ACCORD Follow-Up: Intensive Glycemic Control Has Neutral Long-Term Effect

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Long-term follow-up from ACCORD shows that intensive glycemic control has a neutral effect on death and CV events.
Long-term follow-up from ACCORD shows that intensive glycemic control has a neutral effect on death and CV events.

(HealthDay News) — During long-term follow-up, the impact of a 4-year period of intensive glycemic control has a neutral effect on death and nonfatal cardiovascular events, according to a study published in Diabetes Care.

Hertzel C. Gerstein, MD, from McMaster University and Hamilton Health Sciences in Canada, and colleagues examined the long-term effects of intensive glycemic control in type 2 diabetes as part of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. 

Data were included for 8601 patients, representing 98% of those who did not suffer a primary outcome or death during the ACCORD trial, and who were treated in the follow-on study according to their health care provider's judgment. 

Participants were followed for a median of 8.8 years and a mean of 7.7 years from randomization.

The researchers found that a mean of 3.7 years of intensive glucose lowering had a neutral long-term effect on the primary composite outcome (nonfatal myocardial infarction, nonfatal stroke, or cardiovascular disease), death from any cause, and an expanded composite outcome that included all-cause death. There was also a decrease in the risk for cardiovascular mortality (hazard ratio=1.20), which was noted during the active phase.

"In high-risk people with type 2 diabetes monitored for 9 years, a mean of 3.7 years of intensive glycemic control had a neutral effect on death and nonfatal cardiovascular events but increased cardiovascular-related death," the researchers wrote.

Several authors disclosed financial ties to the biopharmaceutical industry; several pharmaceutical companies provided study medications, equipment, or supplies during ACCORD.

Reference

  1. The ACCORD Study Group Writing Committee. 9-Year Effects of 3.7 Years of Intensive Glycemic Control on Cardiovascular Outcomes. Diabetes Care. 2016. doi:10.2337/dc15-2283.
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