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MUSC patients part of research that finds benefits of strict control of blood sugar When Kathi Dixon' diabetes was diagnosed in the 1970s, doctors didn't have much positive to say about life with the disease. Her future, they told her, was sure to be tripped up by blindness, heart attacks or the kinds of circulatory problems that lead to crippling amputations. " I never dreamed that in 30 years I'd be this healthy," said Dixon, an Anderson resident who visits the Medical University of South Carolina every three months to have her disease monitored. "I doubted I'd even still be alive, and if I was, I figured I'd be walking around on stumps." Her predictions were wrong. The results of a new national study on Type 1 diabetes and cardiovascular disease show that the future looks bright for Dixon and others with her disease, as long as they're willing to work for it. Doctors announced Sunday that a 20-year study on Type 1 diabetes treatment shows that strict control of blood sugar levels slashes patients' risk of heart attacks and stroke, the most dreaded complications of the disease. The news, released during the American Diabetes Association's annual scientific meeting in San Diego, reinforces previous evidence showing that strict control decreases patients' odds of contracting eye, kidney or nerve diseases linked to diabetes. The study followed about 1,400 patients, including Dixon and 55 others from South Carolina, Georgia and Florida who were treated at MUSC, since 1983. Researchers needed to watch patients in the study during the 20-year period because even after the first 10 years, it was still unclear whether the tight regimen could ward off long-term cardiovascular problems such as heart attack and stroke and the need for bypass surgery or placement of cardiac stents. The participants in the study are now in their 30s, 40s and 50s, and researchers found that the tight control of blood sugars has cut their risk of cardiovascular problems by 42 percent, compared with statistics for patients who don't closely monitor their glucose levels. When doctors looked only at episodes of heart attacks and strokes, they found that patients on strict control saw a 58 percent reduction in risk. To reap the most long-term benefit from the new findings, doctors say patients must monitor their blood glucose levels at least six times daily with needle sticks and must administer insulin, either with frequent injections or an insulin pump. The researchers estimate less than 20 percent of Type 1 diabetic patients are using that treatment schedule, instead favoring less-frequent sugar monitoring and consistent insulin injections two or three times a day. " The eye and nerve problems don't kill you, but heart attacks and strokes will, so maybe now more people will listen to the advice," said Dr. John Colwell, the MUSC professor who served as principal investigator at the local site and is a former president of the American Diabetes Association. Left unchecked, the excess glucose molecules in a diabetic's bloodstream attach to proteins in the heart muscle and blood vessels and, in time, weaken the cardiovascular system. Though the study examined only Type 1 diabetics — those whose bodies don't make insulin, often called juvenile diabetics — experts think the results offer lessons to Type 2 diabetics, as well. Those patients' conditions often can be managed through diet and exercise, but they, too, must be vigilant about their care to set the stage for a healthy future. More than 270,000 South Carolinians have Type 2 diabetes, nearly double the number who had it 10 years ago, and public health officials count it as one of their top priorities. Type 1 and Type 2 diabetes combined are linked to 200,000 deaths each year in the United States, mostly because of cardiovascular problems, according to the American Diabetes Association. Carolyn Jenkins, who serves as principal investigator for REACH 2010, a coalition that works with black diabetics, has put that message to work in the community. Jenkins, a professor in MUSC's College of Nursing, presented research during the association's weekend meeting on the program's success slashing diabetic-related amputations by 50 percent in the past three years. To people who are reluctant to closely monitor their disease, or who deny how sick they really are, Jenkins urges them to heed the new findings. " I say to those folks who believe that God takes care of them, 'God has given us a brain and a body, and we can help God do a lot of things to help take care of ourselves,' " she said. "This is not one of those things where we can turn over the management of our diabetes to God or our provider or our families." Holly Auer covers health and medicine. She can be reached at hauer@postandcourier.com |
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