Intensive Glycemic Control Associated with Fewer CV Events in Extended Follow-Up

By Christine Sadlowski

Edited by Susan Sadoughi, MD

Intensive glycemic control for type 2 diabetes showed a benefit in reducing nonfatal cardiovascular events during long-term follow-up that was not apparent in an initial study, researchers report in the New England Journal of Medicine.

Researchers randomized nearly 2000 patients (mean age, 61; mean diabetes duration, 12 years) to intensive or standard glycemic control. After a median follow-up of 5.6 years, the authors reported a nonsignificant difference in cardiovascular outcomes.

After an additional 4 years with standard glycemic control in both groups, there was little difference between groups in glycated hemoglobin levels. Meanwhile, the difference in cardiovascular outcomes became significant, with 8.6 fewer major cardiovascular events per 1000 person-years in those who had received intensive therapy. Mortality was still similar between the groups.

NEJM Journal Watch General Medicine Editor-in-Chief Allan Brett, MD, concludes: "These results shouldn't change our general approach to glycemic control in older adults with long-standing type 2 diabetes: Individualize intensity of antidiabetic therapy depending on patient preference and risk for hypoglycemia."