That's not a fair representation of what happened. That study was going for _aggressive_ control - beyond what any normal person would do. They were combining multiple drugs to force blood sugar down rapidly, including right after meals (when it _should_ be going up).

Paying more attention to your blood sugar and acting reasonably to keep it in check isn't giving anyone heart attacks.

From the AI

> The concern was not that lower glucose is inherently bad. Rather, pushing blood sugar down rapidly and very tightly—especially with insulin and multiple glucose-lowering drugs—caused more episodes of hypoglycemia, weight gain, and treatment complexity. Severe low blood sugar can trigger abnormal heart rhythms and other cardiovascular stress. The intensive-treatment arm was stopped early after about 3.5 years because it had a higher death rate, although the exact mechanism was not definitively established.

I'll be showing my bias here, but you're probably referring to NICE-SUGAR, which I think suffered mainly from having a pretty uninspired control algorithm. We built and simulated it and several other clinical protocols and it had the widest spread of performance, but it lost a ton of points to hypoglycemia performance, which is where you get into increasing mortality. The NICE-SUGAR protocol [1] has no notion of weight based dosing, and even has some completely missed edge cases. There have been similar studies in Japan with a better algorithm and they showed the expected benefits.

[1] - https://www.glycemiccontrol.net/NICE/StudyDesign/NiceALGORIT...

Interesting! Found this overview: https://emcrit.org/pulmcrit/tight-glycemic-control/

Nonsense, you can fast or live in ketosis for years without any adverse consequences.