Table 3.

T2DM and CVD Risk Reduction: Lessons from ADVANCE, ACCORD, VADT, and UKPDS

Avoid hypoglycemia; severe hypoglycemia associated with mortality, regardless of treatment

Achieve lower glycemic levels earlier to prevent microvascular complications

In early diabetes without advanced CVD, use more extensive glycemic control for modest CVD risk reduction (e.g., target HbA1c ≤6.5%?)

Aim to achieve lipid and blood pressure goals; use antiplatelet therapy and promote smoking cessation

Individualize glucose goals for patients with advanced CVD (treat other established cardiovascular risk factors, with more flexible HbA1c goal)

T2DM, type 2 diabetes; CVD, cardiovascular disease; ADVANCE, Action in Diabetes and Vascular Disease—Preterax and Diamicron Modified Release Controlled Evaluation; ACCORD, Action to Control Cardiovascular Risk in Diabetes; VADT, Veterans Affairs Diabetes Trial; UKPDS, United Kingdom Prospective Diabetes Study; HbA1c, glycosylated hemoglobin.