Lower blood sugar levels reduce organ damage risk
The association between blood glucose levels and risks of organ impairment in people with type 1 diabetes can make a vital contribution to diabetes care, according to researchers.
The Swedish study, published in the British Medical Journal (BMJ) involved looking at the health data of more than 10,000 adults and children with type 1 diabetes using the Swedish Diabetes Register.
Knowing more about the association between blood glucose level and risk is extremely important since the health care services, the community, patients and their parents make heavy use of resources in attaining a particular blood glucose level Professor Johnny Ludvigsson
Analysis of HbA1c levels showed that a value above 52 mmol/mol is associated with an elevated risk of mild changes to the eyes and kidneys.
Vision-threatening eye damage occurs mainly at substantially higher values. Staying at 52 or below, reduces the risk of organs being affected, but a value below 48 showed no further risk reduction.
In Sweden, the target HbA1c value in people with type 1 diabetes is 52 mmol/mol or below, and 47 or lower in children. In the UK an ideal HbA1c level is 48mmol/mol or below.
First author Professor Marcus Lind, from the Sahlgrenska Academy, University of Gothenburg, and senior consultant at the NU Hospital Group in Uddevalla, Sweden, said: “We were unable to see that fewer instances of organ damage occurred at these lower levels. As for loss of consciousness and cramp, which are unusual, low blood glucose caused a 30 percent rise in risk. Patients with low HbA1c need to make sure they don’t have excessively low glucose levels, fluctuations or efforts in managing their diabetes.”
Professor Johnny Ludvigsson, a senior professor at Linköping University, whose specialty is childhood diabetes, added: “Knowing more about the association between blood glucose level and risk is extremely important since the health care services, the community, patients and their parents make heavy use of resources in attaining a particular blood glucose level.
“Attaining a low HbA1c value may, in some cases, require children to be woken up several times a night, plus extra glucose monitoring and strict attention to diet and physical activity day after day, which can be extremely burdensome.”