Healthy Diabetics Die Sooner...
The 10,000-patient study, dubbed ACCORD, was supposed to answer a big question: Could pushing blood sugar to near-normal levels, below today's recommended target, help protect these high-risk patients' hearts?
Instead, the National Institutes of Health took the rare step of halting part of the study 18 months early — citing 257 deaths among aggressively treated patients compared to 203 among diabetics given more standard care.
First up, what does "aggressive treatment" look like? Were these diabetics beaten when caught staring at Ding-Dongs? But I digress...
The goal of the study was to produce an A1C reading of below 6, which translates to a blood sugar reading of 135 ("normal" is 80-120). Most docs encourage diabetics to get below 7 (170) and the AACE recommends being below 6.5. (I had this one annoying Doc who told me that I was 6.4, however lower is always better. What a dork. How's that for incentive? That's like telling someone that their resting heart rate of 50 is good but lower is better. Until when? Zero?)
Here's what I find curious about all of this. It's something I've never read about or seen studies about. It's just a diabetic thing that *I know*, which may not be true for you. You ready? Here it is:
I feel better when my blood sugar is 150 than I do when it's 100. I have more energy. I'm more alert and more creative. I run faster and can do so for a longer period of time.
Also, at 150, you're not spilling sugar into your urine so your kidneys couldn't care less, either.
Now, keep in mind, that 150 is close to 200, and once I'm at 200, I don't feel good. But 150 *to me* feels good. And - at least - according to one study, it'll make me live longer.
Let's hear it, baby: 150 is the new black!
here's another perspective by Sheri Colberg-- http://blog.shericolberg.com/?p=65#more-65
ReplyDeleteFor me, how I feel depends on my average. For example, when I was first diagnosed, I was shaking like crazy at 200. I agree, floating around 90-100, I might feel a bit on the verge of being low, but I wonder if this is just because my average BG is much higher than that.
For sure, seeing a BG of 90 during run puts me on alert!
Yes,
ReplyDeleteWe feel more normal at "not normal" blood sugars because we're diabetics. If we take the "normal" range, 80-120, (I've heard that for different people this range is different.) a person without diabetes probably feels better with a blood sugar of 115. At 80, a person without diabetes is going to feel grumpy, tired, and hungry.
Because our blood sugars are usually higher, we feel "low" at higher blood sugar levels.
Anyway, if you google around for other articles on this topic, you'll find that the researchers wanted it stressed that the people who died were already at an elevated risk.
It is still, of course, recommended that diabetics keep their blood sugars as close to normal as practical, to prevent all of those other nasty "complications" of diabetes.
There has been a lot of effort to straighten out the sensationalism that tainted a few articles that came out following this announcement.
http://www.dlife.com/blog/archives/2008/02/the_media_blows.html
Thanks Anne and Jerry,
ReplyDeleteAnne - I didn't know Sheri Colberg had a blog. Very cool.
Jerry - The key word in your post is "practical." Too many times, I see and hear doctors saying to keep blood sugar as low as "possible."
Frankly, I could keep mine lower, but I think the results would move me into more "impractical" situations.
I guess my point is this: if endocrinologists recommend a 6.5 or lower and I feel great at a 6.4, why would I want to go lower?
I've been trying the Bernstein Diet for the past 2 weeks, which keeps your BG below 100, and my mood has been better, but my energy level sucks. I can barely run, and when you start a run low it is darn near impossible to maintain....let alone bring it up to a higher level. Sounds like you've found a happy medium, and if it works for you...stick to it. I'd be very happy with 150 if I could stay there...I have the problem of always being either too high or too low. I think mood is most affected when BG swings up and down. If you can keep it consistent, you are much better off.
ReplyDeletere: "I think mood is most affected when BG swings up and down."
ReplyDeleteI couldn't agree more. I think that's a HUGE part of feeling good.
I think we pretty much agree on this. *IF* we could stay consistently in the range between 80 and 120, or better yet, between 90 and 110, that would be great, and we'd all be glad to do it.
ReplyDeleteBut I haven't been able to get close to that.
Lower is not always better. It isn't better if you find yourself waking up on gurneys frequently.
There are doctors who think control is impossible, so whatever numbers you get are OK, and there are doctors who think that we should always have perfect control.
A few doctors understand that we just do the best we can, walking the tightrope between too high and too low.
I know you don't believe "healthy diabetics die sooner..." but there seems to be an increasing rather than decreasing amount of ignorance about diabetes in the world.
You're right, Jerry. I don't believe healthy diabetics sooner. At least, I hope not!
ReplyDeleteFrankly, though, I don't think media stupidity is remotely isolated to diabetes. There are just so many more outlets for content to get published today and when you have more outlets for content, you also get a lot of BAD content.
I see the media screw up diabetes the same way they screw up industries I've worked in, and for every good article, it often seems there are 3 bad ones which dull the affect of good writing.