The Role of Glycemia Management in the Prevention of Cardiovascular Disease—Starting Over?
Authors: David M. Nathan
Journal: Annals of Internal Medicine (2009)

Editorials15 December 2009The Role of Glycemia Management in the Prevention of Cardiovascular Disease—Starting Over?David M. Nathan, MDDavid M. Nathan, MDFrom Massachusetts General Hospital Diabetes Center, Boston, MA 02114.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-12-200912150-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The DCCT (Diabetes Control and Complications Trial) for type 1 diabetes (1) and the UKPDS (United Kingdom Prospective Diabetes Study) for type 2 diabetes (2) seemed to lay to rest the contentious debate over the relationship between glycemic control and the long-term complications of diabetes mellitus. These randomized trials of intensive therapy to achieve near-normal glucose control established the benefits of intensive therapy over conventional (at the time) therapy on the microvascular and neurologic complications that epidemiologic studies had shown to be associated with the level of chronic glycemia (3, 4). Neither trial established that intensive therapy reduced cardiovascular disease ...References1. Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977-86. [PMID: 8366922] CrossrefMedlineGoogle Scholar2. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837-53. [PMID: 9742976] CrossrefMedlineGoogle Scholar3. 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Int J Clin Pract. 2009;63:1421-5. [PMID: 19769698] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Massachusetts General Hospital Diabetes Center, Boston, MA 02114.Disclosures: None disclosed.Corresponding Author: David M. Nathan, MD, Massachusetts General Hospital Diabetes Center, 50 Staniford Street, Boston, MA 02114; e-mail, [email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComorbidity Affects the Relationship Between Glycemic Control and Cardiovascular Outcomes in Diabetes Sheldon Greenfield , John Billimek , Fabio Pellegrini , Monica Franciosi , Giorgia De Berardis , Antonio Nicolucci , and Sherrie H. Kaplan Metrics Cited ByThe potential for renoprotection with incretin-based drugsPharmacologic Prevention of Microvascular and Macrovascular Complications in Diabetes MellitusLe diabète accélère le vieillissement artériel : aspects morphologiques et fonctionnels 15 December 2009Volume 151, Issue 12Page: 888-889KeywordsCardiovascular diseasesForecastingGlucoseHbA1cHemoglobinHypertensionMorbidityPatientsType 2 diabetes ePublished: 15 December 2009 Issue Published: 15 December 2009 CopyrightCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...