New analysis confirms benefits for type 2 diabetes

Following the recent release of three major studies into the management of type 2 diabetes there has been uncertainty into the effects of tight glucose control among patients, particularly regarding the prevention of heart attack and stroke.

However, a new meta-analysis of four studies: ADVANCE, ACCORD, VADT and UKPDS, has confirmed that intensive blood glucose (sugar) control protects patients with type 2 diabetes against major cardiovascular events, such as heart attack and stroke. The findings, which have been published in the international journal, Diabetologia demonstrate that patients could benefit from a 15% reduction in the risk of a heart attack.

The aim of this new analyses was to generate more precise estimates of the effects of more-intensive, compared with less-intensive, glucose control on the risk of major cardiovascular events amongst patients with type 2 diabetes.

Diabetes mellitus is one of the greatest threats to the health of populations worldwide. Globally, there are approximately 250 million people with diabetes and that number is estimated to rise to 380 million in 2025.

Researchers point out that patients without a history of heart disease appear to derive greater benefits compared to those patients who have already experienced heart complications. While the results showed an increased risk of hypoglycaemia (very low blood sugar levels) with intensive control, there was no evidence of increased risk in mortality (as had been seen with ACCORD). However, researchers suggest that glucose lowering regimens should be tailored to the individual patient.

ADVANCE was initiated and designed by The George Institute and involved a group of independent medical researchers from 20 countries worldwide. The study involved 11,140 patients with type 2 diabetes who were treated and followed up for five years. When combined with the other three major research studies, this meta-analysis was able to assess a total of 27,049 participants. It is hoped that these results will not only provide reassurance to clinicians and patients about the value of lowering glucose but also inform type 2 diabetes guidelines to improve management and prevent complications for the millions of patients worldwide.