TY - JOUR
T1 - Intensive insulin for type 2 diabetes
T2 - The risk of causing harm
AU - Nolan, Christopher J.
AU - Ruderman, Neil B.
AU - Prentki, Marc
PY - 2013/9
Y1 - 2013/9
N2 - The ACCORD study showed that aggressive intensification of glycaemic control in patients with type 2 diabetes can increase mortality (hazard ratio [HR] 1·22, 95% CI 1·011·46), including death from cardiovascular causes (1·35, 1·041·76).1 The reason for this unexpected fi nding is unknown. Of note was the high percentage of intensively treated patients receiving insulin therapy (77%) or thiazolidinedione therapy (with or without insulin) (92%), and their greater weight gain (3·5 kg vs 0·4 kg).1 Results of post-hoc analyses did not support the hypothesis that increased hypoglycaemia in patients who were intensively treated caused the excess deaths.2 The analyses showed, however, that a higher baseline HbA1c and a failure to improve average HbA1c throughout the study were linked to the increased mortality.
AB - The ACCORD study showed that aggressive intensification of glycaemic control in patients with type 2 diabetes can increase mortality (hazard ratio [HR] 1·22, 95% CI 1·011·46), including death from cardiovascular causes (1·35, 1·041·76).1 The reason for this unexpected fi nding is unknown. Of note was the high percentage of intensively treated patients receiving insulin therapy (77%) or thiazolidinedione therapy (with or without insulin) (92%), and their greater weight gain (3·5 kg vs 0·4 kg).1 Results of post-hoc analyses did not support the hypothesis that increased hypoglycaemia in patients who were intensively treated caused the excess deaths.2 The analyses showed, however, that a higher baseline HbA1c and a failure to improve average HbA1c throughout the study were linked to the increased mortality.
UR - http://www.scopus.com/inward/record.url?scp=84882572778&partnerID=8YFLogxK
U2 - 10.1016/S2213-8587(13)70027-5
DO - 10.1016/S2213-8587(13)70027-5
M3 - Letter
SN - 2213-8587
VL - 1
SP - 9
EP - 10
JO - The Lancet Diabetes and Endocrinology
JF - The Lancet Diabetes and Endocrinology
IS - 1
ER -