Featured Research

from universities, journals, and other organizations

Just drop it: One-size-fits-all approach to blood sugar control, that is

Date:
August 3, 2010
Source:
American Society of Nephrology
Summary:
Aggressive blood sugar control does not improve survival in diabetic patients with kidney failure, according to a new study. The results suggest that physicians should individualize blood sugar targets for these patients and not rely on recommendations based on studies in the general population.

Aggressive blood sugar control does not improve survival in diabetic patients with kidney failure, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN). The results suggest that physicians should individualize blood sugar targets for these patients and not rely on recommendations based on studies in the general population.

Uncontrolled blood sugar levels can cause serious health problems for diabetic patients with kidney failure; however, studies provide conflicting results on the benefits and risks of aggressive blood sugar control in these individuals.

By studying 24,875 dialysis patients for a maximum of three years of follow-up, Mark Williams, MD (Joslin Diabetes Center) and his colleagues found that only sustained extremes -- either high or low -- in blood sugar levels increased patients' risk of dying prematurely. Type 2 diabetes patients with hemoglobin A1c levels (a measure of average blood sugar levels) greater 11.0% were particularly at risk, with a 21% increased likelihood of dying during the study. In the small (5.5%) subgroup of patients with type 1 diabetes, those with hemoglobin A1c levels greater than 9% had a 52% increased risk of dying during the study.

"In the absence of randomized, controlled trials, these results suggest that aggressive [blood sugar] control cannot be routinely recommended for all diabetic hemodialysis patients on the basis of reducing mortality risk," the authors concluded. They encouraged physicians who treat diabetic patients with kidney failure to individualize blood sugar targets based on the potential risks and benefits for each patient.

Study co-authors include Eduardo Lacson Jr., MD, Weiling Wang, J. Michael Lazarus, MD, Raymond Hakim, MD, PhD (Fresenius Medical Care-North America).

In reviewing the results of this study in an accompanying editorial, Joachim Ix, MD (University of California, San Diego and Veterans Affairs San Diego Healthcare System) noted that "to date, there are no data available from randomized clinical trials targeting different hemoglobin A1c levels and powered for cardiovascular events or mortality in end-stage renal disease populations. In their absence, the marked statistical power and elegant analyses provided by these… investigators provide useful insights." He agreed that individualized hemoglobin A1c targets might be more appropriate than a one-size-fits-all target.


Story Source:

The above story is based on materials provided by American Society of Nephrology. Note: Materials may be edited for content and length.


Journal References:

  1. Mark E. Williams, Eduardo Lacson Jr., Weiling Wang, J. Michael Lazarus, and Raymond Hakim. Glycemic Control and Extended Hemodialysis Survival in Patients with Diabetes Mellitus: Comparative Results of Traditional and Time-Dependent Cox Model Analyses. Clinical Journal of the American Society Nephrology, 2010; DOI: 10.2215/CJN.09301209
  2. Joachim H. Ix. Hemoglobin A1c in Hemodialysis Patients: Should One Size Fit All? Clinical Journal of the American Society Nephrology, 2010; DOI: 10.2215/CJN.04410510

Cite This Page:

American Society of Nephrology. "Just drop it: One-size-fits-all approach to blood sugar control, that is." ScienceDaily. ScienceDaily, 3 August 2010. <www.sciencedaily.com/releases/2010/07/100729172328.htm>.
American Society of Nephrology. (2010, August 3). Just drop it: One-size-fits-all approach to blood sugar control, that is. ScienceDaily. Retrieved September 21, 2014 from www.sciencedaily.com/releases/2010/07/100729172328.htm
American Society of Nephrology. "Just drop it: One-size-fits-all approach to blood sugar control, that is." ScienceDaily. www.sciencedaily.com/releases/2010/07/100729172328.htm (accessed September 21, 2014).

Share This



More Health & Medicine News

Sunday, September 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Sierra Leone's Nationwide Ebola Curfew Underway

Sierra Leone's Nationwide Ebola Curfew Underway

Newsy (Sep. 20, 2014) Sierra Leone is locked down as aid workers and volunteers look for new cases of Ebola. Video provided by Newsy
Powered by NewsLook.com
Changes Found In Brain After One Dose Of Antidepressants

Changes Found In Brain After One Dose Of Antidepressants

Newsy (Sep. 19, 2014) A study suggest antidepressants can kick in much sooner than previously thought. Video provided by Newsy
Powered by NewsLook.com
Could Grief Affect The Immune Systems Of Senior Citizens?

Could Grief Affect The Immune Systems Of Senior Citizens?

Newsy (Sep. 19, 2014) The study found elderly people are much more likely to become susceptible to infection than younger adults going though a similar situation. Video provided by Newsy
Powered by NewsLook.com
Jury Delivers Verdict in Salmonella Trial

Jury Delivers Verdict in Salmonella Trial

AP (Sep. 19, 2014) A federal jury has convicted three people in connection with an outbreak of salmonella poisoning five years ago that sickened hundreds of people and was linked to a number of deaths. (Sept. 19) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins