Intensive Glucose Lowering Does Not Cut CV Risks in Patients with Long-Standing Type 2 Diabetes

In the recent ACCORD and ADVANCE trials, intensive glucose-lowering therapy did not lower risks for cardiovascular (CV) death, nonfatal myocardial infarction, or nonfatal stroke in people with type 2 diabetes and end-organ complications or CV risk factors (JW Jun 6 2008). The results of a similar trial, the Veterans Affairs Diabetes Trial (VADT), are now available.

Investigators randomized 1791 veterans (mean age, 60) with long-standing type 2 diabetes (mean duration, 11.5 years) to receive intensive glucose-lowering therapy or standard therapy. Other CV risk factors were treated uniformly in both groups. After a median follow-up of 5.6 years, the median glycosylated hemoglobin (HbA_1c) level was significantly lower in the intensive-therapy g…