Tight blood glucose control: Is it worth it?
Byron J. Hoogwerf, MDAddress reprint requests to B.J.H., Department of Endocrinology, The Cleveland Clinic Foundation, One Clinic Center, 9500 Euclid Avenue, Cleveland, Ohio 44195.
Several investigations have assessed the relationship between glycemic control and complications in diabetes mellitus. Key evidence is reviewed that supports the beneficial effects of “tight” blood glucose control. Pertinent animal data show that good blood glucose control is associated with less retinopathy and nephropathy and fewer congenital anomalies in offspring. Short-term studies in humans show similar trends in microvascular complications and pregnancy. Similarly, peripheral neuropathy may be lessened with lower blood glucose. Although no studies have demonstrated a reduction in atherosclerotic disease with improved glycemic control, dyslipidosis frequently improves, which should reduce the risk for coronary heart and peripheral vascular disease.