Document Detail


Effect of intensive glycemic control on cardiovascular outcomes and all-cause mortality in type 2 diabetes: Overview and metaanalysis of five trials.
MedLine Citation:
PMID:  20115934     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
More intensive diabetes control prevents microangiopathy in patients with both type 1 diabetes and type 2 diabetes. The data related to prevention of macrovascular disease in patients with type 2 diabetes are controversial. The data confirming benefit of the HbA(1c) levels below 6.5% came almost exclusively from epidemiological studies. The following article reviews the data from five large clinical randomized trials which compared the more intensive glucose lowering strategy with the standard antidiabetic treatment i.e. UKPDS, PROactive, ACCORD, ADVANCE and VADT. Metaanalysis of five trials showed a highly significant reduction of the incidence of non fatal myocardial infarction [OR 0.84 (95% CI 0.75-0.93), p = 0.001] in patients with intensive glycemic control. No significant differences were observed by combined analysis for the non-fatal stroke, cardiovascular mortality and all-cause mortality between the compared groups. The reason for the discordance of the results of the epidemiological and interventional studies is not clear. The possible explanations could include short duration of the trials to show effect of glucose lowering, as well as attenuating of the beneficial effect of better glycemic control by increased hypoglycemia-related mortality in patients with preexisting cardiovascular disease.
Authors:
Ivan Tk?c
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetes research and clinical practice     Volume:  86 Suppl 1     ISSN:  1872-8227     ISO Abbreviation:  Diabetes Res. Clin. Pract.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-02-01     Completed Date:  2010-04-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508335     Medline TA:  Diabetes Res Clin Pract     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  S57-62     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Internal Medicine 4, Saf?rik University, Faculty of Medicine, L. Pasteur Faculty Hospital, Kosice, Slovakia. IvanTkac@medic.upjs.sk
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MeSH Terms
Descriptor/Qualifier:
Blood Glucose / metabolism*
Cardiovascular Diseases / epidemiology*,  mortality,  prevention & control
Controlled Clinical Trials as Topic
Diabetes Mellitus, Type 1 / complications,  mortality
Diabetes Mellitus, Type 2 / complications*,  mortality
Diabetic Angiopathies / epidemiology*,  mortality,  prevention & control
Homeostasis
Humans
Risk Reduction Behavior*
Chemical
Reg. No./Substance:
0/Blood Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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