Table 1.
Early major trials evaluating the effects of intensive glycemic control of diabetes
| Study | Diabetes type | CV composite | MI | CV mortality | All-cause mortality | ||||
|---|---|---|---|---|---|---|---|---|---|
| DCCT/EDIC (17,26,27) | Type 1 | ↔ | ↓ | — | — | — | — | ↔ | ↓ |
| UKPDS | Type 2 | ||||||||
| Main randomization (SU or insulin vs. conventional therapy) (18,28) | — | — | ↔ | ↓ | — | — | ↔ | ↓ | |
| Additional randomization of overweight patients (metformin vs. SU vs. conventional therapy) (19,28) | — | — | ↓* | ↓* | — | — | ↓* | ↓* | |
| ACCORD (20,30) | Type 2 | ↔ | ↔ | ↓ | ↔ | ↑ | ↑ | ↑ | ↔ |
| ADVANCE (21) | Type 2 | ↔† | ↔ | ↔ | ↔ | ||||
| VADT (22,29) | Type 2 | ↔ | ↓ | ↔ | ↔ | ↔ | ↔ | ↔ | ↔ |
Left columns show initial results; right columns show long-term follow-up. ↔, Neutral effect; ↓, decrease; ↑, increase; —, not assessed/reported; ADVANCE, Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation; SU, sulfonylurea. Adapted from Bergenstal et al. (97).
*Metformin group only.
†A decrease was reported in a combined CV/microvascular composite but was found to be mostly attributable to nephropathy.