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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EIntensive glucose-lowering therapy, defined as aiming for HbA1C levels below 7%, improves glycemic control among high-risk patients with type 2 diabetes mellitus. However, it has no long-term effect on cardiovascular outcomes in this patient population, according to findings from the Veterans Affairs Diabetes Trial [VADT].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Ecoronary artery disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ediabetes mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Emyocardial infarction\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eendocrinology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ediabetes \u0026amp; endocrinology clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EIntensive glucose-lowering therapy, defined as aiming for HbA1c levels below 7%, improves glycemic control among high-risk patients with type 2 diabetes mellitus (T2DM). However, it has no long-term effect on cardiovascular outcomes in this patient population, according to findings from the Veterans Administration Diabetes Trial (VADT).\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EVADT (\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00032487\u0026amp;atom=%2Fspmdc%2F8%2F7%2F13.atom\u0022\u003ENCT00032487\u003C\/a\u003E) was designed to evaluate whether intensive control of blood glucose levels would reduce the risk of cardiovascular events compared with standard therapy among 1,791 patients with T2DM who were at high risk for cardiovascular disease (CVD). The primary outcome was a composite of cardiovascular events, including cardiovascular death, myocardial infarction (MI), congestive heart failure, and severe coronary artery disease (CAD); amputation for ischemia; and interventions for CAD and peripheral vascular disease.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003ECompared with other recent trials of standard versus intensive glycemic control such as ADVANCE and ACCORD, VADT enrolled patients with a longer duration of T2DM and more severe cardiovascular risk, said VADT Co-Chair William Duckworth, MD, Veterans Administration Medical Center, Phoenix, AZ. The VADT study population included mostly male (97%), older patients (mean age, 60 years) with high background cardiovascular risk. At baseline, the mean HbA1c was 9.5%. Patients tended to be obese (mean body mass index, 31 kg\/m\u003Csup\u003E2\u003C\/sup\u003E), 72% of patients had high blood pressure (mean, 132\/76 mm Hg), 50% had an abnormal lipid profile, and 40% had a history of MI, angina, bypass surgery, stroke, or transient ischemic events. In addition, 43% had diabetic neuropathy at baseline, and 62% had retinopathy.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EAfter a median of 6 years, patients in the intensive-treatment arm had a lower HbA1c (6.9%) than those in the standard-treatment arm (8.4%). As expected, compared with standard therapy, intensive glucose control was more likely to lead to episodes of mild hypoglycemia (77.1% vs 93.4%; p=0.01) and severe hypoglycemia (9.7% vs 21.1%; p=0.01).\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EDespite differences in glucose control, there was no difference in the time to primary outcome between the two treatment groups (p=0.12). Moreover, compared with standard therapy, intensive glucose control had no affect on the risk of all-cause mortality (HR=1.065; p=0.67).\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EInterestingly, the VADT investigators found that patients with a shorter duration of T2DM were more likely to benefit from intensive therapy (p\u0026lt;0.0001). This suggests that the damage inflicted by many years of T2DM is too great for even intensive therapy to overcome, Dr. Duckworth said. However, if verified, these data support the use of intensive therapy early in the treatment of T2DM, he concluded.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2008 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/8\/7\/13.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmbuq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}