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    ACCORD Trial (2008): Effects of Intensive Glucose Lowering in Type 2 Diabetes

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    ACCORD Trial Summary: Gerstein et al randomized 10,251 patients with type 2 diabetes mellitus, hemoglobin A1c ≥7.5% with CAD or ≥2 cardiovascular risk factors (dyslipidemia, HTN, current smoking, obesity) to either standard glycemic control HbA1c 7-7.9% (n=5,123) or intensive glycemic control HbA1c <6% (n=5,128). The primary objective was to assess if intensive glycemic control targeting a HbA1c <6% versus standard glycemic control targeting a HbA1c 7-7.9% reduce the risk of CV events in patients with type II diabetes. The primary outcome of nonfatal MI or nonfatal stroke or CV death was non-significant among both groups. However, intesive glucose control was associated with higher all-cause and CV mortality. The authors of ACCORD trial concluded that in patients with T2DM, intensive glycemic control (target HbA1c <6%) increases mortality compared to standard control (target A1c 7-7.9%).

    Source: 2008, Effects of Intensive Glucose Lowering in Type 2 Diabetes, NEJM