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- W2129013602 abstract "One of the central issues in the treatment of patients with diabetes is whether tight glycemic control will reduce Cardiovascular Disease (CVD) morbidity and mortality. The Diabetes control and complications trial (DCCT) conclusively showed that the greater the average blood glucose in patients with type 1 diabetes, the greater the risk of developing neuropathy, retinopathy and nephropathy. 1 The Diabetes control and complications trialEpidemiology of Diabetes Interventions Complications (DCCTEDIC) trial showed that a history of tight glycemic control significantly reduces the rate of CVD. 2 Data from the Stockholm diabetes intervention study indicated that, in patients with type 1 diabetes, tight control retards the development of atherosclerosis as measured by the development of carotid intima – media thickening. 3 In the United Kingdom Prospective Diabetes Study (UKPDS), a comparison between an intensive treatment group and a conventional treatment group demonstrated a 16% reduction in the risk of fatal and non fatal MI (p=0.052), but all cause mortality did not differ between the two groups. 4 The 10 years follow up of the UKPDS trial showed a reduction of 15% in myocardial events and 13% of death from any cause. 5 While The Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) study concluded that lowered HbA1c value to 6.5% yielded a 10% relative reduction in the combined outcome of major macrovascular and microvascular events primarily as a consequence of a 21% relative reduction in nephropathy. 6 The study also showed no significant effects of the type of glucose control on major macrovascular events (p=0.32), death from cardiovascular causes (p=0.12) or death from any cause (p =0.28). In the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, the mean baseline for HbA1c in the intensive therapy group was 8.3+ 1.1%, while it was 8.3+1.1% in the standard group therapy. 7 During the follow up period, (mean of 5.6 years) the study asked whether a therapeutic strategy targeting normal HbA1c of 6.5% would reduce the rate of cardiovascular events with strategy targeting HbA1c on the range of 7-7.9% in the middle aged and older patients with type 2 diabetes. The investigators in the study concluded that intensive therapeutic" @default.
- W2129013602 created "2016-06-24" @default.
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- W2129013602 date "2010-07-01" @default.
- W2129013602 modified "2023-09-23" @default.
- W2129013602 title "Glycemic Control in Diabetes" @default.
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- W2129013602 doi "https://doi.org/10.5001/omj.2010.65" @default.
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