Early Diabetes Not Helped by Intense Therapy

By Crystal Phend, Senior Staff Writer, MedPage TodayPublished: September 23, 2010 Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner STOCKHOLM -- Early treatment of screen-detected type 2 diabetes works regardless of how intensively glucose, lipids, and blood pressure are managed, experts concluded on the basis of a large randomized trial presented here. The ADDITION trial showed that early intensive therapy was feasible in primary care but failed to reduce the major cardiovascular complications of diabetes, Simon J. Griffin, MD, of the University of Cambridge, England, and colleagues reported here at the European Association for the Study of Diabetes meeting. Intensive management yielded a nonsignificant 17% lower risk of composite cardiovascular events after five years compared with good routine care (rate 7.2% versus 8.5%, hazard ratio 0.83, P=0.12). The researchers had hoped to reverse the string of almost universally negative results with intensive management -- notably in ACCORD, ADVANCE, and the VA Diabetes Trial -- by starting earlier in the disease course./.../