Three recent studies – ACCORD, ADVANCE and VADT – have given cause to re-examine the intensity of outpatient glycaemic control for diabetes.
The ACCORD study randomized 10,251 participants with significant cardiovascular risk/history, aiming to achieve Hba1c < 6% in the study group. This study was halted early due to excess deaths (driven by cardiovascular death) in the intense treatment group.......
ADVANCE randomized 11,140 participants with known vascular disease/ risk factors, aiming for a target Hba1c <6.5%, using gliclizide to achieve this target in the study group. Median Hba1c levels were 6.3% and 7.0% in the study and control groups, but this took several years to achieve.........
VADT randomized 1,791 participants with uncontrolled diabetes (median Hba1c 9.4%) to intensive (target Hba1C <6.0%) or standard glycaemic control. Composite cardiovascular events were 12% lower (non-significant) in the study group after 5.6 years (p = 0.12).....
The complete bulletin can be downloaded here
The 2009 RGH E-Bulletins are archived here.
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