In February I wrote about the results of the ACCORD trial, a study designed to test whether strict glucose control in patients with diabetes helps prevent strokes and heart attacks and prolongs life.  The startling results were that the patients with diabetes who were randomized to have their glucose lowered to normal levels died sooner than those with more lax sugar control.

This week the New England Journal of Medicine published the results of another study, the ADVANCE trial, which was designed to answer the same question.  Over eleven thousand patients with type 2 diabetes were randomized to two groups.  One group was managed intensively with a goal of normal blood glucose.  The second group had less strict sugar control.  The groups were followed to measure the frequency of strokes, heart attacks, worsening of kidney disease, diabetic eye disease and death.

Again, in this trial, strict sugar control did not save any lives (though at least, it didn’t cause extra deaths like in ACCORD).  Strict sugar control also didn’t prevent strokes, heart attacks or eye disease.  The one benefit that was detected was that patients with strict control had less kidney disease than patients with lax sugar control.

The common theme seems to be that normal sugars are not the goal of diabetic treatment, or at least not the only goal.  Heart attack and stroke prevention in patients with diabetes involves many other proven therapies like smoking cessation, cholesterol lowering with statins, blood pressure medications and aspirin.

Learn More:

My post in February about the ACCORD trial:  What We Don’t Know About Diabetes

The New England Journal article publishing the results from the ADVANCE trial:  Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes

The New England Journal article publishing the results from the ACCORD trial:  Effects of Intensive Glucose Lowering in Type 2 Diabetes

Tangential Miscellany:

I hope us dads all get to spend some time with our kids this weekend, and all of us who are fortunate enough to still have our fathers in our lives have a chance to express our love and gratitude for everything they’ve done for us.  Happy Father’s Day!