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Randomised controlled trial
Intensive glucose lowering (HbA1c target<6.0%) for people with type 2 diabetes increases mortality
  1. Jonathan E Shaw
  1. Baker IDI Heart and Diabetes Institute, Department of Clinical Diabetes and Epidemiology, Melbourne, Australia
  1. Correspondence to Jonathan E Shaw
    Baker IDI Heart and Diabetes Institute, Department of Clinical Diabetes and Epidemiology, Level 4 99 Commercial Road Melbourne VIC 3004, Australia; jonathan.shaw{at}bakeridi.edu.au

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Context

The Action to Control Cardiovascular Risk in Diabetes (ACCORD)trial attempted to address the uncertainty that exists over whether intensively lowering blood glucose can reduce the significant excess of cardiovascular risk in people with type 2 diabetes. The trial was stopped after 3.5 years, because of an excess of deaths in the intensive glycaemia arm.1 The ACCORD investigators have now reported outcomes from an extended follow-up.

Methods

The ACCORD trial recruited 10 251 patients with inadequately controlled type 2 diabetes (haemoglobin A1c (HbA1c)>7.5%) in the USA and Canada. Participants were aged 40–79 with either prior cardiovascular disease (CVD) or with CVD risk factors, had a mean diabetes duration of 10 years, and were randomised to either intensive blood glucose control (HbA1c target<6%) or standard control (HbA1c target 7.0–7.9%), to be …

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