Does Insulin Therapy Prevent Adverse Cardiovascular Events in Early Diabetes?

In the ACCORD, ADVANCE, and VADT trials, intensive glycemic control did not prevent fatal plus nonfatal cardiovascular (CV) events in patients with long-standing type 2 diabetes (JW Cardiol Jun 6 2008 and JW Gen Med Dec 24 2008). In those studies, substantial proportions of patients in both the intensive-treatment and control groups received insulin. In a new study (the ORIGIN trial), researchers asked a somewhat different question: In patients with early diabetes, does provision of basal insulin itself confer CV benefit?

The trial included 12,500 patients with either previous adverse CV events (59%) or high CV risk. Additionally, 88% of patients had mild diabetes (stable on 0 or 1 oral agent, and not receiving insulin), and the other 12% ha…