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Therapeutics
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

https://doi.org/10.1136/ebmed-2011-100035

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    Commentary on: ACCORD Study Group, Gerstein HC, Miller ME, et al. Long-term effects of intensive glucose lowering on cardiovascular outcomes. N Engl J Med 2011;364:818–28.OpenUrlCrossRefPubMed

    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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    Footnotes

    • Competing interests J Shaw has received lecturing fees, travel support and consultancy fees from Merck, Novartis, Pfizer, Novo Nordisk, Eli Lilly, Sanofi Aventis, Boehringer Ingelheim, Astra Zeneca, Bristol Myer Squibb.