Hormonal
Intensive glycaemic control in type 2 diabetes does not reduce all-cause or cardiovascular mortality compared to conventional control, but significantly increases the risk of severe hypoglycaemia.
For Type 2 Diabetes, aggressively lowering blood sugar to very low targets (like <6.0%) does not extend life and significantly increases the risk of severe hypoglycaemia. Standard guidelines (HbA1c <7.0%) are generally safer and equally effective for mortality prevention compared to intensive targets.
Intensive glycaemic control does not seem to reduce all cause mortality in patients with type 2 diabetes... Intensive glycaemic control increases the relative risk of severe hypoglycaemia by 30%.
Why this rating
Systematic review of 14 RCTs with 28,614 participants, though trial sequential analysis indicated insufficient evidence for some secondary outcomes.
Source
Intensive glycaemic control for patients with type 2 diabetes: systematic review with meta-analysis and trial sequential analysis of randomised clinical trials
Bianca Hemmingsen et al. · BMJ · 2011
DOI 10.1136/bmj.d6898
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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