Some Diabetes Treatments Are Just Too Much

Type 2 diabetes patients do not lower death risks with glucose lowering treatment

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) It is obvious that people with diabetes need to be treated for their disease. Doctors should be careful the treatments they prescribe. Some treatments can be too much for patients.

Intensive treatment for lowering blood sugar levels did not reduce the risk of death from heart problems in patients with type 2 diabetes. In fact, intensive treatment did not reduce the risk of death from any causes.

"Be careful with intensive diabetes treatments."

A team of French researchers - led by Catherine Cornu, M.D., Ph.D., from the Louis Pradel Hospital in Bron, France - carried out this study. They say that their results show that doctors should carefully consider whether it will help a diabetes patient to go on intensive treatment to lower blood sugar.

It is obvious that diabetes needs to be treated. People with diabetes face the possibility of an early death if they go without treatment. Be that as it may, not all patients need intensive therapy. For the most part, patients will get a normal insulinotherapy (treatment to lower blood sugar) that requires only two or three injections of insulin each day. Intensive insulinotherapy, on the other hand, calls for four or more injections of insulin per day.

Type 2 diabetes is a disease that can cause all sorts of heart, kidney, and visual problems. To stop these complications, doctors sometimes treat people with intensive insulinotherapy. However, past research has not found clear benefits to such treatments.

So, Dr. Cornu and colleagues went looking through these past studies to see if cardiovascular events (any incidents that damage the heart) were related to the intensity of treatment to lower blood sugar.

The researchers looked at 13 studies that included 34,533 patients. More than 18,300 of these patients were given were given intensive treatment to lower blood sugar. Another 16,218 patients were given normal treatments.

They found that intensive treatment did not reduce the risk of death from heart problems or from all causes. However, the risk of non-fatal heart attacks went down by 15 percent. There was also a 10 percent decrease in microalbuminuria - a sign of kidney problems and heart disease.

On the other hand, patients were more than twice as likely to suffer from hypoglycemia (dangerously low blood sugar levels) after intensive treatment.

According to the researchers, over the course of a five-year treatment period, 117 to 150 patients would need to be treated to stop just one heart attack. About 32 to 142 patients would have to be treated to stop one case of microalbuminuria, and about 15 to 52 patients would need to receive treatment to prevent one hypoglycemic episode.

An editorial response to the study says that doctors need to think carefully about all the possible risks and benefits of intensive treatment for each individual patient. The best treatment for one patient may be less intense than the best treatment for another patient.

The study by Dr. Cornu and colleagues is published in the British Medical Journal.

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Review Date: 
July 27, 2011
Last Updated:
August 1, 2011