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Myths in the treatment of type 2 diabetes: an alternative viewpoint based on randomized controlled trials

Matthew T Wade1, Joseph P Rindone

  • 1Clinical Pharmacy Section, Northern Arizona VA Health Care System, 500 N Hwy 89, Prescott, Arizona 86313.

American Journal of Therapeutics
|January 21, 2011
PubMed

Insights

Randomized trials question common type 2 diabetes (T2DM) treatments. Self-monitoring, glucose control, triglyceride reduction, aggressive hypertension management, and aspirin therapy show questionable benefits and potential harm.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Clinical Trials

Background:

  • Type 2 diabetes mellitus (T2DM) management involves numerous interventions.
  • Recent randomized control trials (RCTs) raise concerns about the efficacy and safety of these therapies.

Purpose of the Study:

  • To review RCT evidence on common T2DM therapeutic interventions.
  • To evaluate the effectiveness and safety of these treatments based on hard endpoints.

Main Methods:

  • Systematic review of RCTs, excluding meta-analyses and ad hoc analyses.
  • Focused on trials concerning self-monitoring of blood glucose, hyperglycemia treatment, triglyceride reduction, aggressive hypertension management, and aspirin therapy.

Main Results:

  • Evidence suggests self-monitoring of blood glucose offers questionable value in T2DM.
  • Lowering blood glucose, reducing triglycerides, aggressive hypertension treatment, and aspirin therapy demonstrate questionable benefits and potential harm.
  • Most T2DM therapies reviewed show questionable value based on RCT data.

Conclusions:

  • Current common therapies for T2DM, including glucose control and aspirin, may not be beneficial and could be harmful.
  • The medical community needs to re-evaluate the clinical utility of widely used T2DM management strategies.

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