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ADA: Intensive Glucose Control Not Beneficial in CVD

No significant reduction in cardiovascular disease events observed in diabetic, high-risk veterans

MONDAY, June 9 (HealthDay News) -- In U.S. veterans with type 2 diabetes and multiple risk factors for heart attacks and strokes, intensive glucose control results in a non-significant reduction of subsequent cardiovascular disease events, according to research presented this week at the American Diabetes Association's 68th Annual Scientific Sessions in San Francisco.

Carlos Abraira, M.D., of the Miami VA Medical Center and the University of Miami Miller School of Medicine, and colleagues from the VA Diabetes Trial randomly assigned 1,791 veterans (average age 60, 97 percent male) to receive either standard glucose control therapy or intensive glucose control therapy. At the study's outset, all of the subjects had already failed simple therapy, 40.4 percent had experienced prior cardiovascular disease events, 80 percent were hypertensive, more than 50 percent had lipid abnormalities, and most were obese.

After an average follow-up of 6.25 years, the researchers found that the intensive therapy group had lower mean A1C than the standard therapy group (6.9 percent versus 8.4 percent) and that both groups had significantly reduced their cardiovascular disease risk factors. But there were no significant group differences in the primary endpoint -- a composite of cardiovascular disease events -- with 231 such events occurring in the intensive therapy group compared to 263 in the standard therapy group.

"We had significantly fewer cardiovascular disease events in both groups than predicted," William C. Duckworth, M.D., of the Carl T. Hayden VA Medical Center in Phoenix, a study co-author, said in a statement. "Based on historical studies, we believe this was largely due to the excellent blood pressure control, lipid control, improved diet and exercise, and treatment with aspirin. Both our intensive and control groups reduced their blood pressure levels to a mean of 127/70 mm Hg, and both improved lipid control to near or at American Diabetes Association guidelines."

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