Tuesday, March 25, 2008

New Findings Shows Tighter Blood Sugar Control May Reduce Diabetic Stroke Risk

According to a recent study, diabetics may face a significant increase for the risk of ischemic stroke when blood sugar levels are even slightly above target. These new findings indicate that more aggressive approaches may be warranted to control fasting blood sugars in the diabetic population.

Included in the research were 3298 diabetic participants, without prior incidence of stroke, from an urban community that included multiple ethnic groups. Of these, 338 had elevated blood sugar levels; 572 participants reported a history of diabetes. The mean age was 59 to 79 years and included three groups: those with fasting blood sugar levels greater than 126 ml/dL who had diabetes; less than 126 ml/dL with diabetes; no diabetes.

Follow up was done via telephone over a period of six years - there were 190 ischemic strokes and 585 vascular events. The group whose fasting glucose remained at target showed no increased risk of stroke. The results indicate that stricter guidelines may significantly reduce the risk of stroke in diabetics.

Past studies have not directly addressed the risk of stroke among diabetics, though we have known that diabetics carry twice the risk of developing heart disease. This study showed that even when fasting blood sugars remained at 126 ml/dL, the risk outcome was the same when compared to those with fasting glucose levels of 159mg/dL.

According to Bernadette Boden-Albala, MPH, DrPH, from the Columbia University College of Physicians and Surgeons, the Mailman School of Public Health, in New York, NY, "There is insufficient randomized trial data to support evidence-based recommendations for tight control of fasting blood glucose (FBG) among diabetics in primary stroke prevention. Ongoing rigorous clinical trials such as ACCORD [Action to Control Cardiovascular Risk in Diabetes], a study of over 10,000 adults with diabetes, will ultimately provide conclusive evidence regarding the importance of glycemic control in preventing macrovascular disease including ischemic stroke."

Proper control of blood sugar is not always easy. According to the American Diabetes Association, 14.6 million people have diagnosed diabetes and 2 million adolescents have pre-diabetes. "The prevalence of diabetes is at least 2 to 4 times higher among non-Hispanic Black, Hispanic/Latino American, American Indian, and Asian/Pacific Islander women than among non-Hispanic white women." In addition, it's estimated that 33% of the population has undiagnosed diabetes.

If you think you may have diabetes, take the diabetic risk test. Visit the National Diabetes Association for more information on what you can do to prevent or control diabetes.

Ref: Diabetes Care. Published online March 13, 2008.