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Study: Tight glucose control cuts diabetics' heart risk


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SAN DIEGO, California (MedPage Today)external link -- A landmark finding a decade ago that sharply enhanced the lives of insulin-dependent diabetics now turns out to be much more beneficial than anyone suspected.

In a report delivered Sunday at the American Diabetes Association meeting here, doctors reported that daily close monitoring of blood sugar levels of insulin-dependent patients, known as type 1 diabetics, goes significantly beyond the important reduction of serious diabetic complications.

After a follow-up of 6 1/2 years, it emerged than these patients also have a 57 percent reduction in the rate of heart attacks and strokes, said Dr. David Nathan of the Massachusetts General Hospital in Boston.

The patients had been part of the landmark Diabetes Control and Complications Trial (DCCT), which had provided evidence that so-called tight control of glucose had worked. It reduced by as much as 76 percent the microvascular complications of type 1 diabetes-diabetic retinopathy, diabetic nephropathy, and diabetic peripheral neuropathy.

"But the one lingering question was whether tight glycemic control would also reduce cardiovascular disease," said Dr. Nathan. "Now we know"

Although cardiovascular disease is most often considered a risk for patients with the more common form of diabetes, type 2 disease, Nathan said that cardiovascular disease is the No. 1 cause of death among all diabetics.

"There is about a tenfold increase in risk of cardiovascular disease conferred by type 1 diabetes, which is much higher than the two- to threefold increase in risk seen with type 2 diabetes," he said.

Nathan said that every 1 percent reduction in HbA1C "correlated with about 20 percent reduction in cardiovascular risk."


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