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Doctors doubt effectiveness of glucose reduction target

6 March 2009

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Targets that will earn GPs cash for reducing blood glucose in people with diabetes may not be beneficial and could harm patients, two doctors have said.

The new goals – which require doctors to cut blood glucose levels in half of their type 2 diabetic patients to below 7% – are aimed at cutting the risk of heart disease in diabetics.

But Oxfordshire GP Richard Lehman and Harlan Krumholz, Professor of Medicine at Yale University School of Medicine in the US, condemned the new target.

Writing in the British Medical Journal (BMJ), they said: “Reducing glycated haemoglobin below 7% is not supported by evidence and may even be harmful. Tens of thousands of patients will need to be given additional oral treatment or will be treated with insulin.

“Treatment with insulin brings with it an increased risk of hypoglycaemia (potentially dangerous low blood sugar levels) and the additional costs of daily blood glucose monitoring and the insulin itself.

“It may also result in people who drive for a living losing their jobs if the new target leads them to be treated with insulin.”

The targets are part of the government’s Quality and Outcomes Framework.

The article also claims that the targets, agreed on by the NHS and the British Medical Association, were announced just as evidence was gathering that tight glucose control in established type 2 diabetes has little benefit and can even be harmful.

Copyright © Press Association 2009