Physicians' Academy for Cardiovascular Education

Controversies in glycaemia management. Implications of recent trials

Slides (presentation) - Dec. 3, 2009

Controversies in glycaemia management.
Implications of recent trials; ADVANCE, VADT, ACCORD, UKPDS

Dr Kausik Ray
BSc (Hons), MBChB, MRCP, MD, MPhil (Cantab), FACC, FESC
University of Cambridge
London, Dec 2009

Controversies in glycaemia management. Implications of recent trials: ADVANCE, VADT, ACCORD, UKPDS
Continuous relationship between HbA1c in whole population (male participants-EPIC Norfolk)
UKPDS 35: Significant Risk Reduction for T2DM Complications with Each 1% Reduction in Mean HbA1c
UKPDSextension-CVbenefitsobserveddespitenosignificantdifferencesinHbA1cduringFU
ClassIrecommendation
Dia 6
Methods 1
10 trials screened and 5 trials included
Methods
Baseline characteristics
Treatment regimen
Endpoints
EffectofmorevslessintensivecontrolofglucoseonNF-MI
EffectofmorevslessintensivecontrolofglucoseonCHD
Effectofmorevslessintensivecontrolofglucoseonstroke
Effectofmorevslessintensivecontrolofglucoseondeath
EffectofmorevslessintensivecontrolofglucoseonHF
Comparisonofeffectofmoreintensiveglycaemiccontrolonclinicaloutcomesinstudieswithavailableinformationontheseoutcomes*
Adverse events
Benefit of different interventions per 200 diabetic pts treated for 5 years
Benefit of different interventions per 200 diabetic pts treated for 5 years
Benefit of different interventions per 200 diabetic pts treated for 5 years
TurnbulletalDiabetalogia2009
ManuccietalNutMetCVdisease2009
Conclusion 1
Conclusion 2
Future trials

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