The Fats of Life in Diabetes
The Fats of Life in Diabetes
There is a long-standing debate about the role of glycaemic control in CVD risk reduction. The original evidence from UKPDS is that reducing blood glucose from an HbA1C of 9% to 8% will translate into CVD benefit on CVD events and eventually mortality. This is seen and proven first for metformin but also applies, though less strongly, to sulfonylureas. Further reduction in HbA1C as explored in the ACCORD and ADVANCE studies with mostly oral hypoglycaemic drugs and lately confirmed in the ORIGIN trial with insulin adds little and may increase CVD events in some cases.
Glycaemic Control and CVD in Diabetes
There is a long-standing debate about the role of glycaemic control in CVD risk reduction. The original evidence from UKPDS is that reducing blood glucose from an HbA1C of 9% to 8% will translate into CVD benefit on CVD events and eventually mortality. This is seen and proven first for metformin but also applies, though less strongly, to sulfonylureas. Further reduction in HbA1C as explored in the ACCORD and ADVANCE studies with mostly oral hypoglycaemic drugs and lately confirmed in the ORIGIN trial with insulin adds little and may increase CVD events in some cases.
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