# keeping Sugars below 7 kills diabetics



## Russell Williams (Feb 6, 2008)

WASHINGTON - An unexpected number of deaths among patients receiving intense therapy to lower their blood sugar forced the National Institutes of Health to abruptly cut short part of a major study on diabetes and heart disease.

The therapy was aimed at reducing to normal levels the blood sugar of type 2 diabetics at especially high risk of heart attack and stroke. There were 257 deaths among people receiving intense diabetes treatment, compared with 203 in the standard treatment group, NIHs National Heart Lung and Blood Institute said.

More than 18 million Americans have diabetes, with type 2 the most common form.


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## Russell Williams (Feb 6, 2008)

WASHINGTON - An unexpected number of deaths among patients receiving intense therapy to lower their blood sugar forced the National Institutes of Health to abruptly cut short part of a major study on diabetes and heart disease.

The therapy was aimed at reducing to normal levels the blood sugar of type 2 diabetics at especially high risk of heart attack and stroke. There were 257 deaths among people receiving intense diabetes treatment, compared with 203 in the standard treatment group, NIHs National Heart Lung and Blood Institute said.

More than 18 million Americans have diabetes, with type 2 the most common form.


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## imfree (Feb 6, 2008)

Russell Williams said:


> WASHINGTON - An unexpected number of deaths among patients receiving intense therapy to lower their blood sugar forced the National Institutes of Health to abruptly cut short part of a major study on diabetes and heart disease.
> 
> The therapy was aimed at reducing to normal levels the blood sugar of type 2 diabetics at especially high risk of heart attack and stroke. There were 257 deaths among people receiving intense diabetes treatment, compared with 203 in the standard treatment group, NIHs National Heart Lung and Blood Institute said.
> 
> More than 18 million Americans have diabetes, with type 2 the most common form.


 

"Below 7" looks to mean "A1c", which a blood parameter that can be 
used to estimate average blood sugar. Is that correct?


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## Emma (Feb 6, 2008)

How comes you didn't post the full article or at least a link to it?

Anyways people 

http://rhodeisland.cox.net/cci/news...=article&id=D8UKU34G2&_action=validatearticle


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## imfree (Feb 6, 2008)

QUOTE
What is A1C?

Your A1C test measures your average blood sugar levels over a three-month period by taking a sample of hemoglobin A1C moleculesa specific component of your red blood cells.

Some blood sugar (or glucose) naturally attaches itself to these A1C molecules as they move through your bloodstream. When this happens, the molecule is considered "glycated." The more sugar in your blood, the higher the percentage of glycated A1C molecules you'll have.1

Once a cell has been glycated, it stays that way. And since each A1C molecule has a lifespan of about four months, your A1C sample will include cells that are a few days, a few weeks and a few months old. That's how the test result covers a span of about three months.

Of course, without regular self-testing to provide day-to-day insights, an A1C result can be misleading.1 Because it gives a long-term view, a person with frequent highs and lows could have an average A1C that looks quite healthy.2 The only way to get a complete picture of your blood sugar control is by reviewing your daily log along with your regular A1C tests, and working closely with your healthcare team to interpret the results.

To learn more about your A1C, visit the Diabetes Care Coalition.

1 American Diabetes Association, "A1C Test." Available at http://www.diabetes.org/type-1-diabetes/a1c-test.jsp. Accessed November 7, 2007.
2 Medscape Today. "How Should Hemoglobin A1c (HbA1c) Results Be Interpreted in Your Patients with Diabetes?" Available at: http://www.medscape.com/viewarticle/413375. Accessed November 7, 2007. 
END OF QUOTE

A1C is in per-cent (%). Maintaining an A1C below 7 would 
be dangerous for a diabetic because that goal would 
result in periodic unsafely low blood sugar levels.


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## jamie (Feb 6, 2008)

Here is a link to an entire article on this study and the termination of part of the program: http://www.cnn.com/2008/HEALTH/conditions/02/06/diabetes.heart.trial.ap/index.html


And to clarify - I feel your sensationalist headline is unfair and incorrect. Keeping the HgA1c below 7 has not been shown to kill diabetics. The participants in the study who were experiencing fatal cardiac events were part of an "intensive" plan to lower blood sugars to below 6. These people already had two major risk factors - diabetes and some other heart failure risk - like high blood pressure or high cholesterol. They are unsure what the connection is to "intensively lowering blood sugar levels" and the existing cardiac risks. Keeping the A1c between 7 and 7.9 is standard best practice diabetic care.



article said:


> The study focuses on treatments for adults with type 2 diabetes, the most common form, who are at especially high risk for heart disease, meaning they had at least two risk factors, which include high blood pressure, high cholesterol, obesity and smoking.





article said:


> NHLBI said the intensive treatment group had a target blood sugar goal of less than 6 percent, which is similar to blood sugar levels in adults without diabetes. The standard treatment group aimed for a target similar to what is achieved, on average, by those with diabetes in the United States, of 7 to 7.9 percent.



It is fine to have an opinion on the study and the world and whatever else you would like, but to me, to post a headline like that is irresponsible. Diabetics have to get their HgA1c down and that is not debated in the study or the medical community.


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## imfree (Feb 6, 2008)

jamie said:


> Here is a link to an entire article on this study and the termination of part of the program: http://www.cnn.com/2008/HEALTH/conditions/02/06/diabetes.heart.trial.ap/index.html
> 
> 
> And to clarify - I feel your sensationalist headline is unfair and incorrect. Keeping the HgA1c below 7 has not been shown to kill diabetics. The participants in the study who were experiencing fatal cardiac events were part of an "intensive" plan to lower blood sugars to below 6. These people already had two major risk factors - diabetes and some other heart failure risk - like high blood pressure or high cholesterol. They are unsure what the connection is to "intensively lowering blood sugar levels" and the existing cardiac risks. Keeping the A1c between 7 and 7.9 is standard best practice diabetic care.
> ...



A1c between 7 and 7.9 makes the most sense,
because maintaining an A1c of 6 would require
periods of unsafely low blood-sugar.


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## fatchicksrockuk (Feb 6, 2008)

jamie said:


> Here is a link to an entire article on this study and the termination of part of the program: http://www.cnn.com/2008/HEALTH/conditions/02/06/diabetes.heart.trial.ap/index.html
> 
> 
> And to clarify - I feel your sensationalist headline is unfair and incorrect.



Russell, sensationalist? Never! lol


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## Tina (Feb 6, 2008)

Russell, please only post on one board. This is health-related, so your Main Board post was merged with this one, which is why you appear to be repeating yourself.

And yeah, definitely some hyperbole there. I think that what they were doing with the test group was too extreme.


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## MisticalMisty (Feb 6, 2008)

Humm..I thought you wanted an A1C between 4 and 7? Mine was 5.6. that averages out to 100 a reading.


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## Sandie_Zitkus (Feb 6, 2008)

MisticalMisty said:


> Humm..I thought you wanted an A1C between 4 and 7? Mine was 5.6. that averages out to 100 a reading.



Me to. Mine is averaging A1C 5.8 and my Dr. is very happy with that.


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## jamie (Feb 7, 2008)

I think ... and I am not a healthcare professional, would have to defer to MissVickie and Socialbutterfly for their expertise... that most doctors would be praising you both as major success stories. Between 7 and 7.9 is just a sort of "let's at least get you to here" point, to my understanding.

I have been buried under work and haven't gotten a chance to read the actual report, but I am guessing that part of the problem was either the intensity of the program (and the combination of meds) - or the combination of the intensity and the cardio risks that were present.

I am not even going to mention my last A1c :doh:...but I do have an appointment with a specialist on Feb 21..woohoo. I wish I could take the Actos again. It worked so well with the sugars but so badly with my weight. Y'all are doing a great job!


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## Sandie_Zitkus (Feb 8, 2008)

I'm taking Actos since September '07 and I am not gaining weight. I'm taking 15 milligrams once a day. Did you guys gain weight right away??


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## MisticalMisty (Feb 8, 2008)

I gained 50 lbs in 3 months on it.

Jamie..talk to your dr. about combining metformin/glipizide. That's the combination I used before actos..and now after actos and my A1C has never been over 6.


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## Miss Vickie (Feb 8, 2008)

jamie said:


> I think ... and I am not a healthcare professional, would have to defer to MissVickie and Socialbutterfly for their expertise... that most doctors would be praising you both as major success stories. Between 7 and 7.9 is just a sort of "let's at least get you to here" point, to my understanding.



I wish I were keeping up on the latest research but we don't use the A1C marker as much with pregnant women with have gestational diabetes so... yeah, I'm useless. But if someone is asymptomatic for hypoglycemia, has normal fasting and postprandial sugars, that sounds good to me! Especially if they're tolerating their meds, which as you guys know isn't always the case.



> I have been buried under work and haven't gotten a chance to read the actual report, but I am guessing that part of the problem was either the intensity of the program (and the combination of meds) - or the combination of the intensity and the cardio risks that were present.



That could definitely be a problem. Also, sometimes people are better at taking meds than they are at keeping track of their sugars as they ought. I know that many of these drugs aren't supposed to cause hypoglycemia but I've seen it happen (firsthand when I was on Glucophage for insulin resistance and in others as well). So it's really important to keep track and I see an almost cavalier attitude in some people (and some doctors) about keeping regular track. I dunno, I'm no super genius but it seems to me that if you're on a med that affects your sugars it makes sense to... you know... monitor them regularly. And yet I see quite a number of folks who are put on these drugs with their sugars never checked. That seems bizarre to me.



> I am not even going to mention my last A1c :doh:...but I do have an appointment with a specialist on Feb 21..woohoo. I wish I could take the Actos again. It worked so well with the sugars but so badly with my weight. Y'all are doing a great job!



You're too special to lose or have get sick so I'm glad you're seeing a specialist. I hope you can find something that works really well for you. They're coming out with new stuff it seems all the time so maybe they can find the right med for you. I know a woman I'm working with is on one of the new oral ones -- no weight gain at all and her sugars dropped quickly (they had to for her to get approved for sugary). I'll find out what it is -- I'm sending over a hot dish of mac and cheese for her kids while she recovers.


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## jamie (Feb 8, 2008)

I took it for a while and never really gained anything. Then my doctor (who was also working for a drug company at the time) put me on a new med that didn't work for me, and when I went back on the Actos a second time I gained 40lbs in a month. I don't know what changed, but something clicked the wrong way that time. Hope it keeps working for you..sounds like it is doing the job.



Sandie_Zitkus said:


> I'm taking Actos since September '07 and I am not gaining weight. I'm taking 15 milligrams once a day. Did you guys gain weight right away??



Misty - I can't take metformin at all...not the extended release, not spaced out over the day, not mixed with something...we do not get along. I look like that chick out of The Exorcist while I am on it. 

Thanks for the info, Vickie.. and the good wishes.


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## Sandie_Zitkus (Feb 8, 2008)

Metformin is the Devil! Evil - vile drug!




jamie said:


> I took it for a while and never really gained anything. Then my doctor (who was also working for a drug company at the time) put me on a new med that didn't work for me, and when I went back on the Actos a second time I gained 40lbs in a month. I don't know what changed, but something clicked the wrong way that time. Hope it keeps working for you..sounds like it is doing the job.
> 
> 
> 
> ...


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## DeniseW (Feb 9, 2008)

Sandie_Zitkus said:


> Metformin is the Devil! Evil - vile drug!



hmmmm, why do you say that? I take it for now and haven't had anything bad happen except in the beginning, a little stomach distress. Just curious why you think it's bad....


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## Sandie_Zitkus (Feb 9, 2008)

DeniseW said:


> hmmmm, why do you say that? I take it for now and haven't had anything bad happen except in the beginning, a little stomach distress. Just curious why you think it's bad....



OMG - personal experience!

I took it for about 9 months a few years back and it was a living hell. Everyone talks about diarrhea with this drug. NOT ME! Nope - I got the worst constipation of my life. And I mean - couldn't go for days - doubled over painful - trying to pass a rock - constipation. My doctor kept assuring me it would get better. It didn't. It got worse. Because of the constipation - I got hemorhoids from hell. I would lay in bed crying from the pain - it was horrible. The hemorrhoids got so bad I couldn't sit - AT ALL!!! It was a living hell. So - one day I just stopped taking it. Everything cleared up. Except now - thanks to that doctor I have chronic hemorrhoid flair ups.

I changed doctors too. Stupid bastard!!

This time with my new doctor when Diabetes meds were brought up(I was on Metphormen for PCOS) I looked her dead in the eye and said "I will NOT take metphormen!" She laughed and said - "I understand."


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## Tinkertoy (Feb 26, 2008)

If your A1c is over 6.0, you are playing with fire and will increase your changes of complications down the road. I was diagnosed with 10.1 A1c and since then have never been over 6.0 (last one was 5.5). I do not experience lows - I simply have tight control. It can be done - doctors just don't push it because very few people have the self control to keep their blood sugars at a good level.


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## Elfcat (Mar 1, 2008)

I think the point was that overly aggressive anti-diabetic measures have their own dangers and have to be balanced against diabetic risks, rather than having a sub 6 A1C is risky in and of itself.


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