Diabetes mellitus, type 2 is an epidemic problem in the United States, with at least 21M people diagnosed, a problem made more complex with very disappointing new trial data.Two new reports from the ACCORD trial released yesterday show that lowering either blood pressure or cholesterol below current guidelines does not provide additional benefit and, in fact, increases the risk of side effects. A third arm of the study, known from two years ago, shows that excessively lowering blood sugar levels actually increases the risk of heart disease.

This is very frustrating news, given that the pipeline for novel therapies is not advancing at a rate congruent enough with the increasing incidence since the start of this century. Is aggressive management of other risk factors of cardiac disease and strokes actually harmful to these patients? While these developments throw into question far-reaching guidelines on the issue, some physicians in response are taking results of these negative studies (here and here) [PDF] and applying them on a case-by-case basis. | LINK

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