(ePharmaNews) - We know that strict control of blood sugar is essential to prevent the terrible complications of diabetes like amputations, blindness, kidney and heart diseases, but it seems that there is an exception for this in patients who have both diabetes and heart failure.
A new study -lead by researchers in UCLA- found that for patients with diabetes and an advanced heart failure, having higher blood glucose levels may actually help improving survival rates.
Published online in the American Journal of Cardiology, UCLA researchers compared levels of a marker used to track glucose levels called glycosylated hemoglobin in advanced heart failure patients with and without diabetes. The marker is gauged through a simple blood test.
The study assessed the relationship between levels of the marker and the mortality outcomes. Researchers found that for heart failure patients who also have diabetes, for every unit increase in this marker, there was a 15 percent decrease in mortality.
"We were surprised that the optimal level of glycosylated hemoglobin in this patient population with diabetes was higher than levels in current treatment guidelines," said senior author Dr. Tamara Horwich, assistant professor of cardiology, David Geffen School of Medicine at UCLA. "We may find that doctors who treat patients who have both advanced heart failure and diabetes may not need to focus on aggressively lowering blood sugar, but rather keep it under moderate control."
This study included 845 patients, most of them (72 percent) were men and the average age was 55.
Patients were classified as having diabetes or not and also grouped by four levels of glycosylated hemoglobin. Using statistical analysis, researchers calculated risk of death or need for an urgent heart transplant.
Researchers found that for diabetic heart-failure patients, two-year event-free survival was highest amongst patients with the highest elevated glycosylated hemoglobin levels: 65 percent survival rate for patients with level four (greater than 8.6 percent of the marker) and 48 percent survival rate for patients with level one.
"For heart failure patients with diabetes, we found that higher, not lower levels, of the marker had better outcomes," said first author Sofia Tomova, a medical student in the division of cardiology, Geffen School of Medicine.
However, researchers has not found this difference in survival rates among patients who have heart failure without diabetes, meaning their survival rates does not improve if their glycosylated hemoglobin is lower within the normal range, on the other hand, diabetic patients who have high blood sugar levels are at increased risk for developing heart failure, but once this happens, it is better for them to keep their blood sugar somewhat high, to live longer!
