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Neutral Long-Term Effect for Intensive Glycemic Control

Follow-up of patients from ACCORD trial shows neutral effect on primary composite outcome

diabetes monitor

WEDNESDAY, Feb. 3, 2016 (HealthDay News) -- During long-term follow-up, the impact of a four-year period of intensive glycemic control has a neutral effect on death and nonfatal cardiovascular events, according to a study published online Jan. 28 in Diabetes Care.

Hertzel C. Gerstein, M.D., from McMaster University and Hamilton Health Sciences in Canada, and colleagues examined the long-term effects of intensive glycemic control in type 2 diabetes as part of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Data were included for 8,601 patients, representing 98 percent of those who did not suffer a primary outcome or death during the ACCORD trial, and who were treated in the follow-on study according to their health care provider's judgment. Participants were followed for a median of 8.8 years and a mean of 7.7 years from randomization.

The researchers found that a mean of 3.7 years of intensive glucose lowering had a neutral long-term effect on the primary composite outcome (nonfatal myocardial infarction, nonfatal stroke, or cardiovascular disease), death from any cause, and an expanded composite outcome that included all-cause death. There was also a decrease in the risk of cardiovascular mortality (hazard ratio, 1.20), which was noted during the active phase.

"In high-risk people with type 2 diabetes monitored for nine years, a mean of 3.7 years of intensive glycemic control had a neutral effect on death and nonfatal cardiovascular events but increased cardiovascular-related death," the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry; several pharmaceutical companies provided study medications, equipment, or supplies during ACCORD.

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