Blood Sugar Levels Are Not Essential

Presented: IAS Scientific Symposium 2009; NLA Chicago 2010; FAS Hamburg; Germany 2010


Purpose: To investigate the causes of atherothrombotic disease in diabetics.

Methods: Examination of patients in the Bowling Green Study database, who developed some clinical atherothrombotic disease event, stratified in terms of blood sugar levels.

Patient count: 800

Results and Conclusion: Prediction of the population at risk of atherothrombotic disease is independent of initial blood sugar level. Prediction is made using dyslipidemia, cigarette smoking, and hypertension as risk factors. Physicians treating diabetics and wishing to prevent atherothrombotic disease must treat the associated risk factors, not just blood sugar.


Based on Hafner’s East-West Study, the National Cholesterol Education Panel has designated diabetes mellitus as an atherosclerotic disease equivalent. (1) The question that must be asked, however, is this: Is it the entire diabetic condition that is the coronary equivalent, or is it a single component-or a combination of components-that determines risk of atherosclerotic/atherothrombotic disease (ATD)? More specifically, does the blood sugar level, in absence of the other components of the diabetic complex, cause ATD? It is the purpose of this paper to demonstrate that the blood sugar level is not necessary for the prediction of the population at risk of ATD. Furthermore, this paper will show that diabetes leads to ATD via the established ATD risk factors: Cigarette smoking, dyslipidemia, and hypertension.

The paper will also discuss the increased mortality rates on all patients with diabetes. The data described here are taken from the author’s own study, termed the Bowling Green Study (BGS) of the Primary and Secondary Prevention of ATD. (2-4))

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