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Intensive glycemic control and macrovascular events in type 2 diabetes mellitus: a meta-analysis of randomized

Hong Wu1, Mao-jin Xu, Da-jin Zou

  • 1Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai, China.

Chinese Medical Journal
|November 2, 2010
PubMed
Abstract

Insights

Intensive glucose control in type 2 diabetes significantly reduces major macrovascular events. However, this approach showed no impact on overall or cardiovascular mortality compared to conventional control.

Area of Science:

  • Endocrinology
  • Cardiology
  • Metabolic Diseases

Background:

  • Disagreement exists on intensive glucose control's effect on macrovascular events in type 2 diabetes.
  • Meta-analysis needed to compare intensive vs. conventional glucose control in randomized trials.

Purpose of the Study:

  • To compare the incidence of major macrovascular events in patients with type 2 diabetes under intensive glucose control versus conventional glucose control.

Main Methods:

  • Systematic search of multiple databases (MEDLINE, EMBASE, Cochrane, Science Citation Index).
  • Inclusion of six randomized controlled trials involving 28,065 patients.
  • Primary outcome measure: incidence of major macrovascular events.

Main Results:

  • Intensive glucose treatment significantly decreased the incidence of major macrovascular events (RR 0.92; 95%CI 0.87, 0.98; P = 0.005).
  • No significant differences observed in all-cause mortality (RR 0.95; 95%CI 0.80, 1.12; P = 0.55).
  • No significant differences observed in cardiovascular death incidence (RR 1.10, 95%CI 0.79, 1.53; P = 0.57).

Conclusions:

  • Achieving normal or near-normal glycemia in type 2 diabetes effectively reduces major macrovascular events.
  • Intensive glucose control strategies did not show significant differences in all-cause or cardiovascular mortality compared to conventional strategies.

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