Blood Sugar Not the Biggest Diabetes Risk Factor

Monday, 04 Feb 2013 01:24 PM

By Nick Tate

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For diabetics, keeping blood pressure and cholesterol in check is even more important than meeting the guidelines for blood sugar control in reducing the risk of heart attack or stroke, according to a new Kaiser Permanente study.
The research, published in the Journal of General Internal Medicine, involved more than 26,000 patients with diabetes. Those who met the blood pressure and cholesterol guidelines — or all three blood recommendations — were least likely to be hospitalized for a heart attack or stroke. But those who met only the blood sugar guidelines — or none of the guidelines — were most likely to be hospitalized for a heart attack or stroke.
"People with diabetes are often focused on controlling their blood sugar, but our study found that controlling blood pressure and cholesterol is even more important in preventing heart disease," said lead researcher Greg Nichols, a senior investigator with the Kaiser Permanente Center for Health Research.

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"This doesn't mean that people with diabetes should ignore their blood sugar levels. They should still get regular A1C tests to measure and control their blood glucose, but it's also important to pay attention to other factors that increase the risk for cardiovascular disease."
Diabetics are up to four times more likely to have cardiovascular disease, and most people with diabetes will die from a heart attack or stroke, according to the U.S. Department of Health and Human Services.

Controlling the “ABCs” of diabetes — A1C (an average measure of blood sugar), blood pressure, and cholesterol — can reduce cardiovascular risks, but until now it has been unclear which of these factors is most important.
The American Diabetes Association recommends that patients with diabetes maintain a target blood pressure reading of less than 130/80 mm Hg, an LDL “bad” cholesterol level of less than 100 mg/dl, and an A1C blood glucose level of less than 7 percent.
For the new study, researchers examined the medical charts of 26,636 Kaiser Permanente diabetes patients in Oregon and Washington between 2002 and 2010. They tracked patients’ blood pressure, cholesterol, and A1C every six months, at least.
The results showed about 13 percent of patients in the study met the guidelines for all three risk factors. In addition to finding that patients who kept cholesterol and blood pressure in check faced lower risks than those who did not, the results also showed the rate of hospitalization for heart attack and stroke was about 2.5 times lower for diabetics who met all three target guidelines than patients who met none of the targets.

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