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Intensive glucose-lowering therapy is widely believed to prevent macrovascular complications in patients with type 2 diabetes. However, results from several recent trials have cast doubt on this assumption.
In the ACCORD trial, researchers randomized about 10,000 type 2 diabetic patients (mean age, 62) with known cardiovascular (CV) disease or at least two CV risk factors to either intensive glucose-lowering therapy or standard therapy. Glycemic control was significantly better in the intensive-treatment group (glycosylated hemoglobin [HbA1c], 6.4% vs. 7.5%). However, after a mean follow-up of 3.5 years, the intensive-treatment group had significantly higher mortality than the standard-treatment group did (5% vs. 4%; P=0.04). Furthermore, no…