Intense Blood Glucose Control and Cardiovascular Benefits for Type 2 Diabetes Patients
One of our continuous mantras is: "Please keep your HbA1c below 7%." This is suggested by the ADA. Tight control has been linked to control of long-term complications of diabetes.
The December 15th Annals of Internal Medicine has an article titled "Comorbidity affects the relationship between glycemic control and cardiovascular outcomes in diabetes: A cohort study." The study is by Sheldon Greenfield, MD et al.
Recently, other studies have provided mixed results about that long-held belief that strict glucose control reduces the likelihood that you'll have diabetes-related cardiovascular complications.
In this study, the researchers look at whether having an HbA1c of 6.5% or less or 7% or less benefits patients who already have other co-morbidities for cardiovascular events. In other words: if you're already at an increased risk for cardiovascular issues, does keeping your HbA1c at (or below) the recommended level help?
The study took place over five years, and the researchers looked at people with type 2 diabetes. They divided the group into high and low-to-moderate co-morbidity subgroups.
The researchers found that for the low-to-moderate co-morbidity group, reaching an HbA1c level of 6.5% or less or 7% or less led to a lower incidence of cardiovascular events over five years. That was not true for the high co-morbidity subgroup.
Therefore, the researchers concluded that type 2 diabetes patients with high co-morbidities may not benefit as much (in terms of cardiovascular benefits) from intensive blood glucose control. When doctors are looking at glucose-lowering plans for patients, they should take into account the co-morbidities to help weigh the benefits.
To read the abstract of the article, go here.
Tall Latte, Please: Does Coffee Protect You from Diabetes?
As I write this, I am on my second cup of black coffee of the morning.
Perhaps that's why this article from the December 14/28 Archives of Internal Medicine caught my eye: "Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus" by Rachel Huxley, DPhil et al. The researchers report on their meta-analysis (analyzing otherstudies) for the association of coffee, decaffeinated coffee, and tea consumption with the risk of diabetes.
The researchers looked at 18 studies, and that gave them 457, 922 participants total. The studies were done from 1966 to 2009, and the researchers in this current study compiled the results.
The basic result is easy: they found that with every extra cup of coffee you drink a day, you get a 7% reduction in your risk of developing type 2 diabetes. The same goes for tea and decaffeinated coffee.
This isn't free rein to stop at Starbucks every time you feel like it, nor does it mean that you should make a pot of coffee just for you every day at the office. Instead, this study shows that there should be more studies on this topic. The researchers recommend more trials (not just meta-analyses) to look into the protective effects of coffee and tea.
To read more details on this coffee study, go here.
Rising Rate of Diabetes: What to Do?
I found this last headline on CNN News. It reported on an article in the December Diabetes Care journal. Diabetes makes headlines frequently; we wish this one was not the harbinger of illness it appears to be.
The article states that the number of American with diabetes will nearly double in the next 25 years and the cost of treating these people will triple. The projected numbers in a University of Chicago report released in November adds fuel to the arguments about reining in health costs. By 2034, 44.1 million Americans will be living with diabetes-nearly twice the number of 23.7 million who have the disease today. 90% of this population has type 2 diabetes.
"The numbers are disturbing," stated Dr. Elbert Huang, the lead author of the article from the University of Chicago. The estimates also don't factor in immigration, or the rising populations of ethnic minorities. Latinos and African-Americans suffer from diabetes at higher rates than the US population as a whole.
You can read more about these diabetes statistics and predictions here.