Jaiwant Rangi, MD, FACEEndocrinologist | Founder, Lower The Dose® | Speaker

Chasing Numbers, Losing Patients: The Deadly Flaw in Early Diabetes Treatment

30 Jul 2026 · 1 min

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Dr. Jaiwant Rangi explains how aggressive glucose-lowering became standard practice in diabetes care, despite the ACCORD trial being halted early because intensive treatment in older adults increased mortality. Chasing low blood sugar numbers while ignoring the heart can actually worsen cardiovascular risk.

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The old model was simple: lower the sugar at any cost and assume everything else will follow. That's what we knew. Even during my training, which I finished in 2005 in Michigan, we were not so concerned about the heart being the primary organ with diabetes. We learned sometimes the hard way, and that you can drive the sugar numbers down with certain drugs and not change or even worsen a person's risk of heart attack. One large trial called the ACCORD trial actually had to be stopped early because pushing the sugar too aggressively down in older adults led to more deaths, not fewer.