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See Latest ArticlesIntensive glycemic control: Implications of the ACCORD, ADVANCE, and VADT trials for family physicians
Canadian Family Physician, 08/14/09
Dhar GC – The benefits of intensive glycemic control on microvascular and macrovascular complications are well established in patients with type 2 diabetes and in those with type 1 diabetes. Physicians should note the following conclusions drawn as a result of ACCORD, ADVANCE, VADT, and other observational studies.
- The general target of HbA1c levels < 7% should remain the same. Targets should be individualized for patients with additional cardiovascular risk factors.
- Patients who have not had type 2 diabetes for long and who do not have established atherosclerotic diseases might derive cardiovascular benefit from intensive glycemic control.
- Physicians should encourage cardiovascular risk reduction through smoking cessation, dietary, and physical activity counseling; following evidence–based recommendation for blood pressure control with angiotensin–converting enzyme inhibitors or angiotensin II receptor blockers and lipid–lowering therapy with statin and aspirin prophylaxis; and recommending other healthy lifestyle and behavioural changes.
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