Conflicting Results on Diabetes Control

About 10 days ago I posted a piece about the news that very tight control of blood sugar may not be the best thing for type 2 diabetics. Specifically, the ACCORD clinical study showed that treatment aimed at lowering the HbA1c to below 6.0% led to more deaths than those in the group with a less intensive goal – an HbA1c of 7.0% to 7.9%.

Now comes a counterblast from Australia. The ADVANCE trial investigators have looked at their available results and found no confirmation of the mortality trend reported by ACCORD. Their study was aiming for an HbA1c of 6.5% or below, and they actually achieved an average of 6.4% - the same level as that reached in the intesive arm of the ACCORD study. They have no explanation for the discrepancy in the results of the two studies, but point out that they had twice as many patients in their study.

Now the experts will argue about the possible reasons for the difference. Different ages of the patients, different duration of diabetes, different HbA1c levels at baseline, different agressiveness in tryingto reach the target, and so on . . .

Whatever the reason, the difference in outcome only reminds us of the likelihood that what we learn today will be denied or revised tomorrow.