Hazard of aggressive blood glucose reduction in diabetics

A glucose-reduction trial was halted when researchers found that volunteers receiving aggressive therapy were more likely to die. (Science 15 February 2008: Vol. 319. no. 5865, pp. 884 – 885).

Investigators in the United States and Canada recruited 10,251 people with type 2 diabetes. Blood sugar was assessed by hemoglobin A1c, a measure of sugar inside blood cells. After nearly 4 years, 257 people in intensive treatment, whose A1c averaged 6.4%, had died, compared with 203 in standard care, whose A1c was on average 7.5%. The deaths had various causes--surgical complications, sepsis, strokes. But many were heart attacks.

Medicine postulates that the only healthy (normal) blood sugar level is that observed in healthy individuals, and treatment of diabetic patients ought to lower  blood sugar to this level.  However this trial shows that in diabetics such a normo-glycemia is unhealthy. We ought therefore  redefine what a normal blood sugar is.  As diabetes progresses so does its normo-glycemia. Each diabetic patient has its own normo-glycemia. Obviously when compared with a healthy individual this normo-glycemia is actually hyper-glycemic while  the normo-glycemia of the healthy individual is hypo-glycemic to the particular diabetic patient.

From the patient’s perspective, the measures applied in the trial drove patients to hypo-glycemia and raised their risk to die. It is striking that the death was attributed to various causes indicating the  body as a whole suffered from the false treatment.

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