Link Between Extreme Glucose Levels In Diabetic Patients With Heart Failure And Increased Risk Of Death

Link Between Extreme Glucose Levels In Diabetic Patients With Heart Failure
And Increased Risk Of Death

Main Category: Diabetes
Also Included In: Heart Disease
Article Date: 22 Jul 2009 - 0:00 PDT

Source: http://www.medicalnewstoday.com/articles/158280.php



Compared with patients with moderately controlled glucose levels, diabetic
patients who have heart failure and either too high or too low glucose
levels may be at increased risk of death, said researchers at Baylor College
of Medicine in a report published in the current issue of Journal of the
American College of Cardiology.

To determine average glucose levels in the blood over a two to three month
period, doctors measure glycosylated hemoglobin (the oxygen-carrying protein
in the blood that is bound to the sugar glucose). In general, higher levels
have been associated with increased risk of heart disease, said Dr. David
Aguilar, assistant professor of medicine - cardiology at BCM.

"Most doctors try to keep glucose levels of those with diabetes as low as
they can to lower the risk of complications such as eye problems, kidney
disease or the development of heart disease," said Aguilar, senior author of
the study. "However, we found that in diabetic patients with heart failure,
glucose levels slightly higher than what are normally recommended had the
lowest risk of death."

Researchers at BCM and the Michael E. DeBakey Veterans Affairs Medical
Center in Houston identified 5,815 veterans with heart failure and diabetes
who were receiving treatment at VA medical centers across the nation. They
followed the patients for two years, dividing them into five categories
based on their glycosylated hemoglobin levels.

Most medical professionals recommend levels at 7 and below as the target for
optimal health for diabetic patients. However, the results of the study of
diabetic patients with heart failure showed that those with levels 7.1 to
7.8 had the lowest rate of death. Those patients at both ends of the
spectrum had the higher death risks.

"This doesn't mean that diabetic patients with heart failure should change
their target goal for glucose levels," Aguilar said. "The results could
simply be telling us that the glycosylated hemoglobin levels are a marker
for other risks that are contributing to increased risk of death, but not
necessarily the cause of the problem."

Aguilar said the correlation needs to be further investigated to confirm the
findings and see what other factors could be contributing to the mortality
rate.

The research is supported by a V.A. Health Services Research and Development
Service grants and a National Institutes of Health Mentored Career
Development Award.

Other researchers who took part in this study include, Drs. Biykem Bozkurt,
Kumudha Ramasubbu and Anita Deswal, all from the Winters Center for Heart
Failure Research and Section of Cardiology, and the Department of Medicine
at BCM. Deswal is also at the Houston Center for Quality of Care and
Utilization Studies at the Michael E. DeBakey V. A. Medical Center in
Houston.

Source:
Graciela Gutierrez
Baylor College of Medicine
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