Our analyses did not show any statistically significant reduction in either death from any cause or death from heart disease when targeting intensive glycaemic control compared with conventional control. Intensive glycaemic control seemed to reduce the risk of non-fatal myocardial infarction, amputation of a lower extremity, and microvascular complications while increasing the risk of severe adverse events and hypoglycaemia. Targeting intensive glycaemic control did not appear to change the risk of non-fatal stroke, cardiac revascularization (a procedure to reconstruct damaged heart blood vessels), and peripheral revascularization. Health-related quality of life did not differ significantly when comparing targeting intensive with conventional glycaemic control.
There is a need for more powerful RCTs with low risk of bias to guide the choice of targeting intensive versus conventional glycaemic control in patients with T2D.
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