Effects of Intensive Glucose Lowering in Type 2

New England Journal of Medicine, Article June 12, 2008. “Effects of Intensive Glucose Lowering in Type 2 Diabetes.”

This has to do with an article that just used one drug, a Sulfonylurea, to lower the glucose. This one drug significantly lowered the hemoglobin A1C and changed other metabolic measurements.

This program increased glucose control for 3 ½ years, resulting in increased mortality but no other evidence of cardiovascular disease or success. Another major outcome was kidney improvement.

The additional difficulty I have seen in my practice is dramatic worsening of retinopathy. We had one 35 year old woman in a situation where she was getting 4 to 5 operations per month to control retinal bleeding with a detached retina

This study again indicates that diabetes is a multifactorial problem and control of glucose alone may not be the best treatment.