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Drug Mix May Tame Diabetes Heart Risk

Controlling Blood Sugar Is Just Part of Picture, Type 2 Diabetes Study Shows
By
WebMD Health News
Reviewed by Louise Chang, MD

Feb. 6, 2008 -- Type 2 diabetes raises heart risks, and it may be possible to cut that risk by taking a multi-pronged approach instead of just focusing on blood sugar. And the sooner, the better.

That's the message from a new Danish study of 160 adults with type 2 diabetes and microalbuminuria, which is a sign that their diabetes had started to affect their kidneys.

Half of the patients got conventional drug treatment for their diabetes. The other half got intensive treatment, which included blood pressure drugs, cholesterol-lowering statin drugs, and aspirin, as well as drugs to control their blood sugar.

The patients were followed for 13 years. During that time, 24 patients in the intensive therapy group died, compared with 40 patients in the conventional treatment group.

Compared with patients who received conventional treatment, patients in the intensive treatment group were 46% less likely to die of any cause, 57% less likely to die of a heart problem, and 59% less likely to suffer a heart attack, stroke, or other cardiovascular event.

It's not clear which aspect of the intensive treatment was most important.

The patients in the intensive treatment group were also supposed to eat a low-fat diet, quit smoking, and get 30 minutes of exercise several times a week. But they didn't, which may mean they missed out on further cutting their risk of heart problems and death.

"Despite enormous efforts to change lifestyle in the intensive arm, we were not successful in this study of middle-aged and elderly people," Professor of Medicine Oluf Pedersen, MD, DMSc, of Denmark's Steno Diabetes Center, tells WebMD by email. "Lifestyle should be changed at much younger ages."

"It's not enough to just know your blood glucose, cholesterol, and blood pressure levels. You need to take action and do something about those risk factors" early on and stick with it, Pedersen says.

The report appears in tomorrow's edition of The New England Journal of Medicine.

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