Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes

Abstract

The prevalence of Type 2 diabetes is increasing rapidly and is associated with significant cardiovascular adverse effects. The authors tested the hypothesis that, in patients with type II diabetes, intensive glucose control as evidenced by lowering the glycated hemoglobin level to to ≤6.5% would result in lower rates of major microvascular and macrovascular events. There were 11,140 patients with Type 2 diabetes who were randomly assigned to undergo standard glucose control or intensive glucose control. Intensive glucose control was achieved with the use of gliclazide (modified release) and other drugs as required to reach a glycated hemoglobin ≤6.5%. Primary end points were composites of major microvascular events (new or worsening nephropathy or retinopathy) or macrovascular events (death from cardiovascular causes, non-fatal myocardial infarction, or non-fatal stroke). End points were assessed both jointly and separately.