People with diabetes who maintain intensive, low blood sugar levels are significantly less likely to suffer heart attacks and coronary heart disease, new research published today in The Lancet has shown.
By undertaking a meta-analysis which pooled information from five large trials, researchers at the University of Cambridge were for the first time able to provide reliable evidence linking intensive blood sugar level (or glucose) control with fewer heart attacks.
The research, funded by the British Heart Foundation, pointed to a 17 % reduction in heart attacks and a 15 % reduction in coronary heart disease. However, the study found a more modest trend towards reduction in strokes with intensive control of glucose levels compared to standard care. Importantly, in contrast to smaller studies which had suggested possible harm from better blood sugar control, there were no adverse effects on deaths from any cause.
It is well documented that diabetics are at increased risk of heart disease. Even though patients can reduce their risk by maintaining healthy blood pressure levels and cholesterol reduction, the risk remains high.
Dr Kausik Ray of the University of Cambridge, lead author of the study, said: "Previous studies have been inconclusive, leaving diabetics and their doctors unsure as to whether maintaining lower blood sugar levels actually benefitted the patients. Although additional research needs to be conducted, our findings provide insight into the importance of improving glucose levels which should include lifestyle changes as well as medication."
The five trials involved more than 33,000 individuals, including 1497 heart attack cases, 2,318 cases of coronary heart disease, and 1227 strokes. In order to assess the possible risk of various heart conditions, Dr Ray and his team analyzed the data collected on the glucose levels in blood, specifically a long-term marker of glucose control called HbA1c. In healthy individuals, HbA1c levels average between 4-5%. However, diabetics often have levels above 6.5%.