The message to diabetics has been remarkably consistent for years: Lower your blood sugar to near-normal levels to protect yourself from deadly and disabling complications.

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But the findings of a national study, released last week, suggest that the advice may need to be tempered slightly for diabetics who have heart disease or are at high risk for it because of high blood pressure, high cholesterol, a history of smoking or obesity. In the study, long-term diabetics with those conditions who reduced their blood sugar very close to normal were slightly more likely to die than those who settled for a bit higher level. The leaders of the study, surprised by the findings, cannot explain the increased deaths.

As diabetes specialists search for explanations, they urge patients to consult their doctors before making any adjustments in their treatments. Most diabetics are unable to reduce their blood sugar to near-normal levels with their current treatment, anyway.

The following are more details about the study and its implications for diabetics. - See Diabetes study upends another long held belief for the complete report.