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The Best Way to Lower Blood Sugar |
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 If you have type 2 diabetes, you may have heard that intense lowering of your blood sugar can decrease the risk of damage to the small vessels in your body; vessels like those found in the eyes and kidneys. Because of this, experts have thought that intense lowering of blood sugar can also decrease the risk of damage to larger vessels, like those around the heart, that contribute to cardiovascular disease. Now, recent studies warn us that lowering your blood sugar too fast may not be a good idea.
Hemoglobin A1C is a way to measure average blood sugar over the last 3 months. Current U.S. guidelines recommend lowering the Hemoglobin A1C to less than 7% if you have diabetes. But new studies show that less aggressive blood sugar lowering may be better for older patients with long-standing type 2 diabetes. For these patients, ‘starting low and going slow’ may be a good idea when it comes to diabetes medications.
In fact, intensely lowering the A1C to 6.5% or less does not reduce cardiovascular problems in these patients and may actually INCREASE their risk of cardiovascular death . Current guidelines have not yet addressed this issue because more data may be needed. It is unclear if the A1C targets should be adjusted for these patient or if they just need to go about getting to the target more slowly.
In the meantime, it may be reasonable to be less aggressive with therapy if you are older and have long-standing diabetes. If you fall into this category, consider keeping your A1C less than 7%, but consider lowering the blood sugar more slowly in order to achieve this goal. As always, talk with your doctor before making any changes to your diabetes treatment regimen and work closely with your doctor when developing new treatment plans.
Author: Christi Larson, Pharm. D.
Dr. Larson is a Clinical Infusion Pharmacist, author of Empowered Medicine; A Guide for Consumers and creator of www.empoweredmedicine.com. You can read more about her by visiting www.EmpoweredMedicine.com and clicking on the 'About Us' tab. EmpoweredMedicine.com is committed to providing evidence-based medical information.
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