WEDNESDAY, Feb. 6 (HealthDay News) -- People with type 2 diabetes who are already showing signs of some kidney damage may be able to significantly lower their risk of death by treating multiple risk factors at once.

That's the conclusion of a new Danish study, published in the Feb. 7 issue of the New England Journal of Medicine, that found intensive therapy, including tight blood sugar control, low-dose aspirin, and cholesterol- and blood pressure-lowering medications when necessary, lowered the risk of all-cause mortality and cardiovascular death.

"The Steno-2 study shows a 20 percent absolute risk reduction in all-cause mortality in patients who originally were offered intensive therapy when compared with patients given the usual treatment," said the study's principal investigator, Dr. Oluf Pedersen, director at the Steno Diabetes Center in Copenhagen. "Similarly, the absolute risk for cardiovascular death was reduced by 12.5 percent in absolute terms."

The findings were published the same day that U.S. health officials announced a halt to a large diabetes trial because of high death rates among those receiving aggressive therapy. The study, involving more than 10,000 people, was dubbed the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial, and was stopped early on safety concerns after researchers found an increased risk of mortality in those whose blood sugar was aggressively managed.

Although the death rates in both treatment arms of the ACCORD trial were lower than is seen in the general population, 257 people who were on therapy to get their blood sugar levels in the non-diabetic range died versus 203 people receiving standard treatment.

"In the ACCORD trial we wanted to learn, does aggressive glucose lowering decrease the risk of cardiovascular disease? But, we found that in patients whose [blood sugar levels are] high, if we try to drive it to normal, there may be harm," said Dr. Hertzel Gerstein, a principal ACCORD investigator, and a professor of medicine at McMaster University in Hamilton, Ontario, Canada.

The ACCORD researchers are currently analyzing their data to try to figure out why the intensively managed blood glucose group had a higher death rate, Gerstein added.

For the Steno-2 study, Pedersen and his colleagues randomly assigned 160 people with type 2 diabetes and persistent microalbuminuria to receive either intensive management or standard therapy. Microalbuminuria means that albumin -- a type of protein -- is spilling into the urine, which indicates that some kidney damage has already occurred. The average participant's age at the start of the study in 1993 was 55.

The goals for the intensive therapy group included an A1C level of 6.5 percent or lower, a fasting blood cholesterol level of 175 milligrams per deciliter, a fasting blood triglyceride level of less than 150 milligrams per deciliter, systolic blood pressure of less than 130 mm/Hg and diastolic blood pressure of less than 80 mm/Hg. In addition, regardless of blood pressure levels, those in intensive management were treated with angiotensin inhibitors -- commonly used blood pressure-lowering medications -- and daily low-dose aspirin.

"Although most of the patients didn't achieve the intensive targets, there was an absolute 20 percent different in the death rate compared to the conventional group," said Dr. Kirit Tolia, director of the Joslin Diabates Center at Providence Hospital in Southfield, Mich.

"Diabetes is a very serious disease that needs to be addressed in a very aggressive fashion, and that intervention needs to be multi-targeted," Tolia added.

Nearly 21 million Americans have diabetes, according to the U.S. Centers for Disease Control and Prevention, and their risk of death, particularly cardiovascular death, is much higher than for those without diabetes. Additionally, diabetes increases the risk of high blood pressure, blindness, kidney disease and nerve damage.

However, the CDC reports that good control of blood sugar levels can decrease the risk of complications. For each percentage point drop in A1C levels -- a long-term measure of blood sugar control -- the risk of eye, kidney and nerve damage drops by 40 percent, according to the CDC.

"It's not enough to just know your blood glucose, cholesterol and blood pressure levels. You need to take action and do something about those risk factors early -- and long-term," Pedersen said.

Of Steno-2, Gerstein noted that the study shows that for people with type 2 diabetes and microalbuminuria, doctors "should use a comprehensive approach to reduce as many risk factors as possible."

Both study investigators said their findings are only applicable to those people with type 2 diabetes, not those with type 1.

More information

To learn about preventing type 2 diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases.

THURSDAY, Jan. 31 (HealthDay News) -- Consumption of sugar-sweetened soft drinks and fructose is strongly associated with increased risk of gout in men, a new study says.

Gout, caused by excess uric acid in the blood, is a joint disease that causes extreme pain and swelling. Cases of gout, which is most common in men, have doubled in the United States over the past few decades.

In this study, published in BMJ Online First, researchers looked at more than 46,000 men, aged 40 and older, with no history of gout. Information on the men's food and beverage intake was collected at the start of the study, and details about their weight, medication use and medical conditions were recorded every two years during the 12-year study.

During that time, 755 of the men were diagnosed with gout. The risk was much higher in men who drank five to six servings of sugar-sweetened soft drinks per week and was 85 percent higher in those who drank two or more of the beverages a day, compared to those who had less than one serving per month.

The increased risk was independent of other gout risk factors such as body-mass index, age, diuretic use, high blood pressure, alcohol intake and dietary habits. Diet soft drinks did not increase gout risk.

The study also found that fruit juice and fructose-rich fruits such as apples and oranges were associated with increased gout risk. But the researchers said this higher risk of gout needs to be balanced against the many health benefits provided by fresh fruits and vegetables.

More information

The American Academy of Family Physicians has more about gout  .

FRIDAY, Jan. 25 (HealthDay News) -- Diabetes-related medical and economic costs in the United States hit $174 billion in 2007, a 32 percent increase from 2002, a new study shows.

The research, commissioned by the American Diabetes Association (ADA), found medical care costs for people with diabetes were about $116 billion, and a disproportionate percentage of those costs resulted from the treatment and hospitalization of people with diabetes-related complications.

About one out of every five health-care dollars in the United States is spent caring for someone with diagnosed diabetes. Last year, diabetes caused more than 284,000 deaths in the United States.

"The findings reaffirm that diabetes is a public health crisis and its implications are painful and far-reaching," Ann L. Albright, president of health care and education at the ADA, said in a prepared statement. "This underscores the importance of early diagnosis and treatment. Diabetes becomes much more costly in financial and human terms when the disease is not properly treated."

The economic costs of diabetes in 2007 were estimated to be $58 billion, a figure that includes reduced productivity of both people in the labor force and unpaid workers, unemployment from diabetes-related disability, and increased absenteeism.

It's believed that about 6 million people in the United States have undiagnosed diabetes, which means the actual total cost of diabetes in 2007 may have been much more than $174 billion, the study said.

"Diabetes plagues more than just the individual with the disease. It is common, it is costly, it creates numerous complications, and there is no cure. Until we start reversing current trends, through increased awareness, prevention and aggressive disease management, diabetes will continue to have an adverse impact on our society as a whole," R. Stewart Perry, ADA's chairman of the board, said in a prepared statement.

The findings were discussed Wednesday at a Congressional briefing in Washington, D.C.

More information

The U.S. Centers for Disease Control and Prevention has more about diabetes.