Hormonal
Intensive glucose-lowering strategies in type 2 diabetes significantly reduce the risk of non-fatal myocardial infarction and microvascular complications (retinopathy, nephropathy) compared to standard therapy, but do not significantly reduce major adverse cardiovascular events (MACE) or all-cause mortality.
For people with Type 2 Diabetes, aiming for very low blood sugar levels (intensive control) is beneficial for protecting your eyes and kidneys, and may slightly reduce the risk of non-fatal heart attacks. However, it does not significantly reduce the risk of major heart events, stroke, or death compared to standard control. Therefore, intensive glucose lowering should be combined with aggressive management of blood pressure and lipids, rather than being the sole focus for heart health.
Intensive versus standard therapy reduced the risk of non-fatal myocardial infarction (HR 0.84; 95% CI 0.75-0.94) with no difference in the risk of major adverse cardiovascular events (HR 0.97; 95% CI 0.92-1.03)... Intensive versus standard therapy reduced the risk of retinopathy (HR 0.85; 0.78-0.93), nephropathy (HR 0.71; 0.58-0.87)...
Why this rating
Systematic review and meta-analysis of 11 RCTs with >50,000 patients, though downgraded due to open-label designs.
Source
Glycaemic control and macrovascular and microvascular outcomes: A systematic review and meta‐analysis of trials investigating intensive glucose‐lowering strategies in people with type 2 diabetes
Setor K. Kunutsor et al. · Diabetes Obesity and Metabolism · 2024
DOI 10.1111/dom.15511
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