Table 1.
Landmark Clinical Trials of Glycemic Targets in Patients With Diabetes
| Study | Study Population | Study Arms | Achieved HbA1c, % | Outcomes |
|---|---|---|---|---|
| DCCT and EDIC studies27,30 | Type 1 diabetes | Intensive Fasting glucose 70–1 Post-meal glucose <180 mg/dL HbA1c <6.05% Conventional No target |
7.4 versus 9.1 7.9 versus 7.3 |
↓Microvascular disease ↓CV disease |
| UKPDS and post-trial follow-up studies28,31 | Newly diagnosed type 2 diabetes | Intensive Insulin or sulfonylurea § metformin Conventional No target |
7.0 versus 7.9 | ↓ Microvascular disease ↓CV disease/death(post-trial) |
| ACCORD trial32 | Type 2 diabetes + CV disease or CV risk factors | Intensive HbA1c <6.0% Standard HbA1c 7% to 9% |
6.4 versus 7.5 | ↑ CV events |
| ADVANCE trial33 | Type 2 diabetes + macrovascular/microvascular + vascular risk factors |
Intensive HbA1c ≤6.5% Standard Local guidelines |
6.5 versus 7.3 | No difference in CV outcomes |
| Veterans Affairs diabetes trial34 | Type 2 diabetes | Intensive –HbA1c <6.0% –Standard –HbA1c <9.0% |
6.9 versus 8.4 | No difference in CV outcomes |
Abbreviations: ACCORD, Action to Control Cardiovascular Risk in Diabetes; ADVANCE, Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation; CV, cardiovascular; DCCT, Diabetes Control and Complications Trial; EDIC, Epidemiology of Diabetes Interventions and Complications; HbA1c, glycated hemoglobin; UKPDS, United Kingdom Prospective Diabetes Study.