Tight blood sugar control with insulin slashes the risk of heart disease for people with type 1 diabetes in half, new research shows.

Two-thirds of people with diabetes die of heart attack or stroke. The risk of heart disease is 10 times higher in people with type 1 diabetes without diabetes.

But a landmark study shows that by keeping their blood sugar under tight control, people with type 1 diabetes can reduce their risk of heart attack, stroke, and death from heart disease by 57%. Saul Genuth, MD, of Case Western Reserve University, chaired the study.

We see a greater reduction in [heart attack, stroke, and death] from intensive blood glucose control than from drugs that lower blood pressure and cholesterol, Genuth says, in a news release. This therapy should begin as early as possible and be maintained as long as possible.

It's likely that tight blood-sugar control will help people with type 2 diabetes, too. But proof that the benefits outweigh the risks won't arrive until a study of such patients is finished in 2009. Nevertheless, the current report -- in the Dec. 22 issue of the New England Journal of Medicine -- powerfully links high blood sugar to heart disease