Hormonal
Intensive glucose lowering treatment reduces the risk of non-fatal myocardial infarction and microalbuminuria, but these benefits disappear when restricted to high-quality double-blind trials.
While intensive glucose lowering might slightly reduce the risk of non-fatal heart attacks or early kidney signs (microalbuminuria), this benefit is not robust enough to be seen in the most rigorous studies. Given the increased risk of dangerous low blood sugar, these marginal gains may not be worth the trade-off for many patients.
Intensive therapy was, however, associated with reductions in the risk of non-fatal myocardial infarction (0.85, 0.74 to 0.96, P<0.001), and microalbuminuria (0.90, 0.85 to 0.96, P<0.001)... In analysis restricted to high quality studies (Jadad score >3), intensive treatment was not associated with any significant risk of reductions
Why this rating
Meta-analysis of 13 RCTs, but sensitivity analysis on high-quality studies negates the primary finding of benefit.
Source
Effect of intensive glucose lowering treatment on all cause mortality, cardiovascular death, and microvascular events in type 2 diabetes: meta-analysis of randomised controlled trials
Rémy Boussageon et al. · BMJ · 2011
DOI 10.1136/bmj.d4169
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