By Colin Kenny, Editor – Diabetes Distilled
Investigators analysed a subset of people living with type 2 diabetes and pre-existing cardiovascular disease (CVD) to see whether intensive glucose control, versus standard of care, improved cardiovascular outcomes. Their literature review concluded that there was no difference in the risk of cardiovascular events in adults with type 2 diabetes and CVD allocated to intensive glucose control compared with those in the standard care.
Studies examining the role of intensive glucose control in people with type 2 diabetes and pre-existing CVD have been controversial, due to lack of homogeneity in trial participants. The investigators found eight trials that met the study inclusion and exclusion criteria. These trials included data on 32,067 participants whose ages ranged from 53 to 66 years, of which 8,339 had both diabetes and established CVD. Participants who were newly-diagnosed with diabetes were compared to those with established diabetes, and data on those with tighter versus less stringent glucose control.
The investigators concluded that both intensive and standard glycaemic control had a neutral effect on CVD outcomes in people with diabetes and pre-existing CVD. They also found that intensive control made no difference if the diabetes was newly diagnosed or established. These data do, however, help to diminish prior concerns voiced about cardiovascular safety with intensive control in this subgroup of patients.
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