Researchers at the National Institutes of Health releasedfindings of the ACCORD study which appeared to show that driving blood sugar tolow levels in diabetics leads to an increased rate of dying. Over 10,000 patients were studied, with257 deaths in the intensive therapy group and 203 in the standard group.
This study was quickly misinterpreted by many in the mediaas somehow signifying that diabetes drugs with the goal of lowering blood sugarare somehow unsafe. Add this to the negative press Avandia has receivedrecently, and I can easily imagine my diabetic patients reaching for ice creamcones rather than essential medication capsules.
This tendency in the media to see some of our best Rx drugtreatments as dangerous leads physicians and their patients to jump fromoveruse to disuse. This, in the case of diabetes, despite the fact that severalstudies have shown that reducing blood sugar in diabetics can significantlylower the risks of acquiring eye disease, kidney disease and nerve disease. It would be a shameif misinterpretation and panic in the wake of the ACCORD study actually leadsto more disease.
Don’t get me wrong, the ACCORD study is valuable, as itappears to show that an overzealous treatment plan intended to bring adiabetics’ blood sugar down to the level of a non-diabetic may carry with itintrinsic medical risks. But this observation is not really surprising when youconsider that we’ve known for a long time that very low blood sugars areriskier than high blood sugars. It is not surprising that patients who hadtheir blood sugars aggressively lowered in the study were more likely to die ofheart attacks than those whose sugars were moderately lowered.
The take home message should be that we can’t always havethe same treatment goals in ill folks as we have in healthy ones. I also wishfor once that the media could learn to tell the difference between a study’sconclusions and the hype that can be drawn from it.
Marc Siegel, MD, is an internist and associate professor ofmedicine at New York University and the author of False Alarm: The Truth Aboutthe Epidemic of Fear
From the March 01, 2008 Issue of MM+M - Medical Marketing and Media
