The effects of intensive compared to standard glucose control on cardiovascular events was examined in the Veterans Affairs Diabetes Trial, which included 1,791 individuals with suboptimal response to type 2 diabetes therapy. After the median follow-up of 5.6 years, glycated hemoglobin levels were 8.4% in the standard-therapy group and 6.9% in the intensive-therapy group. The intensive therapy was not associated with significant benefits regarding time to the occurrence of a first cardiovascular event (hazard ratio=0.88, 95% CI: 0.74-1.05, p=0.14). Moreover, no differences were observed between the two groups for microvascular complications. There were more episodes of hypoglycemia in the intensive-therapy group than in the standard-therapy group (p<0.001). Results of this study along with two recent studies, ACCORD and ADVANCE, do not support intensive glycemic control alone as an effective way to prevent cardiovascular morbidity or mortality.
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