Related Experiment Video

Updated: Dec 2, 2025

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

26.3K

Intensive Risk Factor Management and Cardiovascular Autonomic Neuropathy in Type 2 Diabetes: The ACCORD Trial

Yaling Tang1,2, Hetal Shah1,2, Carlos Roberto Bueno Junior1

  • 1Research Division, Joslin Diabetes Center, Boston, MA.

Diabetes Care
|November 4, 2020
PubMed
Abstract

Insights

Intensive treatment of hyperglycemia and hypertension significantly reduces cardiovascular autonomic neuropathy (CAN) risk in type 2 diabetes (T2D). Intensive glucose control benefits those without prior cardiovascular disease (CVD), while intensive blood pressure management aids older adults.

Area of Science:

  • Cardiology
  • Endocrinology
  • Diabetology

Background:

  • Cardiovascular autonomic neuropathy (CAN) is a complication of type 2 diabetes (T2D).
  • The effectiveness of interventions targeting traditional risk factors for CAN is not well-established.
  • The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial investigated intensive risk factor management in T2D.

Purpose of the Study:

  • To evaluate the impact of intensive risk factor management on CAN in individuals with T2D and high cardiovascular risk.
  • To determine if intensive glucose, blood pressure, or lipid control affects the development or progression of CAN.

Main Methods:

  • Analysis of data from 7,275 participants in the ACCORD trial with CAN evaluations.
  • CAN was defined by heart rate variability indices below the 5th percentile.
  • Generalized linear mixed models were used to analyze the effects of intensive interventions on CAN risk.

Main Results:

  • Intensive glucose treatment reduced CAN risk by 16% (OR 0.84, P=0.003), particularly in those without baseline CVD.
  • Intensive blood pressure intervention decreased CAN risk by 25% (OR 0.75, P=0.001), especially in patients aged 65 and older.
  • Fenofibrate treatment did not show a significant effect on CAN risk (OR 0.91, P=0.26).

Conclusions:

  • Intensive glycemic therapy and intensive blood pressure control are beneficial for preventing CAN in T2D.
  • Patients with T2D and no prior CVD history particularly benefit from intensive glucose control for CAN prevention.
  • Intensive BP management shows significant benefits for CAN prevention, especially in older T2D patients.

More Related Videos

Author Spotlight: Integrating Tai Chi with Mindfulness Training to Achieve an Effective Mind-Body Exercise05:06

Author Spotlight: Integrating Tai Chi with Mindfulness Training to Achieve an Effective Mind-Body Exercise

Published on: July 14, 2023

2.2K
Mouse Electroacupuncture Fixation Device Fabrication for Electroacupuncture Pretreatment in Diabetic Cardiomyopathy Mouse Model05:58

Mouse Electroacupuncture Fixation Device Fabrication for Electroacupuncture Pretreatment in Diabetic Cardiomyopathy Mouse Model

Published on: April 18, 2025

466

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...
746
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
701
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...
4.0K
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...
212
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
142
Atherosclerosis IV: Nursing Management01:23

Atherosclerosis IV: Nursing Management

Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
200