact of differing glucose-lowering regimens on the pattern of association between glucose control and survival' is published in Diabetes, Obesity and Metabolism.

Cardiff University

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.