Highlights
Intensive Blood Glucose Control
- In 2008, interim results from a large study raised concerns that intensive blood sugar (glucose) control may increase the risks for heart attack and stroke in patients with type 2 diabetes who have heart disease risk factors. Other studies have not shown that tight blood sugar control increases these risks.
- The American Diabetes Association continues to recommend a hemoglobin A1C goal of below 7% for most patients. Patients who have heart disease or cardiovascular risk factors should discuss with their doctors individualized treatment goals.
- The HbA1C test provides a measure of long-term blood sugar control. Patients should have their A1C levels tested at least twice a year.
Heart Warnings for Thiazolidinedione Drugs
- In August 2007, manufacturers added a boxed warning to the prescription labels of thiazolidinedione drugs. The new information warns that these drugs can cause or worsen heart failure in certain patients. Thiazolidinedione drugs include rosiglitazone (Avandia) and pioglitazone (Actos).
- In November 2007, a warning about potential increased risk for heart attack was added to the label of rosiglitazone.
Dosing Guidelines for Anemia Treatment
- In 2007, the Food and Drug Administration (FDA) made further changes to its recommended target hemoglobin levels for patients with end-stage kidney disease who are treated with erythpoeisis-stimulating drugs.
- The FDA now recommends that hemoglobin levels should be maintained between 10 - 12 mg/dL. If drugs such as Aranesp, Epogen, and Procrit are given in doses that increase hemoglobin levels beyond 12 mg/dL, the risks increase for stroke, heart attack, and heart failure.
- Anemia is a common complication for patients on dialysis.
