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The effect of intensive glycaemic control on cardiovascular outcomes

D Hill1, M Fisher

  • 1Department of Diabetes, Wishaw General Hospital, Wishaw, UK.

Diabetes, Obesity & Metabolism
|July 2, 2010
PubMed

Insights

Intensive glycaemic control improves diabetes outcomes, reducing cardiovascular events. Early, steady blood sugar management in type 2 diabetes is key to reducing mortality.

Area of Science:

  • Endocrinology
  • Cardiology
  • Metabolic Diseases

Background:

  • The link between blood glucose levels (glycaemia) and cardiovascular disease (CVD) in diabetes is debated.
  • Previous trials like the Diabetes Control and Complications Trial (DCCT) and United Kingdom Prospective Diabetes Study (UKPDS) showed benefits of intensive glycaemic control.

Purpose of the Study:

  • To evaluate the impact of intensive glycaemic control on microvascular and macrovascular outcomes in patients with type 1 and type 2 diabetes.
  • To synthesize findings from multiple major diabetes trials regarding glycaemic control strategies.

Main Methods:

  • Review and synthesis of findings from key clinical trials including DCCT, UKPDS, Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE), and Action to Control Cardiovascular Risk in Diabetes (ACCORD).

Main Results:

  • Intensive glycaemic control demonstrated microvascular benefits in DCCT and UKPDS, with macrovascular event reduction observed on long-term follow-up.
  • ADVANCE showed microvascular benefits, while ACCORD indicated potential harm (weight gain, hypoglycaemia, mortality) with rapid intensive control.
  • Collectively, studies suggest slow, steady intensive glycaemic control improves outcomes.

Conclusions:

  • Gradual, intensive glycaemic control is beneficial for managing diabetes and improving cardiovascular outcomes.
  • Initiating intensive glycaemic control early in type 2 diabetes management is crucial for reducing mortality.

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