Call for ‘less aggressive’ diabetes treatment
People who have chronic heart failure (CHF) and type 2 diabetes should have their diabetes treated less aggressively, according to new research.
A study, conducted by Dundee University looked at the records of 1,447 people who suffered from both conditions, to investigate the importance of blood sugar.
Diabetes and heart disease are frequently seen together and experts say can be a “lethal combination” but according to new research, there are hazardous effects of under-or over-treating diabetes among those people with heart failure.
Professor Chim Lang, from the School of Medicine at Dundee, said: “Clinicians have always struggled with how aggressively to treat diabetes in patients with heart failure.
“Our team has now shown the dangers of not getting the balance right as well as which drugs are safer than others. This work will undoubtedly help guide the treatment of diabetes in patients with heart disease.
“We are the first in the world to pioneer this research which could potentially see this drug treating both diabetes and heart failure simultaneously
“We have already seen recent recommendations by the American Diabetes Association to treat elderly diabetic patients less aggressively. Our research suggests this advice should be extended to those patients who suffer with heart failure.”
The records were monitored between 1993 and 2010, and researchers discovered an increased risk of premature death in patients whoseblood glucose levels were outside of the HbA1c range of 7.1-8 per cent (54.1-63.9 mmol/mol).
It was also noted that this relationship was present in people treated with drugs, but not among those treated with diet alone.
People on “low hypoglycaemia risk” medication, such as metformin, had fewer outcomes than those treated with “high hypoglycaemia risk” medication, such as insulin.
Professor Lang’s team recently received a research grant from the European Foundation for the Study of Diabetes to set up the REFORM Trial.
It will study the cardiovascular effects of SGLT2 inhibitors on people with diabetes and heart failure (NCT02397421).
He said: “We are the first in the world to pioneer this research which could potentially see this drug treating both diabetes and heart failure simultaneously.
Dr Jagdeep Singh who is a clinical research fellow in Professor Lang’s team and the principal investigator of the REFORM Trial, said: “Using state-of-the-art MRI technology and detailed cardio-pulmonary exercise testing, we are confident that we can determine the exact effect of SGLT2 inhibitor therapy on the cardiovascular system.