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dLife CEO Responds to the NY Times

That clacking noise heard around the world yesterday was the sound of millions of people with diabetes putting their blood glucose monitors back on the shelf, relieved to know that the dogged pursuit of tight blood sugar control is no longer necessary. That is, if you read the first paragraph of Thursday’s front page New York Times article on the recently halted arm of the ACCORD study: "For decades, researchers believed that if people with diabetes lowered their blood sugar to normal levels, they would no longer be at high risk of dying from heart disease. But a major federal study …found that lowering blood sugar actually increased their risk of death." This is an exceedingly dangerous takeaway. The bigger story here is what the presentation of this news, not the news itself, tells patients about managing their diabetes appropriately.

Coverage from the Times and others implied that based on this development, you should rethink the pursuit of tight control – and that’s flat out wrong. Other long-term, large-scale studies, including the UKPDS and the DCCT, have conclusively demonstrated that tight control leads to a lower incidence of most diabetes complications. The portion of the ACCORD study the Times reported on looked at a very specific subset of people with type 2 diabetes who had pre-existing and severe cardiovascular risk factors. To extend those conclusions to a population of over 20 million Americans struggling with diabetes for the sake of a headline is a dangerous disservice to all.

Other media outlets didn’t fare much better. Take for example Wednesday’s NBC Nightly News, where Dr. Steven Nissen of the Cleveland Clinic said “lowering blood sugar to a lower level may actually increase mortality for some patients.” That seemingly harmless sound bite, perhaps pulled out of context, provides an excuse for the millions struggling with diabetes management to pull back and rationalize that they may not need to be as diligent as they thought.

I have diabetes, and so do the millions of people dLife reaches through our TV show and website. All of us are extremely challenged by the daily, constant grind of managing our lives to maintain good control. Every day we face a physical, emotional, and psychological battle with the encroaching monster of complications – including heart and kidney disease, blindness, amputation, or death – and our only weapon is vigilant blood sugar management. Now the media’s simplistic reporting on the ACCORD study findings may result in adverse outcomes for many who are lead to believe that even this is not enough.

Let’s step back and take a dose of some common sense. If you can get your blood sugar closer to that of a non-diabetic, it must be better than being out of control with higher blood sugar. The collective and individual uphill struggle to get diabetes under control can’t pause for what is now simply an interesting and developing research story.

Howard Steinberg
CEO
dLife - For Your Diabetes Life

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The Media Blows it Again

Usually a trusted source of medical analysis, The New York Times has really blown it this morning in their analysis of yesterday's developments in the ACCORD trial. In one paragraph, health care writer Gina Kolata sets back diabetes education at least a decade by opening her NYT piece with the following sensationalized - and simplistic - analysis:

"For decades, researchers believed that if people with diabetes lowered their blood sugar to normal levels, they would no longer be at high risk of dying from heart disease. But a major federal study of more than 10,000 middle-aged and older people with Type 2 diabetes has found that lowering blood sugar actually increased their risk of death, researchers reported Wednesday."

And the Times wasn't the only offender. Media outlets nationwide tried to grab consumer attention with the "tight control kills" message, in the process confusing and perhaps endangering millions of Americans. Let's look at the research and stay away from the sensationalism. Tight control of blood glucose levels is proven to DECREASE the risk of diabetic complications for the overwhelming majority of people with type 1 and type 2 diabetes. Period. As reported yesterday, the ACCORD findings impacted only those study participants who were at a highly increased risk of heart disease in the first place, or who had a pre-existing heart condition, and the increased risk of mortality was very small. Kelly Close sums it up well over at Close Concerns. Take a few minutes to read her analysis - it's worth the investment.

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ACCORD Trial Makes News

Today, the National Institutes of Health (NIH) announced a major change in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study - a large-scale North American trial with over 10,000 participants. One arm of the trial, which examined the impact of intensively-controlled type 2 diabetes management (i.e., an A1C goal of less than 6%) in preventing cardiovascular complications, was stopped eighteen months early. The National Heart, Lung, and Blood Institute (NHLBI) found that type 2 ACCORD participants at high risk for heart attack and stroke who were placed in the intensive diabetes management group had an increased risk of death compared with their peers who were placed in a less-intensive standard treatment (i.e., A1C of 7 to 7.9%) group. It's important to note that the increased risk was slight, and was specific to only a subset of patients who had two or more risk factors for heart disease outside of diabetes or who had pre-existing heart disease upon entering the study.

Read more about the ACCORD changes here.

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