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 .
Glycaemic separation and risk factor control in the Veterans Affairs Diabetes Trial: an interim report.
OBJECTIVE The Veterans Affairs Diabetes Trial ( VADT ) will assess the effect of intensive ( INT ) vs improved st and ard ( STD ) glycaemic control on major cardiovascular ( CV ) events , treating other risk factors equally in both arms . Four-year results of main metabolic parameters are presented . RESEARCH DESIGN AND METHODS VADT is a 7.5 years prospect i ve r and omized study of 1791 patients , 20 centres , of men and women of age 60.5 + /- 8.7 years , diagnosed for 11.5 + /- 7.5 years . Their body mass index ( BMI ) at baseline was 31 + /- 4 kg/m(2 ) and mean A1C 9.4 + /- 1.5 % after maximum dose of oral agents or insulin treatment . Step treatment consists of glimepiride or metformin , rosiglitazone , insulin and other agents ; A1C goals are 8 - 9 % in STD and < 6 % in INT . Lifestyle , blood pressure and lipids are treated uniformly in both arms . RESULTS A1C improved in both arms . INT kept median A1C < 7 % all years , A1C separation is 1.5 - 1.7 % . From year 1 to 4 , mean blood pressure is < 129/74 mmHg , similar throughout . Median LDL-C was < 97 mg/dl by year 1 and triglycerides 150 or less by 2 years . Triglycerides were lower in INT ( 12 - 16 mg/dl ; p < 0.01 ) . By 4 years , 88 % are on lipid-lowering agents and 93 % are on antiplatelet/anticoagulant agents . BMI is higher in INT every year ( 0.9 - 1.6 kg/m(2 ) ; p < 0.01 ) . CONCLUSION VADT is maintaining the expected A1C in both STD and INT , and LDL-C , triglycerides and blood pressure are at target . The trial is continuing to June 2008 . It will be the first long-term completed type 2 diabetes study of the role of glycaemia on CV disease with modern treatments
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 .