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  • Intensive glucose-lowering results in increased cardiovascular mortality in younger but not older individuals with type 2 diabetes

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Therapeutics
Post hoc analysis of RCT
Intensive glucose-lowering results in increased cardiovascular mortality in younger but not older individuals with type 2 diabetes
  1. Francesco Giorgino
  1. Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Piazza Giulio Cesare, 11, Bari 70124, Italy; francesco.giorgino@uniba.it

https://doi.org/10.1136/ebmed-2014-110010

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    Commentary on: Miller ME, Williamson JD, Gerstein HC, et al.; ACCORD Investigators. Effects of randomization to intensive glucose control on adverse events, cardiovascular disease, and mortality in older versus younger adults in the ACCORD Trial. Diabetes Care 2014;37:634–43.OpenUrlAbstract/FREE Full Text

    Context

    The glycaemic portion of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial showed that an intensive glucose-lowering strategy may increase overall and cardiovascular (CV) mortality, as compared with a standard management.1 However, it is unclear whether age may influence the effects of intensive glycaemic control. Answering this question is of particular relevance since: (1) diabetes prevalence in individuals over 65 years is increasing; (2) the characteristics of diabetes in the elderly may differ from those in younger patients and (3) limited information is available in the elderly population since it is poorly represented in most diabetes trials.

    Methods

    This is a retrospective subgroup analysis on the ACCORD trial dataset, assessing the …

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    Footnotes

    • Competing interests None.

    • Provenance and peer review Commissioned; internally peer reviewed.