Here comes another proof that intensive glycemic control in type II Diabetics does not reduce Vascular events
NEJM just published Duckworth et al. study that gives more evidence to to what UKPDS showed intensive gylcemic control does not reduce macrovasluar events. But, Duckworth et al. participants also had no reduction in microvascular events! yet there are two points worth noting:
1. Duckworth et al. started with mean 11.5 years type II diabetics how had A1c of 9.4 +/- 2.0. These participants were mean 60.4 years old military veterans. 40% already had a cardiovascular event.
2. Average A1c after intervention was 8.4% in the standard therapy group and 6.9% in the intensive therapy group.
My patients are quite similar to Dunckworth et al. patients. I should start sparing my patients the grief of a seemingly impossible goal (A1c < 7 %).
NEJM — Glucose Control and Vascular Complications in Veterans with Type 2 Diabetes
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