Ya know, I've had some problems with DH's doctor at the VA because of the way she kept changing his meds without seeing him (he's type 2 diabetic, she started him on insulin, and changed his dosages without having talked to us or seen us). But we made an appointment to see her, with a list of concerns he had, spent almost an hour showing her what we had done with dietary changes, and our adjustments to his insulin based on those changes, and got good explanations from her on why she had stopped one of his meds. She also explained why she didn't think it was necessary for him to get his A1c below 6.5 - 7. She said that the benefits of a normal (non-diabetic) A1c of 4.5 to 5 as relates to diabetic complications, are not that much better than at 6.5 to 7.
So when I saw the article about the ACCORD study, it made me appreciate the fact that she's not on the bandwagon of getting his blood sugar as low as it can possibly go (she said as long as he can keep it in the range of 80 - 140 the majority of the time, he'll be fine).
This study seems to be saying that diabetics have to struggle to get their A1c below 6, but from the diabetic lists I've been reading, that doesn't seem to be the case. Most of the posters have A1c's ranging between 4.5 and 6, and they work on having really tight control of it and getting their numbers as low as they can without having episodes of hypoglycemia.
The government abruptly halted aggressive treatment in a major study of diabetes and heart disease after a surprising number of deaths among patients who pushed their blood sugar to super-lows — findings that call into question a growing movement in diabetes care.
Wednesday's move doesn't affect health guidelines for most Type 2 diabetics, but it raises concern about a particularly vulnerable group: Patients at especially high risk of heart attack or stroke.
The 10,000-patient study, dubbed ACCORD, was supposed to answer a big question: Could pushing blood sugar to near-normal levels, below today's recommended target, help protect these high-risk patients' hearts?
There were fewer heart attacks than they expected to see, but more deaths from those heart attacks, and they don't understand why. The patients' weren't hypoglycemic, but their blood sugar was near the norm for a non-diabetic. There were also more unexplained deaths without clear evidence of heart attack.
So for now, the NIH's message: Diabetics with heart disease shouldn't strive for near-normal glucose, but to a level long described as optimal for all diabetics — around 7 on a measurement scale known as the A1C.
The goal for diabetics used to be 8 or 9, and was lowered to 7, each point drop means a 25 to 40 percent lessening of the risk for serious complications, such as blindness or kidney failure. It seems to me that they may have gotten carried away with the how low can you go in order to prevent complications. There seems to be a law of diminishing returns coming into effect here. The lower you go, after a certain point, the less good it's going to do you (gee, does that sound familiar to anyone?).
I'm all for treating diabetes, after all, I want my husband around for a good long time to come. With his family history of diabetes and heart complications, it's a really good thing that his doctor isn't one of those advocating he get his numbers to non-diabetic levels (and she didn't say anything about his weight this time, even though he'd gained back the 10 lbs he lost, and another 4 since starting the insulin). Weight gain can be one of the side effects of insulin, from what I understand (something about better utilization of sugar and storing it as fat instead of dumping it in the blood?).
This whole thing makes me wonder about the health establishment's habit of lowering the threshold for so many aspects of our health. For years, we were told that 120/80 was normal for blood pressure, now it's 110/70. We all know what they've done to the BMI, which is a bullshit measure for health anyway. Are they going to lower the standards so much that no one, thin or fat, is going to be able to meet any of them? I can see it coming...............
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