In type 2 diabetes, there is evidence
that more intensive treatment of
glycemia in newly diagnosed patients
may reduce long-term CVD rates. During
the UKPDS trial, there was a 16%
reduction in CVD events (combined
fatal or nonfatal MI and sudden death)
in the intensive glycemic control
arm that did not reach statistical significance
(P 5 0.052), and there was
no suggestion of benefit on other
CVD outcomes (e.g., stroke). However,
after 10 years of follow-up, those originally
randomized to intensive glycemic
control had significant long-term
reductions in MI (15% with sulfonylurea
or insulin as initial pharmacotherapy,
33% with metformin as initial
pharmacotherapy) and in all-cause
mortality (13% and 27%, respectively)
(34).
In type 2 diabetes, there is evidencethat more intensive treatment ofglycemia in newly diagnosed patientsmay reduce long-term CVD rates. Duringthe UKPDS trial, there was a 16%reduction in CVD events (combinedfatal or nonfatal MI and sudden death)in the intensive glycemic controlarm that did not reach statistical significance(P 5 0.052), and there wasno suggestion of benefit on otherCVD outcomes (e.g., stroke). However,after 10 years of follow-up, those originallyrandomized to intensive glycemiccontrol had significant long-termreductions in MI (15% with sulfonylureaor insulin as initial pharmacotherapy,33% with metformin as initialpharmacotherapy) and in all-causemortality (13% and 27%, respectively)(34).
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