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Systematic Review: Glucose Control and Cardiovascular Disease in Type 2 Diabetes
Annals of Internal Medicine, 09/15/09

Kelly TK et al. – Intensive glucose control reduced the risk for some cardiovascular disease outcomes (such as nonfatal myocardial infarction), did not reduce the risk for cardiovascular death or all–cause mortality, and increased the risk for severe hypoglycemia.

Methods

Studies were retrieved by systematically searching the MEDLINE database (January 1950 to April 2009) with no language restrictions.
Two independent reviewers screened abstracts or full–text articles to identify randomized trials that compared clinical outcomes in patients with type 2 diabetes receiving intensive glucose control and those receiving conventional glucose control.
Two investigators independently abstracted data on study variables and outcomes, including severe hypoglycemia, cardiovascular disease, and all–cause mortality.

Results

5 trials involving 27 802 adults were included.
Intensive glucose targets were lower in the 3 most recent trials.
Summary analyses showed that compared with conventional control, intensive glucose control reduced the risk for cardiovascular disease but not cardiovascular death or all–cause mortality.
Intensive glucose control increased the risk for severe hypoglycemia.
Limitation: Summary rather than individual data were pooled across trials.

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