PMID- 19898642
OWN - NLM
STAT- MEDLINE
DCOM- 20100114
LR  - 20221207
IS  - 1178-2048 (Electronic)
IS  - 1176-6344 (Print)
IS  - 1176-6344 (Linking)
VI  - 5
DP  - 2009
TI  - Cardiovascular disease and intensive glucose control in type 2 diabetes mellitus: 
      moving practice toward evidence-based strategies.
PG  - 859-71
AB  - Type 2 diabetes mellitus (T2DM) is associated with a high risk of complications, 
      essentially macrovascular events. Surprisingly, the effect of improved glucose 
      control on coronary and cerebrovascular complications and the target level of 
      glycated hemoglobin (HbA(1c)) in this population remains questionable. We here 
      report the results of 4 recently published randomized controlled trials (ACCORD, 
      ADVANCE, VADT, UKPDS post-trial), which did not demonstrate a significant 
      reduction of cardiovascular events in the intensive group compared to the 
      standard group. On the contrary, in ACCORD, the study with the most ambitious 
      goal (HbA(1c) < 6%), the overall and cardiovascular mortality was greater in the 
      intensive group, although the risk of microangiopathic complications, especially 
      nephropathy, was significantly decreased. VADT suggests that one possibility for 
      the lack of observed effect of intensive therapy could be that the cardiovascular 
      benefit is delayed. This contrasts strongly with the long-term postintervention 
      outcomes of UKPDS, which show a persistent benefit of glycemic control during 10 
      years of post-trial follow-up ('legacy effect'). Therefore, the best way to 
      protect patients with T2DM against coronary and cerebrovascular disease is to 
      target all cardiovascular risk factors as early as possible by an individualized 
      approach.
FAU - Meier, Matthias
AU  - Meier M
AD  - Clinic for Hypertension and Nephrology, Hannover, Germany. kfnh_hannover@web.de
FAU - Hummel, Michael
AU  - Hummel M
LA  - eng
SI  - ISRCTN/ISRCTN75451837
SI  - ClinicalTrials.gov/NCT00000620
SI  - ClinicalTrials.gov/NCT00032487
SI  - ClinicalTrials.gov/NCT00145925
PT  - Journal Article
PT  - Review
DEP - 20091102
PL  - New Zealand
TA  - Vasc Health Risk Manag
JT  - Vascular health and risk management
JID - 101273479
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
MH  - Aged
MH  - Antihypertensive Agents/therapeutic use
MH  - Blood Glucose/*drug effects
MH  - Blood Pressure/drug effects
MH  - Cardiovascular Diseases/blood/etiology/mortality/physiopathology/*prevention & 
      control
MH  - Diabetes Mellitus, Type 2/blood/complications/*drug 
      therapy/mortality/physiopathology
MH  - Diabetic Angiopathies/blood/etiology/mortality/physiopathology/*prevention & 
      control
MH  - Drug Therapy, Combination
MH  - Evidence-Based Medicine
MH  - Glycated Hemoglobin/*metabolism
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Middle Aged
MH  - Practice Guidelines as Topic
MH  - Randomized Controlled Trials as Topic
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC2773745
OTO - NOTNLM
OT  - ACCORD
OT  - ADVANCE
OT  - UKPDS post-trial
OT  - VADT
OT  - cardiovascular
OT  - glycemic control
EDAT- 2009/11/10 06:00
MHDA- 2010/01/15 06:00
PMCR- 2009/11/02
CRDT- 2009/11/10 06:00
PHST- 2009/10/16 00:00 [received]
PHST- 2009/11/10 06:00 [entrez]
PHST- 2009/11/10 06:00 [pubmed]
PHST- 2010/01/15 06:00 [medline]
PHST- 2009/11/02 00:00 [pmc-release]
AID - vhrm-5-859 [pii]
AID - 10.2147/vhrm.s4808 [doi]
PST - ppublish
SO  - Vasc Health Risk Manag. 2009;5:859-71. doi: 10.2147/vhrm.s4808. Epub 2009 Nov 2.