Glycemic control and cardiovascular mortality

Purpose of reviewDiabetes mellitus is associated with several-fold increased risk of cardiovascular events, including death, yet whether treatment of hyperglycemia can reduce this risk remains controversial. Recent findingsEpidemiologic associations between hyperglycemia and cardiovascular risk have been confirmed and extended to levels below those diagnostic of diabetes. Long-term follow-up of treatment early in diabetes suggests benefits may lag 10 years or more after initiation of treatment. Intensive glycemic treatment of high-risk persons with current methods may increase short-term mortality. SummaryFurther analyses of existing data to define high-risk and lower-risk subgroups of patients may allow revision of treatment guidelines. Future studies may begin early in diabetes, require long-term follow-up, and use improved methods of treatment.

[1]  J. Shaw,et al.  Mortality, All-Cause and Cardiovascular Disease, Over 15 Years in Multiethnic Mauritius , 2010, Diabetes Care.

[2]  W. Ambrosius,et al.  Epidemiologic Relationships Between A1C and All-Cause Mortality During a Median 3.4-Year Follow-up of Glycemic Treatment in the ACCORD Trial , 2010, Diabetes Care.

[3]  D. Simons-Morton,et al.  Effect of Intensive Compared With Standard Glycemia Treatment Strategies on Mortality by Baseline Subgroup Characteristics , 2010, Diabetes Care.

[4]  Michael E. Miller,et al.  The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD study , 2010, BMJ : British Medical Journal.

[5]  Michael E. Miller,et al.  The effects of baseline characteristics, glycaemia treatment approach, and glycated haemoglobin concentration on the risk of severe hypoglycaemia: post hoc epidemiological analysis of the ACCORD study , 2010, BMJ : British Medical Journal.

[6]  Jiang He,et al.  Systematic Review: Glucose Control and Cardiovascular Disease in Type 2 Diabetes , 2009, Annals of Internal Medicine.

[7]  Thomas E. Moritz,et al.  Intensive glucose control and macrovascular outcomes in type 2 diabetes , 2009, Diabetologia.

[8]  S. Saydah,et al.  GHb Level and Subsequent Mortality Among Adults in the U.S. , 2009, Diabetes Care.

[9]  Shah Ebrahim,et al.  Fasting Blood Glucose and the Risk of Stroke and Myocardial Infarction , 2009, Circulation.

[10]  Grant D. Huang,et al.  Glucose control and vascular complications in veterans with type 2 diabetes. , 2009, The New England journal of medicine.

[11]  R. Holman,et al.  10-year follow-up of intensive glucose control in type 2 diabetes. , 2008, The New England journal of medicine.

[12]  Diederick Grobbee,et al.  Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. , 2008, The New England journal of medicine.

[13]  Michael E. Miller,et al.  Effects of intensive glucose lowering in type 2 diabetes. , 2008, The New England journal of medicine.

[14]  B. Zinman,et al.  Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. , 2005, The New England journal of medicine.

[15]  S. Schinner.  Effects of Intensive Glucose Lowering in Type 2 Diabetes , 2009 .

[16]  The Control Group.  Intensive glucose control and macrovascular outcomes in type 2 diabetes , 2009, Diabetologia.

[17]  H. Gerstein,et al.  Rationale, design, and baseline characteristics for a large international trial of cardiovascular disease prevention in people with dysglycemia: the ORIGIN Trial (Outcome Reduction with an Initial Glargine Intervention). , 2008, American heart journal.