Posted by Medivizor on Oct 7, 2017 in Diabetes mellitus |
In a nutshell
This study assessed the potential benefits of controlling blood sugar to a strict level. The authors concluded that intensive blood-sugar control prevented kidney and eye complications, but not nerve complications.
Some background
Poorly-managed type-2 diabetes (T2D) can increase the risk of kidney damage, eye damage and nerve damage. If left untreated, these can lead to complications such as end-stage kidney disease, blindness, ulceration and amputation. Managing blood sugar is one way to prevent these side effects. Intensive blood-sugar control, however, can lead to hypoglycemia (i.e. extremely-low blood sugar). It is not clear whether intensive blood sugar control is more effective at preventing complications than less intensive practices.
Methods & findings
This study pooled the data from four separate trials including 27,049 T2D patients. Most patients had an HbA1C (average blood sugar levels over 3 months) above 7%. This is considered high. All of the trials assessed the effects of varying the intensity of blood-sugar control on preventing kidney, eye, and nerve complications. Patients were followed for an average of 5 years.
After five years, there were 1626 kidney, 795 eye, and 7598 nerve complications. Those who controlled their blood-sugar more intensely reduced their HbA1C by 0.90% compared to less intensive control. These patients were 20% less likely to experience kidney complications and 13% less likely to experience eye complications. There was no effect on nerve complications.
All of the above results remained consistent irrespective of age, initial HbA1C level, race, duration of diabetes, presence of existing heart disease, and kidney filtration rate.
The bottom line
This study concluded that more intensive blood sugar control reduced the risk of kidney and eye complications.
What’s next?
Consult with your doctor how best to balance blood sugar control with the risk of hypoglycemia.
Published By :
The lancet. Diabetes & endocrinology
Original Title :
Effects of intensive glucose control on microvascular outcomes in patients with type 2 diabetes: a meta-analysis of individual participant data from randomised controlled trials.
