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 .
10-year follow-up of intensive glucose control in type 2 diabetes.
BACKGROUND During the United Kingdom Prospect i ve Diabetes Study ( UKPDS ) , patients with type 2 diabetes mellitus who received intensive glucose therapy  had a lower risk of microvascular complications than did those receiving conventional dietary therapy . We conducted post-trial monitoring to determine whether this improved glucose control persisted and whether such therapy had a long-term effect on macrovascular outcomes . METHODS Of 5102 patients with newly diagnosed type 2 diabetes , 4209 were r and omly assigned to receive either conventional therapy ( dietary restriction ) or intensive therapy ( either sulfonylurea or insulin or , in overweight patients , metformin ) for glucose control . In post-trial monitoring , 3277 patients were asked to attend annual UKPDS clinics for 5 years , but no attempts were made to maintain their previously assigned therapies . Annual question naires were used to follow patients who were unable to attend the clinics , and all patients in years 6 to 10 were assessed through question naires . We examined seven prespecified aggregate clinical outcomes from the UKPDS on an intention-to-treat basis , according to previous r and omization categories . RESULTS Between-group differences in glycated hemoglobin levels were lost after the first year . In the sulfonylurea-insulin group , relative reductions in risk persisted at 10 years for any diabetes-related end point ( 9 % , P=0.04 ) and microvascular disease ( 24 % , P=0.001 ) , and risk reductions for myocardial infa rct ion ( 15 % , P=0.01 ) and death from any cause ( 13 % , P=0.007 ) emerged over time , as more events occurred . In the metformin group , significant risk reductions persisted for any diabetes-related end point ( 21 % , P=0.01 ) , myocardial infa rct ion ( 33 % , P=0.005 ) , and death from any cause ( 27 % , P=0.002 ) . CONCLUSIONS Despite an early loss of glycemic differences , a continued reduction in microvascular risk and emergent risk reductions for myocardial infa rct ion and death from any cause were observed during 10 years of post-trial follow-up . A continued benefit after metformin therapy was evident among overweight patients . ( UKPDS 80 ; Current Controlled Trials number , IS RCT N75451837 .
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 .