Control of blood sugar aids health


A 17-year federal study has finally answered one of the most pressing questions about diabetes: Can tight control of blood sugar prevent heart attacks and strokes?

The answer, reported yesterday in The New England Journal of Medicine, is yes. Intense control can reduce the risk by nearly half.

And, the study found, the effect occurred even though the patients had only had a relatively brief period of intense blood sugar control when they were young adults. Nonetheless, more than a decade later, when they reached middle age, when heart disease and strokes normally start to appear, they were protected. The study involved those with Type 1 diabetes, which usually arises early in life and involves the death of insulin-secreting cells.

"This is truly an important study," said Dr. Robert Rizza, a professor of medicine at the Mayo Clinic and the president of the American Diabetes Association. "And I usually don't say that," he added.

The findings are likely to affect clinical practice, encouraging doctors to put more effort into helping patients control their blood sugar, said Dr. John B. Buse, the director of the diabetes care center at the University of North Carolina.

The study is "the most rigorously conducted to date," Buse said, and its authors are "exceptionally well known in the diabetes and medical world."

The question of whether rigid blood sugar control protects against heart disease and strokes has plagued the field for decades, diabetes researchers said.

"It's really a major question that has been around for a long time," said Dr. Judith Fradkin, who directs diabetes research at the National Institute of Diabetes and Digestive and Kidney Diseases.

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