Diabetes Over View

Tight Glucose Control Significantly Reduces Risk of Heart Stroke in Diabetics

A latest research published in the June 5, 2003 issue of the New England Journal of Medicine reveals that strict glucose control in type 1 diabetes reduces the risk of atherosclerosis.

It is well known that intensive glucose control greatly reduces the eye, nerve, and kidney damage of type 1 diabetes. Now, researchers conclude that the benefits of tight glucose control also extend to the heart.

A study was conducted to compare intensive versus conventional management of blood glucose in 1,441 people with type 1 diabetes. Patients on intensive treatment were administered at least three insulin injections a day or an insulin pump and frequent self-monitoring of blood glucose in order to keep glucose levels as close to normal as possible with. Conventional treatment consisted of one or two insulin injections a day with daily urine or blood glucose testing.

After 6½ years of the study, it was observed that blood glucose levels were more close to normal in the intensively treated group as compared to conventionally treated group. When the study ended, those who had been assigned to conventional treatment were encouraged to adopt intensive control and a long-term follow-up study of these participants was done.

Ultrasound was used to measure the thickness of participants' carotid arteries, the two blood vessels in the neck that carry blood from the heart to the brain. Carotid wall thickness reflects the amount of atherosclerosis, or plaque build-up, in the artery. The thicker the arterial wall the greater the risk of later heart attack and stroke.

At the time of the first ultrasound, the diabetic participants' carotid wall thickness was similar to that of non-diabetic controls matched for age and gender. But five years later, the participants had thicker arterial walls than those of the non-diabetic group. Moreover, the thickness of the carotid walls increased less in the intensively treated group during the 5 years than in the conventionally treated group.

Carotid thickening was also linked to known cardiovascular risk factors including

• Age,
• Higher systolic blood pressure,
• Smoking,
• LDL: HDL cholesterol ratio, and
• Urinary albumin (a measure of kidney function).

Clinical results proved that intensively controlled glucose significantly reduces the atherosclerosis underlying heart disease just as it reduces damage to the eyes, nerves, and kidneys in people with type 1 diabetes.