Intensive Glucose Control Fails to Reduce Cardiovascular Events
21 dec 2008--Aggressive glucose control in hitherto poorly controlled type 2 diabetes does not lessen cardiovascular risk, according to a study released online by the New England Journal of Medicine.
Researchers randomized nearly 1800 military veterans with poorly controlled diabetes (hemoglobin A1c levels, 7.5% or greater) to either intensive or standard glucose control. Other cardiovascular risks were treated identically in both groups.
Although the median HbA1c level was 1.5 percentage points lower in the intensive-treatment group than in the standard group by 6 months, both groups showed similar rates of major cardiovascular events by a median follow-up of 5.6 years.
Writing in Journal Watch Cardiology, Harlan Krumholz observes that this is the third study failing to show a drop in cardiovascular risk after intensive glucose control. However, he adds, "critics might wonder if treatment earlier in the course of diabetes or longer follow-up would have altered this study's findings."