More questions about by-the-numbers medicine

There's been a lot of talk lately about whether a "by the numbers" approach to disease is really effective. Do low LDL numbers and high HDL numbers really help prevent heart disease? Are a diabetic's blood-glucose numbers a reliable indicator of just how often--and how severe--complications from the disease might be?

At the American Diabetes Association meeting over the weekend, a few new studies cast further doubt on the effects of tight blood-sugar control. In one study, "Accord," a super-aggressive approach to lowering glycated hemoglobin--considered a major risk factor--actually increased the risk of death. Another, "Advance," showed that super-tight blood sugar control didn't help lower risk of heart disease or death than a more typical approach did.

So what now? No need for an aggressive approach in most patients, researchers said. And instead of relying on blood-sugar control to protect from heart disease, diabetics should turn to the usual pharmalogical suspects for cholesterol and high blood pressure for protection. And in a broader sense, just be prepared for more debate on cholesterol, blood sugar, and other numerical markers.

- read the Wall Street Journal Health Blog post
- check out the New York Times piece

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