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New research findings reported last month found that compared with placebo, 2 drugs improved glycemic control in patients with type 2 diabetes without increasing major adverse cardiovascular events. But is that good enough?
For years, conventional wisdom held that achieving near-normal blood glucose levels in these patients would decrease their risk for microvascular complications such as diabetic retinopathy, nephropathy, and neuropathy and macrovascular complications such as cardiovascular disease and stroke. However, although glycemic control is associated with decreased risk of microvascular complications, studies have yet to find robust evidence that glycemic control decreases macrovascular complications. Indeed, an emerging body of evidence suggests that tight glycemic control increases risk for cardiovascular disease and stroke.
Mitka M. New Drugs Improve Glycemic Control in Type 2 Diabetes, But Improving Heart Health Remains Elusive. JAMA. 2013;310(14):1435-1436. doi:10.1001/jama.2013.279038