The Cambridge University study of 33,000 people found getting it closer to the level for healthy people could cut the risk of heart attacks by 17%.
But charity Diabetes UK warns the steps the researchers recommend in the Lancet will not be appropriate for everyone.
For elderly and frail people with diabetes there is a risk that, if their blood sugar levels are brought too low, they can become dizzy and light-headed and in the worst cases fall into a coma.
The Cambridge team decided to review five of the major research projects carried out into this issue because expert opinion remained divided over the benefits to tighter sugar control.
The current guidance in the UK for the 2.5m with the disease is to keep blood sugar levels at about the 7% mark.
But the study found extra benefits for those who kept the levels closer to the 4% to 5% mark that is common for healthy people.
As well as the reduction in heart attacks, there was a 15% fall in heart disease when blood sugar levels were kept to 6.6% on average.
Lifestyle changes
The researchers said the findings would mean that for every 200 people treated for five years, three lives would be saved from heart attacks.
Lead researcher Dr Kausik Ray said: "Previous studies have been inconclusive, leaving diabetics and their doctors unsure as to whether maintaining lower blood sugar levels actually benefited the patients.
"Although additional research needs to be conducted, our findings provide insight into the importance of improving glucose levels. However, this has to be done through lifestyle changes as well as medication."
But Dr Victoria King, of Diabetes UK, warned tighter sugar control would not be appropriate for everyone.
"Diabetes UK advises that people with diabetes should work towards keeping their blood glucose levels within the target ranges agreed with their healthcare team.
"This reduces the risk of long-term diabetes complications such as heart disease, kidney disease and stroke as well as short-term diabetes complications such as hypoglycaemia."
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