WASHINGTON — Moderate blood sugar levels are recommended for patients with Type 2 diabetes, according to a new research from the Endocrine Society and Avalere Health which was conducted by the American College of Physicians.
The findings published in the journal Annals of Internal Medicine, stated that patients with Type 2 diabetes should be treated to achieve an A1C between 7 percent and 8 percent rather than 6.5 percent to 7 percent.
An A1C test measures a person’s average blood sugar level over the past two or three months. An A1C of 6.5 percent indicates diabetes.
“ACP’s analysis of the evidence behind existing guidelines found that treatment with drugs to targets of 7 percent or less compared to targets of about 8 percent did not reduce deaths or macrovascular complications such as heart attack or stroke but did result in substantial harms,” said researcher Jack Ende.
“The evidence shows that for most people with type 2 diabetes, achieving an A1C between 7 percent and 8 percent will best balance long-term benefits with harms such as low blood sugar, medication burden, and costs.”
ACP recommended that clinicians should personalise goals for blood sugar control in patients with type 2 diabetes based on a discussion of benefits and harms of drug therapy, patients’ preferences, patients’ general health and life expectancy, treatment burden, and costs of care.
The rationale in guidelines that recommended lower treatment targets (below 7 percent or below 6.5 percent) is that more intensive blood sugar control would reduce microvascular complications over many years of treatment.
However, the evidence for reduction is inconsistent and reductions were seen only in surrogate microvascular complications such as the presence of excess proteins in the urine.
Researchers in Sweden and Finland last week, published a new report suggesting that Type 2 diabetes should actually be broken down into five separate types, in the hopes of better tailoring treatments to individuals suffering the disease.
The pancreases of diabetics do not properly process sugar, either because their bodies do not produce enough insulin in Type 1 or because they have too high of an insulin tolerance in the set of variations formerly called Type 2.
If patients with Type 2 diabetes achieve an A1C of less than 6.5 percent, ACP recommended that clinicians consider de-intensifying drug therapy by reducing the dosage of current treatment, removing a medication if the patient is currently taking more than one drug, or discontinuing drug treatment.
“Results from studies included in all the guidelines demonstrate that health outcomes are not improved by treating to A1C levels below 6.5 percent,” Dr. Ende said.
“However, reducing drug interventions for patients with A1C levels persistently below 6.5 percent will reduce unnecessary medication harms, burdens, and costs without negatively impacting the risk of death, heart attacks, strokes, kidney failure, amputations, visual impairment, or painful neuropathy.”
ACP also recommended that clinicians should treat patients with Type 2 diabetes to minimize symptoms related to high blood sugar rather than targeting an A1C level in patients with a life expectancy less than 10 years due to advanced age — 80 years or older — or chronic conditions (such as dementia, cancer, end stage kidney disease, severe COPD or congestive heart failure, and patients residing in nursing homes), as the harms of A1C targeted treatment outweigh the benefits in this patient population.
“Although ACP’s guidance statement focuses on drug therapy to control blood sugar, a lower treatment target is appropriate if it can be achieved with diet and lifestyle modifications such as exercise, dietary changes, and weight loss,” said Dr. Ende.
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Adding glass of milk in breakfast can lower blood glucose
Several research studies have attempted to find a link between drinking milk and a reduced risk for experiencing type 2 diabetes and a new research has found that adding a glass of milk in breakfast is the perfect energy boost for body needs to get through the day.
According to a study published in the Journal of Dairy Science, consuming milk with breakfast cereal reduced postprandial blood glucose concentration compared with water, and high dairy protein concentration reduced postprandial blood glucose concentration compared with normal dairy protein concentration.
H Douglas Goff, PhD, and the team of scientists from the Human Nutraceutical Research Unit at the University of Guelph, in collaboration with the University of Toronto, examined the effects of consuming high-protein milk for breakfast on blood glucose levels.
The high-protein treatment also reduced appetite after the second meal compared with the low-protein equivalent.
“Metabolic diseases are on the rise globally, with type 2 diabetes and obesity as leading concerns in human health. Thus, there is an impetus to develop dietary strategies for the risk reduction and management of obesity and diabetes to empower consumers to improve their personal health,” Goff and his team noted.
Although the team only found a modest difference in food consumption at the lunch meal when increasing whey protein at breakfast, they did find that milk consumed with a high-carbohydrate breakfast reduced blood glucose even after lunch, and high-protein milk had a greater effect.
Milk with an increased proportion of whey protein had a modest effect on pre-lunch blood glucose, achieving a greater decrease than that provided by regular milk.
Likewise, a 2014 study from Lund University in Sweden published in the American Journal of Clinical Nutrition found eating high-fat milk and yogurt reduces a person’s type 2 diabetes risk by as much as one-fifth.
Another study published in the 2011 American Journal of Clinical Nutrition tracked the relationship between a person’s dairy consumption during adolescence and their risk for type 2 diabetes as an adult. The researchers concluded that “higher dairy product intake during adolescence is associated with a lower risk of type 2 diabetes.”Follow @gorkhapost