Type II Diabetes: Sugar Intake Link Not So Sweet

For years, individuals with type 2 diabetes were told their cardiovascular health and outlook depended upon a highly regimented practice of keeping blood-sugar levels low. After all, cardiovascular disease accounts for 65 percent of patient deaths among people with type 2 diabetes and, since diabetes typically features high blood-sugar levels, this was a hypothesis followed and believed true by many in medicine.

During my days in cardiac rehab, I was often told I was lucky that diabetes did not enter into my quest for recovery from my heart attack. Now, according to two studies — one done in the United States and another done in Australia – the hypothesis about low blood sugar helping Type 2 diabetes patients in preventing cardiovascular issues is being challenged in strong fashion.

The American-based study was conducted by the National Institutes of Health and ended before it was supposed to. The Australian study featured participants from 20 countries. Interestingly, those in the Australian study — conducted over a longer interval than its American counterpart, utilized the drug sulfonylurea gliclazide in modified-release form that is not used in the United States.

The surprising results began to emerge in February, when the NIH study terminated. Researchers announced at that time, study participants who were rigorously controlling their blood sugar actually had a higher death rate than those whose blood-sugar control was less stringent.

Meanwhile, the Australian study revealed no increase in deaths among type 2 diabetes patients limiting blood sugar, nor did it show any cardiovascular disease benefit or protection.

The two studies were presented — and widely reported in the media – a few weeks ago at the annual meeting of the American Diabetes Association annual meeting in San Francisco. They are to be published this week in The New England Journal of Medicine.

Both studies appear to affirm the only way someone with Type 2 diabetes can guard against cardiovascular problems is to follow the tried-and-true regimen that I have, as a recovering heart-attack patient, for almost two years.

That, of course, involves not only diet, but the combination of beta-blockers and other medications to control blood pressure and statins to control cholesterol, mixed with an exercise program and weight loss if needed.

The studies also seem to reach the same conclusion, even though the participants in each took different drugs for different periods independent of the other. Limiting blood sugar in type 2 diabetes patients showed a benefit in the area of kidney disease, but, again, not cardiovascular disease.

Special attention was given the type 2 diabetes patients in my cardiac rehab group. Naturally their blood-sugar readings before and after exercise were looked at as seriously as the remainder’s blood-pressure readings in the same setting.

I can only imagine what it would be like for a diabetic to deal with both the stress of cardiac recovery and an additional disease.

The studies make me realize we are all in the same boat in cardiac recovery and that, once again, diet, medication and exercise are what paves the road back to cardiovascular health.