The media loves a good scare. So they’ve jumped all over the failed ACCORD study (Action to Control Cardiovascular Risk in Diabetes) with headlines making it sound like tight blood glucose control is now proven to be “bad for you.” Ugh.
As if it weren’t difficult enough educating the population about diabetes — and educating so many people with diabetes about how to treat it — now we’re supposed to question whether we should forgo blood sugar targets altogether? Geez.
I’m certainly not the first to point out why and how WRONG these sensational headlines are. But I felt compelled to compile some of the best points being made:
* The media is for the most part NOT MAKING IT CLEAR that the ACCORD study results do not extrapolate to the lion’s share of the diabetic population, and that younger people not at risk of heart disease have nothing to fear
* As Close Concerns notes, the study organizers are NOT DISCLOSING DETAILS on drug combinations and doses. “Usually announcements like this come with publishing of data, but not in this case” — which makes it even harder to draw conclusions
* The intensive treatment group in this study had a target blood sugar goal of LESS THAN 6 PERCENT. As anyone with diabetes knows, striving to go that low means frequent hypoglycemia (or risk thereof) which to my mind can’t be good for people with cardiovascular issues — even though the study organizers claim it wasn’t insulin shock that killed all those patients
* Expert endo Dr. Irl Hirsch believes it may have been the speed of the A1c drop that resulted in trauma — he references a similar study about retinopathy that showed something along these lines
* From the latest NY Times story, another theory offered up by Dr. John Buse, vice chairman of the study’s steering committee and the president of medicine and science at the ADA: the sheer stress of the program may have been a factor. “The intensity of what we did is done virtually nowhere on the planet… It’s far beyond what’s common in clinical practice,” he says. More proof that most of us have nothing to worry about striving for “normal” tight glucose control
[According to that article, "Many patients with diabetes feel stressed when they fail to meet blood sugar goals set by their doctors." I have no words...]
* Those not effected by this study: Type 1s, newly diagnosed Type 2s, and any and all younger patients who do not have cardiovascular disease
* If you DO have cardiovascular disease or high risk of it, “The most important thing is get your blood pressure controlled, cholesterol controlled, and do a reasonable job on your diabetes, but don’t go wild,” Buse says. “We are backing away from notion that we always have to push, push, push to get blood sugar lower.”
[Kind of the message we were hoping to bring across in our Know Your Numbers book]
So I hope a few things were learned here from this sweeping study. It’s just a damn shame that 257 people had to die in the process.