Diabetes Q&A

Intensive Glucose Control Reduces Microvascular Event Risk with Diabetes

According to a recent meta-analysis, intensive glucose control reduced the relative risk of kidney events and eye events associated with type 2 diabetes.

The meta-analysis included data from 27,049 participants involved in 4 large-scale randomized controlled trials that compared the effects of intensive glucose control with less intensive glucose control on the risk for microvascular events in patients with type 2 diabetes. The primary outcomes were kidney events (such as renal death), eye events (such as proliferative retinopathy), and nerve events (such as new loss of vibratory sensation).
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During the mean 5-year follow-up, a total of 1626 kidney events, 795 eye events, and 7598 nerve events occurred.

Researchers found that intensive glucose control resulted in an absolute difference in mean HbA1c of −0.90% (95% CI −1.22 to −0.58) at the end of follow-up, compared with less intensive glucose control. Intensive glucose control reduced the relative risk for kidney events by 20% and the relative risk for eye events by 13%. However, intensive glucose control did not reduce the risk for nerve events.

“More intensive glucose control over 5 years reduced both kidney and eye events. Glucose lowering remains important for the prevention of long-term microvascular complications in adults with type 2 diabetes,” the researchers concluded.

—Melissa Weiss

Reference:

Zoungas S, Arima H, Gerstein HC, et al. Effects of intensive glucose control on microvascular outcomes in patients with type 2 diabetes: a meta-analysis of individual participant data from randomised controlled trials [published online March 29, 2017]. Lancet. doi: dx.doi.org/10.1016/S2213-8587(17)30104-3.