WASHINGTON - One week after US researchers announced that pushing down blood sugar levels as close as possible to normal might be dangerous for highrisk diabetes patients, a preliminary analysis of a similar international study has found no such risk.
The seemingly conflicting findings, released yesterday, stoked the new uncertainty about the best strategy for treating type 2 diabetes, one of the most common health problems in the United States and elsewhere.
"This unfortunately just makes things more confusing," said Richard Kahn of the American Diabetes Association. "I think patients will be confused. I think doctors will be confused. So I think the message is: 'Don't do anything until we get this sorted out.' "
Federal health officials said there were a variety of possible explanations for the differing findings, and they planned to meet with their counterparts in the international study.
More than 21 million Americans have type 2 diabetes, which has become increasingly common because of the obesity epidemic. The disease causes blood sugar levels to rise abnormally high, making patients prone to a host of complications, including blindness, nerve damage, kidney failure, heart attacks, and strokes.
Patients typically try to lower their blood sugar through diet and exercise or by taking drugs such as insulin, and researchers have long thought that getting blood sugar levels as close to normal would be most beneficial.
But last week researchers at the National Institutes of Health surprised specialists when they announced their preliminary analysis of an ongoing study involving more than 10,000 patients in the United States and Canada. They found 54 more deaths in the group whose members had intensive therapy to lower their blood sugar levels than in the group whose members got standard treatment.
The announcement about the US-based study prompted a panel monitoring a similar study, known as ADVANCE, to conduct a preliminary analysis of their own data, which involves more than 11,000 patients in Europe, Asia, and Canada, said Anushka Patel of the George Institute for International Health in Australia, the study director.
The ADVANCE analysis found no similar increase in deaths among patients receiving the most intense therapy for an average of five years, she said.
