More from the ACCORD Trial: Ischemic Heart Disease Outcomes

In the ACCORD trial (NEJM JW Gen Med Jun 6 2008), >10,000 patients with type 2 diabetes and additional cardiovascular (CV) risk factors were randomized to intensive glycemic control (target glycosylated hemoglobin [HbA_1c], <6.0%) or standard control (target HbA_1c, 7.0%–7.9%). The study was stopped after nearly 4 years because overall and CV-related mortality were higher in the intensive-therapy group than in the standard-therapy group, although the two groups did not differ in the primary composite CV outcome of nonfatal myocardial infarction (MI), nonfatal stroke, or CV-related death.

Few deaths in ACCORD were attributable to hypoglycemia, and excess risk for death among intensive-therapy patients occurred only in those whose average on-tre…