Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: Dr Hayward and colleagues and Dr Finucane suggest that a 74-year-old woman with type 2 diabetes and well-controlled hypertension, who has no other co-morbid conditions and who has an expected life expectancy of another 13 years, should not be encouraged to achieve an HbA1c value closer to normal. In my article, I stated that the UKPDS showed that “intensive” treatment of participants with type 2 diabetes treated with sulfonylureas and insulin resulted in a 16% relative reduction in risk for myocardial infarction that did not reach statistical significance (P = .052). I agree that further data are needed to support the benefit of intensive glucose control for cardiovascular outcomes in people with type 2 diabetes, even though there is now compelling evidence that improved glycemic control in type 1 diabetes significantly reduces the risk for cardiovascular morbidity.1,2
Abrahamson MJ. Intensive Glucose Control in Elderly Adults—Reply. JAMA. 2007;297(20):2195-2196. doi:10.1001/jama.297.20.2196