The VA Diabetes Trial: 15-Year Follow-Up

The VA Diabetes Trial was one of three randomized trials published in 2008 and 2009 in which intensive glycemic control did not significantly lower the incidence of major adverse cardiovascular (CV) events in older patients with longstanding type 2 diabetes (NEJM JW Gen Med Jan 15 2009 and N Engl J Med 2009; 360:129). During the 5.6-year trial, average glycosylated hemoglobin (HbA_1c) was about 7% with intensive treatment and was 8.5% with standard treatment. During 4 years of post-trial follow-up — during which HbA_1c differences between the original randomized groups narrowed but didn't completely disappear — a small difference in major CV events emerged in the original intensive-treatment group versus the original standard-treatment group …