Intensive glycaemic control does not seem to reduce all cause mortality in patients with type 2 diabetes .
OBJECTIVE To assess the effect of targeting intensive glycaemic control versus conventional glycaemic control on  all cause mortality and cardiovascular mortality , non-fatal myocardial infa rct ion , microvascular complications , and severe hypoglycaemia in patients with type 2 diabetes .
Combined Effects of Routine Blood Pressure Lowering and Intensive Glucose Control on Macrovascular and Microvascular Outcomes in Patients With Type 2 Diabetes
OBJECTIVE To assess the magnitude and independence of the effects of routine blood pressure lowering and intensive glucose control on clinical outcomes in patients with long-st and ing type 2 diabetes . RESEARCH DESIGN AND METHODS This was a multicenter , factorial r and omized trial of perindopril-indapamide versus placebo ( double-blind comparison ) and intensive glucose control with a gliclazide MR – based regimen ( target A1C ≤6.5 % ) versus st and ard glucose control ( open comparison ) in 11,140 participants with type 2 diabetes who participated in the Action in Diabetes and Vascular Disease : Preterax and Diamicron MR Controlled Evaluation ( ADVANCE ) trial .  Annual event rates and risks of major macrovascular and microvascular events considered jointly and separately , renal events , and death during an average 4.3 years of follow-up were assessed , using Cox proportional hazards models . RESULTS There was no interaction between the effects of  routine blood pressure lowering and intensive glucose control for any of the prespecified clinical outcomes ( all P > 0.1 ) : the separate effects of the two interventions for the renal outcomes and death appeared to be additive on the log scale . Compared with neither intervention , combination treatment reduced the risk of new or worsening nephropathy by 33 % ( 95 % CI 12–50 % , P = 0.005 ) , new onset of macroalbuminuria by 54 % ( 35–68 % , P < 0.0001 ) , and new onset of microalbuminuria by 26 % ( 17–34 % ) . Combination treatment was associated with an 18 % reduction in the risk of all-cause death ( 1–32 % , P = 0.04 ) . CONCLUSIONS The effects of routine blood pressure lowering and intensive glucose control were independent of one another . When combined , they produced additional reductions in clinical ly relevant outcomes
Intensive glycaemic control does not seem to reduce all cause mortality in patients with type 2 diabetes .
OBJECTIVE To assess the effect of targeting intensive glycaemic control versus conventional glycaemic control on  all cause mortality and cardiovascular mortality , non-fatal myocardial infa rct ion , microvascular complications , and severe hypoglycaemia in patients with type 2 diabetes .