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Blood glucose control ranks high in US death causes

By Shane Starling , 29-Jun-2009
Last updated on 29-Jun-2009 at 18:26 GMT2009-06-29T18:26:04Z

High blood glucose levels are one of the most common killers of Americans, according to new research from Harvard researchers.

In a study that assessed 12 dietary, lifestyle and metabolic factors risk factors in causes of preventable death, high blood glucose levels came out as the fifth most deadly killer, after tobacco, high blood pressure, overweight/obesity, physical inactivity.

High blood glucose levels were more perilous than high LDL cholesterol, high levels of dietary salt, low omega-3 levels, high levels of trans fatty acids, alcohol use, low levels of fruit and vegetables and low levels of polyunsaturated fatty acids.

According to the mathematical model used by the researchers, there were between 163,000 and 217,000 high blood glucose-related mortalities in 2005 that could have been avoided.

Tobacco smoking ranked as the highest risk factor with 436,000 to 500,000 attributed preventable deaths, followed by high blood pressure (372,000 to 414,000), obesity (188,000 to 237,000), physical inactivity (164,000 to 222,000), high LDL cholesterol (94,000 to 124,000) and high salt intake (97,000 to 107,000).

The other risk factors were alcohol use; low polyunsaturated fatty acids; low fruits and vegetables intake and alcohol use.

High blood glucose levels have been linked to increased rates of obesity and type-2 diabetes but the researchers noted that randomized intervention studies in the past had been inconclusive.

“Possibly the most important case of current discrepancy between prospective observational cohorts and intervention studies is the mortality effect of high blood glucose,” they wrote.

“Prospective studies have shown relatively large associations between usual FPG (fasting plasma glucose) and mortality, but randomized intervention studies have shown null effects, and declines as well as increases in mortality when glucose was lowered intensively relative to those who had conventional management.”

They speculated that this may be due to the fact glucose is a confounded marker, “other underlying metabolic dysfunction so that interventions targeting only glucose may be unsuccessful at ameliorating all of the observed risk.

They called for more research into the relation between blood glucose and mortality and the role of lifestyle and pharmacologic interventions.

The researchers called for more research into the relation between blood glucose and mortality and the role of lifestyle and pharmacologic interventions.

Rhonda Witwer, the senior business development manager in nutrition at National Starch Food Innovation, noted that increased blood glucose levels lead to insulin insensitivity, a key pre-factor in the onset of diabetes.

When insulin sensitivity is lost, the body has to produce more insulin to effectively keep blood glucose under control,” she said.

Over time, it is believed that the pancreas just can't keep up with the need for increased insulin and the individual develops diabetes. Reversing insulin resistance through dietary means can greatly help maintain healthy blood sugar levels.”

Source: Public Library of Science Medicine Journal

Vol. 6, April, 2009

‘The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors’

Authors: Goodarz Danaei, Eric L Ding, Dariush Mozaffarian, Ben Taylor, Jurgen Rehm, Christopher J L Murray, Majid Ezzati

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