Abstract | BACKGROUND AND AIMS: METHODS: The RCTs were included in this meta-analysis if: a) the between-group difference in mean HbA1c during the trial was at least 0.5%, b) they had a planned duration of treatment of at least 3 years, c) if they had a cardiovascular endpoint. Data for analysis were extracted independently by two observers and potential contrasts were resolved by a senior investigator. RESULTS: Five studies (17,267 and 15,362 patients in the intensive and conventional therapy groups, respectively) were included. Intensive treatment, which reduced mean HbA1c by 0.9% on average, was associated with a significant reduction of incident cardiovascular events and myocardial infarction (OR 0.89 [0.83-0.95] and 0.86 [0.78-0.93], respectively), but not of stroke or cardiovascular mortality (OR 0.93 [0.81-1.07] and 0.98 [0.77-1.23], respectively). In meta-regression analysis, a higher BMI duration of diabetes, and incidence of severe hypoglycaemia were associated with greater risk for cardiovascular death in intensive treatment groups. CONCLUSION: Intensified hypoglycaemic treatment in type 2 diabetic patients leads to a significant reduction of the incidence of myocardial infarction, while it does not affect the incidence of stroke and cardiovascular mortality. Hypoglycemia induced by intensified treatment could be associated with increased cardiovascular mortality.
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Authors | E Mannucci, M Monami, C Lamanna, F Gori, N Marchionni |
Journal | Nutrition, metabolism, and cardiovascular diseases : NMCD
(Nutr Metab Cardiovasc Dis)
Vol. 19
Issue 9
Pg. 604-12
(Nov 2009)
ISSN: 1590-3729 [Electronic] Netherlands |
PMID | 19427768
(Publication Type: Journal Article, Meta-Analysis)
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Chemical References |
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Topics |
- Cardiovascular Diseases
(mortality, prevention & control)
- Diabetes Mellitus, Type 2
(drug therapy, mortality)
- Diabetic Angiopathies
(mortality, prevention & control)
- Humans
- Hyperglycemia
(drug therapy, mortality)
- Hypoglycemic Agents
(therapeutic use)
- Randomized Controlled Trials as Topic
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