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Glycemia management and cardiovascular risk in type 2 diabetes: an evolving perspective

Faramarz Ismail-Beigi1, Etie S Moghissi

  • 1Department of Medicine, Case Western Reserve University, Cleveland, Ohio 44106-4951, USA.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|August 30, 2008
PubMed
Abstract

Insights

Recent trials show individualized glycemic control is key for type 2 diabetes patients. Strict management of risk factors like hypertension and dyslipidemia benefits all patients with type 2 diabetes.

Area of Science:

  • Endocrinology
  • Cardiology
  • Diabetology

Background:

  • Type 2 diabetes management aims to reduce cardiovascular disease (CVD) risk.
  • Glycemic control strategies have evolved based on recent clinical trial data.

Purpose of the Study:

  • To review recent glycemia trials for CVD risk reduction in type 2 diabetes.
  • To describe how these findings impact current diabetes management approaches.

Main Methods:

  • Review of landmark trials including ACCORD, ADVANCE, and VADT.
  • Analysis of trial results concerning CVD events and mortality in type 2 diabetes patients.

Main Results:

  • Glycemic control goals for CVD risk reduction are complex and individualized.
  • Individualization should consider diabetes duration and presence of CVD or microvascular complications.

Conclusions:

  • ACCORD, ADVANCE, and VADT studies refined glycemia goal setting for type 2 diabetes.
  • Intensive glycemic control benefits newly diagnosed patients without CVD.
  • For established diabetes with CVD, intensive control does not reduce CVD events; comprehensive risk factor management is crucial.

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