Type 2 diabetes: New guidelines lower blood sugar control levels

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The American College of Physicians
have now published their new
guidelines regarding the desired blood sugar control levels for people with type 2 diabetes. The recommendations aim to change current therapeutic practices, and doctors should aim for a moderate level of blood sugar when treating their patients. According to the most recent estimates, almost 30 million people in the United States have type 2 diabetes, which amounts to over 9 percent of the entire U.S. population.
Once diagnosed with type 2 diabetes, patients are often advised to take what is known as a glycated hemoglobin (HbA1c) test in order to keep blood sugar levels under control. The test averages a person’s blood sugar levels over the past 2 or 3 months, with an HbA1c score of 6.5 percent indicating diabetes.
Patients who score over 6.5 percent would then be prescribed a daily insulin based treatment which they can inject themselves. Rapid-acting injections take effect within 5 to 15 minutes but last for a shorter time of 3 to 5 hours. Long-acting injections take effect after 1 or 2 hours and last for between 14 and 24 hours.
But some studies have pointed out that the HbA1c test may currently be overused in the U.S., and they have suggested that such over-testing may lead to over-treating patients with hypoglycemic drugs. These drugs often have a range of side effects, such as gastrointestinal problems, excessively low blood sugar, weight gain, and even congestive heart failure.
Additionally, as some researchers have pointed out, “Excessive testing contributes to the growing problem of waste in healthcare and increased patient burden in diabetes management.” In this context, the American College of Physicians (ACP) set out to examine the existing guidelines from several organizations and the evidence available in an effort to help physicians make better, more informed decisions about treating people with type 2 diabetes.
Their guidelines were published in the journal Annals of Internal Medicine. As the ACP explain, the current rationale behind the existing recommendations of a score of 6.5 percent — or below 7 percent — is that keeping blood sugar this low would decrease the risk of microvascular complications over time. However, the ACP found that the evidence for such a reduction is “inconsistent.” As Dr. Jack Ende — the president of ACP — puts it, “[Our] analysis of the evidence behind existing guidelines found that treatment with drugs to targets of 7 percent or less compared to targets of about 8 percent did not reduce deaths or macrovascular complications such as heart attack or stroke but did result in substantial harms.” Here are some alternative ways to reduce your blood sugar levels.

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