Intensive versus conventional glycemic control: what is best for patients with type 2 diabetes?

Diabetes Metab Syndr. Jan-Mar 2013;7(1):48-51. doi: 10.1016/j.dsx.2013.02.008. Epub 2013 Mar 9.

Abstract

Background: Recently a hot debate was raised to answer if intensive glycemic control aimed to reduce HbA1c to less than 6.5% is better than conventional therapy in terms of future outcomes. A lot of studies were conducted to explore that but few mega trials were conducted.

Objective: To evaluate the effect and safety of both intensive and conventional insulin therapy in patients with type 2 diabetes.

Methodology: Traditional systematic review was conducted; criteria for studies selection were formatted. Studies selected were criticized.

Results: Three mega trials (3) randomized 23,182 participants with type 2 diabetes (11,591 to intensive glycemic control and 11,591 to conventional glycemic control) were included. Only diabetic nephropathy was noted to be delayed in onset or progression by intensive insulin therapy.

Conclusion: There are no benefits from intensive glycemic therapy (target HbA1c<6.4%) versus conventional glycemic therapy (target HbA1c>6.4%) except for decrease the rate of new onset or progression of nephropathy.

Publication types

  • Comparative Study
  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Blood Glucose / metabolism
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / prevention & control
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetic Angiopathies / blood*
  • Diabetic Angiopathies / epidemiology
  • Diabetic Nephropathies / blood*
  • Diabetic Nephropathies / epidemiology
  • Disease Progression
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / therapeutic use*
  • Male
  • Middle Aged
  • Randomized Controlled Trials as Topic

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • hemoglobin A1c protein, human