T_Dia
02-26-2009, 02:50 PM
Researchers and physicians have long debated whether it's more important to strive to control fasting blood glucose levels or the spikes in glucose that occur after eating (post-prandial levels). Now a study, published in the March issue of Diabetes Care, shows there is no significant benefit to choosing one over the other in trying to prevent the progression of cardiovascular disease.
The study, conducted at 105 centers by researchers in 17 countries, was halted early when it became apparent that it didn't matter whether physicians treated hyperglycemia (high blood glucose levels) following a meal or between meals. According to study investigators, neither approach succeeded in reducing the risk for further cardiovascular events. An editorial accompanying the study suggests that, because all of the patients in this study had already been diagnosed with type 2 diabetes and had recently experienced myocardial infarctions, it may have been too late to prevent the progression of disease.
"Differences in post-prandial glycemia between the two therapies were noted, but were less than expected and may have not been enough to have had an impact on the advanced atherosclerosis of this patient population," said Scott Jacober, research physician for Eli Lilly and Company. "As with other trials (DIGAMI-2, ACCORD, ADVANCE and VADT), research in this area is challenging and further investigations on the relationship between glycemia and cardiovascular outcomes may be warranted."
Antonio Ceriello, of the University of Warwick's Clinical Science Research Center, concludes in an accompanying editorial that this study underscores the need to control hyperglycemia, including post-prandial hyperglycemia, much earlier in the progression of diabetes, when doing so can make a much greater difference in preventing diabetes-related complications.
"We have, again, learned how difficult is the optimal control of hyperglycemia, a goal which seems to be mandatory at a very early stage of diabetes," he wrote.
Note: The American Diabetes Association, in conjunction with the American Heart Association and the American College of Cardiology, issued a position statement in December 2008 regarding intensive glycemic control and the prevention of cardiovascular events and the implications of ACCORD, ADVANCE, and VA Diabetes Trials. This statement was published in Diabetes Care and can be found at http://care.diabetesjournals.org/cgi/content/extract/32/1/187.
To schedule interviews with Scott Jacober, Lilly Research Laboratories, contact J. Scott MacGregor, Lilly Global Product Communications, phone: 317-440-4699 or email: macgregorj @ lilly.com or, directly email sjacober @ lilly.com or phone: 317-433-4281.
To reach editorial author Antonio Ceriello, Warwick Medical School, Clinical Science Research Institute, email Antonio.ceriello @ warwick.ac.uk or phone 44(0) 24 7696 8582.
The study, conducted at 105 centers by researchers in 17 countries, was halted early when it became apparent that it didn't matter whether physicians treated hyperglycemia (high blood glucose levels) following a meal or between meals. According to study investigators, neither approach succeeded in reducing the risk for further cardiovascular events. An editorial accompanying the study suggests that, because all of the patients in this study had already been diagnosed with type 2 diabetes and had recently experienced myocardial infarctions, it may have been too late to prevent the progression of disease.
"Differences in post-prandial glycemia between the two therapies were noted, but were less than expected and may have not been enough to have had an impact on the advanced atherosclerosis of this patient population," said Scott Jacober, research physician for Eli Lilly and Company. "As with other trials (DIGAMI-2, ACCORD, ADVANCE and VADT), research in this area is challenging and further investigations on the relationship between glycemia and cardiovascular outcomes may be warranted."
Antonio Ceriello, of the University of Warwick's Clinical Science Research Center, concludes in an accompanying editorial that this study underscores the need to control hyperglycemia, including post-prandial hyperglycemia, much earlier in the progression of diabetes, when doing so can make a much greater difference in preventing diabetes-related complications.
"We have, again, learned how difficult is the optimal control of hyperglycemia, a goal which seems to be mandatory at a very early stage of diabetes," he wrote.
Note: The American Diabetes Association, in conjunction with the American Heart Association and the American College of Cardiology, issued a position statement in December 2008 regarding intensive glycemic control and the prevention of cardiovascular events and the implications of ACCORD, ADVANCE, and VA Diabetes Trials. This statement was published in Diabetes Care and can be found at http://care.diabetesjournals.org/cgi/content/extract/32/1/187.
To schedule interviews with Scott Jacober, Lilly Research Laboratories, contact J. Scott MacGregor, Lilly Global Product Communications, phone: 317-440-4699 or email: macgregorj @ lilly.com or, directly email sjacober @ lilly.com or phone: 317-433-4281.
To reach editorial author Antonio Ceriello, Warwick Medical School, Clinical Science Research Institute, email Antonio.ceriello @ warwick.ac.uk or phone 44(0) 24 7696 8582.