A large clinical study designed to determine whether intensively lowering blood glucose levels, intensively lowering blood pressure, or treating blood lipid levels could reduce the risk of heart attack, stroke, or death in people with Type 2 diabetes. In 2008, the results of the glucose control study raised some eyebrows. More than 10,000 participants were randomly assigned to receive either standard therapy aimed at achieving a hemoglobin A1c (HbAlc) of 7% to 7.9% or intensive therapy designed to lower HbAc to less than 6%. The intensive therapy arm of the trial was halted early due to excess mortality and no reduction in the rate of heart attack or stroke. Researchers were perplexed. Did this mean that efforts toward intensive control should be abandoned in people with Type 2 diabetes?
Not necessarily. First, intensive blood glucose control has been shown to significantly reduce the risk of diabetic eye, kidney, and nerve disease in people with Type 2 diabetes. Furthermore, a later analysis of the ACCORD results did not find that lowering the HbA1c level was what caused the excess mortality. In fact, the unexpectedly high mortality rate in the intensive therapy group occurred in those patients who failed to lower their HbA1c levels below 7%. Current guidelines from the American Diabetes Association recommend people with Type 2 diabetes discuss their blood glucose goals with their physicians, since intensive control may not be the best approach for everyone with Type 2 diabetes.
Want to learn more about the ACCORD Study? Read “The ACCORD Trial Findings: What You Should Know.”
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