Wednesday, March 23, 2011

More Than Just Blood Sugar


With the diagnosis of diabetes, the first concern by the patient is control of blood sugar. It’s common wisdom that ‘tight’ control is key to reducing some of the bad consequences of diabetes, such as heart disease. There is increasing evidence that measures to control high blood pressure and high cholesterol may be even more important, and is the subject of a new article in Hypertension.

An accompanying editorial states, “Although diabetes remains a risk factor for atherosclerotic cardiovascular disease, the main focus of intervention needs to be directed to hypertension and cholesterol control in terms of reducing this risk, and treatment should most likely be completely independent of the presence of diabetes mellitus.”

Even the notion of ‘tight’ control is under review by the medical community. Certainly blood sugars consistently greater than 200 are unacceptable, but the risks associated with episodes of very low blood sugar must be considered. Getting the right regimen is a team effort and the patient needs to be an active participant.

In addition to medication, I cannot emphasize enough the role of diet and exercise in maintaining health. Food is to be enjoyed, but most of us should enjoy less of it. Food comes out of the ground – it’s not manufactured in a factory and wrapped in cellophane. No one ever got stronger just sitting in a chair; if you are in a chair, move what you can.

Diabetes may be the canary in the coalmine disease: since patients with diabetes receive close medical attention and are followed for a long time, we may be able to gain valuable insight on how to ward off other chronic medical afflictions.

Hypertension. 2011
Published online before print March 14, 2011, doi: 10.1161/HYPERTENSIONAHA.110.162446

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