Strict Blood Sugar Control Lowers Heart Risks in Diabetics

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Among people who received intensive treatment to control their blood sugar, their HbA1c was 0.9 percent lower than patients receiving standard treatment (6.6 percent vs. 7.5 percent).

Those whose blood sugar was strictly controlled saw a 17 percent reduction in non-fatal heart attacks, and a 15 percent reduction in events associated with heart disease, the researchers found.

"Better control of blood sugars reduces risk of heart attacks and heart disease," Ray said. "Treatment should be tailored to individual needs, however."

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Dr. Theodore Mazzone, chief of the Section of Endocrinology, Diabetes and Metabolism at the University of Illinois at Chicago and author of an accompanying journal commentary, noted there have been trials that failed to show that controlling blood sugar reduced heart attacks.

"People with type 2 diabetes are at greatly increased risk for heart attack," Mazzone said. "We do know that treating them with statins and controlling their blood pressure can have a significantly beneficial effect for reducing this risk, but even after that, there still is residual incremental risk compared to non-diabetic patients," he said.

Taken together, the trials analyzed in this study do show a benefit in preventing heart attacks from blood sugar control, Mazzone said. "It would be premature for doctors or patients to completely discard glucose control as a strategy for managing heart attack risk in patients with diabetes," he said.

Glucose control is not as important as lowering cholesterol and blood pressure in preventing heart attacks among diabetics, Mazzone said. "The effect of glucose is going to be smaller," he said.

Adding even the small benefit for heart attack is worthwhile, because it adds to the overall benefit of glucose control in these patients, Mazzone said. It's already well established and well accepted that glucose control can minimize the risk for blindness, minimize the risk for kidney disease, minimize the risk for nerve disease.

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