Concerns About Meta-analysis of Glucose Control and Cardiovascular Disease in Type 2 Diabetes
Authors: John S. Yudkin
Journal: Annals of Internal Medicine (2010)

Letters5 January 2010Concerns About Meta-analysis of Glucose Control and Cardiovascular Disease in Type 2 DiabetesJohn S. Yudkin, MD and Bernd Richter, MD, PhDJohn S. Yudkin, MDFrom University College London, London N7 0AG, United Kingdom; and Cochrane Metabolic and Endocrine Disorders Review Group, Universitaetsklinikum Düsseldorf, 40225 Düsseldorf, Germany.Search for more papers by this author and Bernd Richter, MD, PhDFrom University College London, London N7 0AG, United Kingdom; and Cochrane Metabolic and Endocrine Disorders Review Group, Universitaetsklinikum Düsseldorf, 40225 Düsseldorf, Germany.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-152-1-201001050-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The proposition that glucose lowering affects cardiovascular risk in patients with type 2 diabetes is very important. Although we recognize the value of the article by Kelly and colleagues (1), we would like to draw attention to errors in their meta-analysis that we believe affect the conclusions reached.First, Kelly and colleagues combined data from 3 recent studies (2–4) with 2 substudies of the UKPDS (United Kingdom Prospective Diabetes Study) (5, 6) to suggest that many outcomes differed between the “early” and “late” studies. In so doing, they did not notice that the 411 participants and their ...References1. Kelly TN, Bazzano LA, Fonseca VA, Thethi TK, Reynolds K, He J. Systematic review: glucose control and cardiovascular disease in type 2 diabetes. Ann Intern Med. 2009;151:394-403. [PMID: 19620144] LinkGoogle Scholar2. Gerstein HC, Miller ME, Byington RP, Goff DC, Bigger JT, Buse JB, et al; Action to Control Cardiovascular Risk in Diabetes Study Group. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358:2545-59. [PMID: 18539917] CrossrefMedlineGoogle Scholar3. Patel A, MacMahon S, Chalmers J, Neal B, Billot L, Woodward M, et al; ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358:2560-72. [PMID: 18539916] CrossrefMedlineGoogle Scholar4. Duckworth W, Abraira C, Moritz T, Reda D, Emanuele N, Reaven PD, et al; VADT Investigators. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009;360:129-39. [PMID: 19092145] CrossrefMedlineGoogle Scholar5. 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 Scholar6. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998;352:854-65. [PMID: 9742977] CrossrefMedlineGoogle Scholar7. Turnbull FM, Abraira C, Anderson RJ, Byington RP, Chalmers JP, Duckworth WC, et al. Intensive glucose control and macrovascular outcomes in type 2 diabetes. Diabetologia. 2009;52:2288-98. [PMID: 19655124] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: John S. Yudkin, MD; Bernd Richter, MD, PhDAffiliations: From University College London, London N7 0AG, United Kingdom; and Cochrane Metabolic and Endocrine Disorders Review Group, Universitaetsklinikum Düsseldorf, 40225 Düsseldorf, Germany.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Review: Glucose Control and Cardiovascular Disease in Type 2 Diabetes Tanika N. Kelly , Lydia A. Bazzano , Vivian A. Fonseca , Tina K. Thethi , Kristi Reynolds , and Jiang He Concerns About Meta-analysis of Glucose Control and Cardiovascular Disease in Type 2 Diabetes Tanika N. Kelly and Jiang He Correction: Glucose Control and Cardiovascular Disease in Type 2 Diabetes Metrics Cited byMedical Management of Peripheral Arterial Disease: Deciphering the Intricacies of Therapeutic OptionsQuality scores do not predict discrepant statistical significances among meta-analyses on different targets of glycemic control in type 2 diabetesIntensified glucose lowering in type 2 diabetes. Reply to Czupryniak L, Szymańska-Garbacz E, Pawłowski M et al. [letter], Aizawa T and Funase Y [letter] and DeVries JH [letter]Correction: Glucose Control and Cardiovascular Disease in Type 2 Diabetes 5 January 2010Volume 152, Issue 1Page: 63KeywordsCardiovascular diseasesEpidemiologyGlucoseHypoglycemiaHypoglycemicsMortalityMyocardial infarctionProspective studiesRelative riskType 2 diabetes ePublished: 5 January 2010 Issue Published: 5 January 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...