Diabetes: Low blood sugar increases risk of death

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Type II diabetes: Even low blood sugar levels pose health risks

Lowering the blood sugar level is an essential part of the treatment for type 2 diabetics in order to prevent the negative health consequences of hypoglycaemia (hyperglycaemia). However, lowering the blood sugar level also entails considerable health risks, report the US scientists led by Elbert Huang from the University of Chicago.

In type II diabetes, lowering blood sugar levels is an essential part of treatment. However, lowering the blood sugar level of healthy people can have serious health consequences for diabetics and is therefore not recommended, warn the US researchers at the University of Chicago. In their investigations, they found that the reduction in blood sugar levels was associated with an increased mortality rate for type 2 diabetics.

Reducing blood sugar levels to avoid further illnesses In general, a type 2 diabetes is recommended to reduce blood sugar levels in order to avoid dangerous nerve damage and wound healing disorders and to minimize the risk of stroke or heart attack. Most therapies for type 2 diabetes rely on a lowering of the blood sugar level - if possible to normal values. The so-called HbA1c value expresses the long-term blood sugar values ​​of the past two to three months, which are between four and six percent in healthy people. In the course of the treatment of type 2 diabetics, attempts are made to keep the HbA1c values ​​below eight percent in order to minimize the impending health problems caused by hypoglycaemia, said Elbert Huang and colleagues when they presented their study results. However, a too drastic lowering of the blood sugar level is rather counterproductive, since this can also lead to considerable health problems and an increased risk of death, the US researchers report.

Lowering the blood sugar level increases the risk of death The so-called Accord study had already shown in 2008 that lowering the blood sugar level in type 2 diabetics to the value of healthy people entails an increased risk of death. The number of deaths among participants who lowered their blood sugar to a supposedly normal level with insulin syringes and tablets increased significantly in the course of the study, so that the examination had to be stopped early. In their study, the US researchers have now referred to the data of more than 71,000 people with type 2 diabetes who had participated in an observational study on diabetes and aging for four years. As expected, the US researchers were able to determine an increased number of complications and deaths in type 2 diabetics with long-term blood sugar levels that were well above average. But even with low blood sugar levels, there was a slightly increased risk of death, explained Elbert Huang and colleagues.

Blood sugar values ​​between six and eight percent recommended? For type 2 diabetics, the results of the US researchers show that the risk of death and the health consequences of HbA1c values ​​are the lowest between eight and six percent, emphasized study leader Elbert Huang. The age of the patients did not play a special role, the US researcher continued. "We cannot say whether this result is due to the very low blood sugar levels themselves, the blood sugar control treatment or any other factors that are not directly related to diabetes treatment," said Andrew Karter, who was also involved in the study. Further studies are necessary for a precise evaluation of the results and a transfer to clinical practice.

Diabetics trained for low blood sugar levels The negative consequences of lowering the blood sugar level are probably due to the fact that diabetics who keep their blood sugar levels close to hypoglycaemia for fear of consequential damage, literally train their bodies for low blood sugar levels. The symptoms of hypoglycaemia are often no longer noticed or are noticed too late, and those with blood sugar levels of around 27 milligrams per deciliter suddenly lose consciousness. In addition to the increased risk of death, dementia is one of the possible consequences of this severe hypoglycaemia. (fp)

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