ACCORD study reinterpreted. Tight blood sugar control may not be bad for you after all.

The ACCORD study's purpose was to evaluate the efficacy of lowering A1C in long term T2's with poor control through intervention with drug therapy. The study was halted in 2008 before it was completed because subjects were dying at a higher than expected rate.

The initial take on the results was that reducing A1C was dangerous, and some medical professionals started advising their patients against shooting for a too low an A1C. This interpretation was immediately attacked on the grounds that the goal was only to get their A!C's below 7. Also the only intervention was with drugs known to increase heart disease risk, diet and exercise were not included. Finally the subjects had spent many years with poor control.

Further analysis of the data has honed in on where the problem was located. The subjects that died were disproportionately those for whom the intervention had failed, their A1C's were still well above the target of 7. Those who achieved the modest goal of an A1C below 7 had better outcomes after all. Here's a link describing the study and it's reinterpretation in more detail.

So if you receive advice that trying to get your A1C below 7 is dangerous kindly disregard it. In fact the risk for all complications starts rising at 5.5 and rises exponentially the further above 5.5 you go. The closer you can get to normal the better.

Views: 598

Reply to This

Replies to This Discussion

I aim for something like 5.8 and I accept a lot of blood sugars that would almost never be found in a person without diabetes.

Remember, DCCT considered "intensive management" pumps or MDI with 3-4 shots, and at least 4 BG tests per day.
They used regular insulin too.
I guess a low A1C had more risks of undetected hypo than today.

Today we have analog insulins, "flat" basals, more sticks and CGM. If money was not a problem it would be time for a DCCT 2.0 ......

RSS

Advertisement



REsources

From the Diabetes Hands Foundation blog...

Diabetes Among Hispanics: We’re not all the same

US Hispanics are often portrayed in the press as a single, monolithic group. But anyone who has spent any time in San Francisco’s Mission District or the Bronx can tell you, we’re not all the same. Now we’re finding out Read on! →

Diabetes entre los hispanos: no somos todos iguales

Traducido por Mila Ferrer.    A menudo los Hispanos en Estados Unidos son retratados en la prensa como un solo grupo, monolítico. Pero cualquiera que haya pasado algún tiempo en el  Mission District de San Francisco o el Bronx se Read on! →

Diabetes Hands Foundation Team

DHF TEAM

Manny Hernandez
(Co-Founder, Editor, has LADA)

Emily Coles
(Head of Communities, has type 1)

Mila Ferrer
(EsTuDiabetes Community Manager, mother of a child with type 1)

Mike Lawson
(Head of Experience, has type 1)

Corinna Cornejo
(Development Manager, has type 2)

Desiree Johnson  (Administrative and Programs Assistant, has type 1)


DHF VOLUNTEERS


Lead Administrator

Bradford (has type 1)


Administrators

Lorraine (mother of type 1)
Marie B (has type 1)

Brian (bsc) (has type 2)

Gary (has type 2)

David (dns) (type 2)

 

LIKE us on Facebook

Spread the word

Loading…

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information: verify here.

© 2014   A community of people touched by diabetes, run by the Diabetes Hands Foundation.

Badges  |  Contact Us  |  Terms of Service