Too low, too fast?

Contradictory data were reported last week from two similar studies seeking to reduce blood sugar in Type II diabetes patients to levels more like those seen in non-diabetics. In one study, the intensive glycemic arm was stopped because of a higher rate of deaths than that seen in patients receiving standard treatment. In the other study, intensive glycemic reduction resulted in significantly fewer deaths than standard therapy.

Because of the discordant results, it isn't possible to conclude that lowering HbA1c in Type II diabetics to levels approaching those of normal individuals is to blame for the higher death rate in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study. Indeed, in both trials, mortality rates in both the intensive and conventional treatment arms were well below the expected rate of 5% in a Type II diabetes population with a high risk for heart disease...