Many people know that diabetes can lead to heart disease, kidney problems, and vision issues.
But fewer people have heard of a serious condition called cardiovascular autonomic neuropathy, or CAN.
This problem affects the nerves that control the heart and blood vessels. It is common in people with type 2 diabetes and can be life-threatening. Yet, it often goes undiagnosed.
Now, a new study brings hope. Researchers have found that taking strong action to lower blood sugar and blood pressure levels can help reduce the risk of developing CAN.
The study was led by Dr. Alessandro Doria from Joslin Diabetes Center and Harvard Medical School, along with Dr. Rodica Pop Busui from the University of Michigan. Their findings were published in the journal *Diabetes Care*.
The study looked at data from the ACCORD trial (Action to Control Cardiovascular Risk in Diabetes), which followed about 7,000 people with type 2 diabetes and high risk of heart problems.
Participants were assigned to either standard or intensive treatment for blood sugar, blood pressure, or cholesterol levels. The trial took place from 2001 to 2010, before newer diabetes medications were widely used.
Researchers found that people who received intensive treatment to lower blood sugar had a 17% lower risk of developing CAN. Those who got intensive treatment for high blood pressure had a 22% lower risk. These results remained strong even after taking into account other risk factors like age, weight, and previous heart conditions.
Interestingly, the benefits of these treatments were not the same for everyone. Lowering blood sugar helped only those who had never had heart disease.
Meanwhile, lowering blood pressure was especially helpful for older adults over the age of 65, who saw a 34% drop in CAN risk. These findings suggest that diabetes treatment plans could be tailored to fit each person’s unique needs.
However, there are some concerns. In the original ACCORD trial, people who received very intensive blood sugar treatment had a higher death rate, even though they had fewer heart attacks. This means doctors need to be careful. They must weigh the benefits of preventing CAN against the possible risks and costs of strong treatment.
The study also tested whether a cholesterol-lowering drug called fenofibrate could reduce the risk of CAN. It didn’t work as well. There was no meaningful difference between the group taking fenofibrate and the group that didn’t.
Dr. Doria said that earlier, smaller studies suggested this approach might help, but now we have solid proof that carefully lowering blood sugar and blood pressure can prevent this dangerous complication. Dr. Busui added that CAN is very important to watch for, because even in its early stages, it raises the risk of death and heart failure in people with diabetes.
In summary, the study shows that managing blood sugar and blood pressure more strictly can reduce the risk of nerve damage to the heart in people with type 2 diabetes. However, these treatments must be used with caution.
Doctors should consider each patient’s age and health history before deciding how aggressive treatment should be. More research is needed, but this study provides strong evidence for doctors to consider when treating diabetes.
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