Treating Diabetes and Coronary Artery Disease

The international Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial involved 2368 patients (51% of those screened, 70% men) with type 2 diabetes and coronary artery disease. Participants were randomized to receive either prompt revascularization or medical therapy alone for CAD, and either insulin provision (with insulin or a sulfonylurea) or insulin sensitization (mostly with metformin or rosiglitazone) to a target glycosylated hemoglobin (HbA_1c) level of <7%. All patients had angina and ≥70% stenosis of a major epicardial artery or ≥50% stenosis plus a positive stress test result. Before randomization, patients were judged by their physicians to be best suited for either coronary artery bypass grafting or percu…