RCT TRIAL | MEAN AGE, Y | TRIAL DURATION, Y | HBA1C ATTAINED, % | BENEFITS OR HARMS IN MORE-INTENSIVE GLUCOSE-LOWERING ARM (LOWER HBA1C) VS LESS-INTENSIVE TREATMENT ARM |
---|---|---|---|---|
UKPDS-334 | 54 | 10 | 7.0 vs 7.9 | |
ADVANCE7 | 66 | 5 | 6.5 vs 7.3 |
|
VADT8 (most participants had a history of CV problems) | 60 | 5.6 | 6.9 vs 8.4 |
|
ACCORD9 (35% of participants had a history of CV problems) | 62 | 3.5 | 6.4 vs 7.5 |
|
ACCORD—Action to Control Cardiovascular Risk in Diabetes, ADVANCE—Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation, BG—blood glucose, CV–cardiovascular, HbA1c—glycated hemoglobin A1c, MI—myocardial infarction, NNT—number needed to treat for 1 additional person to benefit, NNH—number needed to treat for 1 additional person to be harmed, RCT—randomized controlled trial, T2DM—type 2 diabetes mellitus, UKPDS—United Kingdom Prospective Diabetes Study, VADT—Veterans Affairs Diabetes Trial.
↵* Major clinical outcomes included CV death, MI, stroke, end-stage renal disease, and blindness.
↵† The UKPDS-345 found a decrease in death (NNT = 14 at 10.7 y) and decrease in stroke (NNT = 48 at 10 y) when metformin specifically was used compared with standard treatment in obese patients with T2DM (HbA1c achieved was 7.4% vs 8.0%).