Reduces Complications of DM2
The risk of nonfatal myocardial infarction was reduced by 17%, and coronary heart disease by 15%.
The reduction “gradual and safe” blood glucose is beneficial to reduce the serious complications of diabetes, including macro vascular events, according to a meta-analysis of five major studies (UKPDS, ADVANCE, ACCORD, VADT, and Proactive) with 33,040 patients conducted by an independent team of researchers from the UK and whose results are published in the journal The Lancet (2009; 373:1765-1772).
The assessment criteria assessed included cardiovascular nonfatal myocardial infarction, coronary heart disease (myocardial infarction, fatal and non fatal), stroke and mortality associated with type 2 diabetes. After five years of treatment, the level of glycated hemoglobin (HbA1c) media in patients who followed the intensive regimen of blood glucose was 0.9 percent lower than those receiving standard treatment.
The reduction was confirmed by a decrease of 17% of the risk of nonfatal myocardial infarction and a 15% reduction of coronary heart disease. However, the intensive treatment had no effect on stroke and not on mortality from other causes.
According to the analysis of the results of various clinical trials, patients of two of these studies, ACCORD and VADT, showed a higher mortality rate. Therefore, the reduction of macro vascular complications may be explained by the results of the ADVANCE study, where the goal of HbA1c were achieved more gradually and with less use of insulin.
Traditionally, an intensive blood glucose control was a risk twice more episodes of severe hypoglycemia and a difference in weight gain of 2.5 kilograms on average, compared with standard treatment. However, in the ADVANCE study there was no effect on weight. Furthermore, the use of glitazones is associated with increased risk of heart failure.
In short, as concluded Dr. Kausik K. Ray, the lead investigator in the light of results of meta-analysis, “is recommended as a clinical practice common sense HbA1c reduced in stages to avoid hypoglycemia, since reducing blood sugar gradually and safely, as was made in ADVANCE, is beneficial for reducing severe complications of diabetes, including macro vascular events.