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Reply #9: One more article, explains the demographics of the group as "high-risk" [View All]

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54anickel Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Feb-10-08 08:46 PM
Response to Reply #2
9. One more article, explains the demographics of the group as "high-risk"
I'm very interested in this stuff as well since diabetes runs in the family and my FBG is coming in as pre-diabetic. Most of the info I'm finding on the net by diabetic "bloggers" is it's best to strive for as close to normal glucose levels as you can. I can see where doing it with this high-risk group may be a problem - my sister would fall into this group and I couldn't imagine bringing her glucose levels below 100 - she acts like a hypo at that point. They sure do seem to be going out of their way in most of the articles to say it has nothing to do with Avandia though.


On Monday, the National Heart, Lung, and Blood Institute at the National Institutes of Health shut down part of a $300 million study called ACCORD that had been following more than 10,000 very high-risk diabetic patients at 77 medical centers for as long as seven years. All had not only long-standing diabetes but also two or more other major cardiovascular risks such as obesity, smoking, or a previous heart-disease history. An unexpectedly large number of deaths had occurred among patients who were being aggressively treated to bring their blood sugar level below currently recommended standards. There were 257 deaths, about 25 percent higher than the 203 deaths in patients who got the usual care. (Because all patients were carefully monitored and managed, the annual death rate for both groups, about 1.4 percent and 1.1 percent respectively, was far below the 5 percent typical of other patients at similarly high risk.)

Diabetes is hard on the heart and the blood vessels. The rates of strokes and heart attacks and of microvascular complications like blindness, kidney failure, and nerve damage are far higher than in those free of the disease. To lower the risk, doctors constantly urge patients to push their blood sugar down and keep it under control. The desirable target for most is thought to be a blood glucose level (termed A1C level) of below 7 percent, compared with about 4 to 6 percent in the nondiabetic population. An important question that one part of the ACCORD trial was trying to answer was whether achieving a goal of below 6 percent could bring down the number of major heart events. So half of the patients were assigned a target A1C of below 6 percent and got an intensive glucose-lowering regimen of medication and close management; the other half got standard care and a typical target of 7 to 7.9 percent.

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