Cardiovascular Benefit of Glycemic Control Is Limited to Those with Low Comorbidity

The effect of glycemic control on preventing adverse cardiovascular events has been difficult to demonstrate, possibly because such effects are limited to particular patient subgroups. To determine whether achieving glycosylated hemoglobin (HbA_1c) targets of 7% versus 6.5% had differential effects by comorbidity, industry-sponsored researchers studied 2613 Italian patients with type 2 diabetes who received care from general practitioners or in diabetes clinics. Comorbidity was measured by questionnaire and was dichotomized at a level that was associated with excess mortality. Comorbidities included heart disease, lung disease, arthritis, genitourinary disease, vision loss, adverse gastrointestinal conditions, and foot disease.

Among patients…