Low Blood Sugar is Also a Fatal Risk for Diabetics, says Study

The first thing your doctor will tell you after you have been diagnosed with diabetes is that controlling your blood sugar levels and managing your condition is of vital importance.  In theUShours of appointments and many healthcare dollars are given over to advising diabetics on the best ways to manage their condition and so reduce the risks of the serious complications that go with this disease.

Insulin, medications such as metformin, exercise and diet are used to reduce and stabilize blood sugar levels.  A diabetic, whether type 1 or type 2, will try to avoid high carbohydrate or sugary food and increase his fiber intake to prevent blood sugar spikes and so moderate his symptoms.

It is easy for diabetics to become fixated on keeping their blood sugar levels down, but keeping them up is just as important.  Hyperglycemia – low blood sugar – carries the risk of unpleasant symptoms, including mental confusion and coma, and even ultimately death.  But it can also lead to many of the complications associated with high blood sugar, says Dr Kamyar Kalantar-Zadeh, a diabetes expert at the David Geffen School of Medicine at the University of California.

Dr Kalantar-Zadeh spoke at the recent American Society of Nephrology annual meeting – “Kidney Week 2011” – saying diabetics who fail to control their blood sugar, whether they keep it too low or let it rise too high, face death.  He said that a six year study had demonstrated that hyperglycemia – low blood sugar – increased the likelihood of death from heart disease and other fatal conditions associated with diabetes.  These also include strokes and kidney failure – Dr Kalantar-Zadeh, a professor of medicine, pediatrics and epidemiology, pointed out that almost half of all kidney dialysis patients are diabetics.

The doctor and his colleagues carried out a six year study on dialysis patients between 2001 and 2007, with follow ups in 2007.  They recorded test results for the patients for blood glucose level management, using the HbA1c glycated hemoglobin test.  They also looked at random blood glucose testing without fasting.

The team found the lowest mortality rates were associated with patients whose HbA1c test results were between 6% and 8% – ideal blood sugar level maintenance.  These patients also had fewer incidences of heart attacks and death from heart disease.  Blood sugar levels between 100mg/dL and 200mg/dL were associated with a lowered death rate, while levels below 100mg/dL and above 200mg/dL were linked with higher death rates and higher incidence of death from heart attack or heart disease.

With patients whose test results were higher than 8% death rates rose, up to double at levels above 10%.  But the researchers also found that lower blood sugar levels increased death rates as well, with an HbA1c reading at 5% or less being associated with higher death rates and increased likelihood of death from heart disease.

Dr Kalantar-Zadeh commented, “Diabetes mellitus is a potent cardiovascular risk factor in both the general population and dialysis patients, almost half of whom suffer from diabetes in theUnited States.”  He expressed concern that there are no clear guidelines on blood glucose targets for renal dialysis patients.

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