Intensive glycemic control and cardiovascular disease: an update

Related Experiment Video

Updated: Jun 13, 2026

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
10:03

A Zebrafish Model of Diabetes Mellitus and Metabolic Memory

Published on: February 28, 2013

Aparna Brown1, L Raymond Reynolds, Dennis Bruemmer

  • 1Division of Endocrinology and Molecular Medicine, University of Kentucky, Wethington Building, Room 575, 900 South Limestone Street, Lexington, KY 40536-0200, USA.

Nature Reviews. Cardiology
|April 21, 2010
PubMed

Insights

Intensive glycemic control prevents microvascular complications in diabetes. However, its effect on major cardiovascular events is debated, with some studies showing benefits and others suggesting no effect or harm.

Area of Science:

  • Endocrinology
  • Cardiology
  • Diabetes Research

Background:

  • Cardiovascular complications are the leading cause of death in diabetic patients.
  • Intensive glycemic control is proven to prevent microvascular complications in type 1 and type 2 diabetes.
  • The impact of intensive glucose lowering on macrovascular disease and cardiovascular events remains uncertain.

Purpose of the Study:

  • To discuss the effects of intensive glycemic control on cardiovascular disease.
  • To examine trial design differences that may explain disparate findings on cardiovascular outcomes.
  • To highlight current recommendations on intensive glycemic control for cardiovascular disease prevention.

Main Methods:

  • Review of findings from major diabetes trials, including DCCT, UKPDS, ACCORD, ADVANCE, and VADT.
  • Analysis of extended follow-up data on cardiovascular events.
  • Examination of trial design elements and patient populations.

Main Results:

  • Extended follow-up of DCCT and UKPDS indicated intensive glycemic control reduced long-term cardiovascular events.
  • ACCORD, ADVANCE, and VADT suggested intensive glycemic control to near-normoglycemia had no, or potentially detrimental, effects on cardiovascular outcomes.
  • Discrepancies in findings may stem from differences in trial design, patient characteristics, and intervention durations.

Conclusions:

  • The effect of intensive glycemic control on macrovascular complications and cardiovascular events is complex and debated.
  • Differences in trial methodologies may explain conflicting results regarding cardiovascular outcomes.
  • Current guidelines emphasize a balanced approach to glycemic control, considering individual patient risk factors for cardiovascular disease.

More Related Videos

Improving IV Insulin Administration in a Community Hospital12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Related Concept Videos

Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Complications of Diabetes Mellitus01:22

Complications of Diabetes Mellitus

Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin deficiency, resistance, or both. Prolonged hyperglycemia disrupts metabolic homeostasis and leads to acute and chronic complications.Acute ComplicationsAcute complications result from sudden metabolic imbalance.Diabetic ketoacidosis (DKA) mainly appears in type 1 diabetes but may also develop in type 2 diabetes, particularly under extreme stress. It arises from severe insulin deficiency,...
Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and narrowing...