Hormonal
Intensive glycemic control reduces cardiovascular mortality only in patients with early-stage diabetes (duration <10-15 years), whereas it may increase mortality in patients with long-standing diabetes.
If you have had Type 2 Diabetes for many years (over 10), aiming for very low blood sugar levels might actually increase your risk of death due to side effects like severe hypoglycemia. Focus on stable control rather than aggressive lowering. If you have recently been diagnosed, aggressive control can provide long-term 'legacy' protection for your heart.
the impact of intensive glycemic control on mortality in these two studies was diametrically opposite, i.e., positive in the UKPDS follow-up... and negative in the ACCORD trial... The hypothesis that the mortality benefit of intensive glucose lowering is restricted to subjects with early diabetes is further substantiated by a stratified analysis from Veteran’s Affairs Diabetes Trial (VADT) follow-up study
Why this rating
Supported by multiple large CVOTs (UKPDS, ACCORD, VADT, DCCT/EDIC) showing divergent mortality outcomes based on duration.
Source
Glucose Lowering Strategies for Cardiac Benefits: Pathophysiological Mechanisms
Harpreet S. Bajaj et al. · Physiology · 2018
DOI 10.1152/physiol.00004.2018
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Related findings · Hormonal
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- 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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