In the story of Goldilocks and the Three Bears, children learn that too much and too little are not good. We all need to strive for just right. The same may be true for the management of type 2 diabetes.
There was a time when tight blood sugar control was considered highly desirable. This often meant treating type 2 diabetes quite aggressively in an attempt to achieve as close to normal blood glucose levels as possible. The hope was that this strategy would lower the risk of heart attacks, strokes and other complications of diabetes.
A new report published in The Lancet, however, suggests that such an approach may produce unexpected complications. In this European study patients who used insulin to bring blood sugar levels close to normal had a 49 percent higher risk of dying than those who just used oral medications to manage their diabetes. The results confirm those of a large U.S. trial that was stopped prematurely because there were one fifth more deaths in diabetes patients who were treated aggressively than among those treated more cautiously. The message seems to be that blood sugar should never be too high or too low.
[The Lancet, Feb. 6, 2010]
