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Effect of intensive versus standard blood glucose control on major microvascular outcomes in type 2 diabetes

Effect of intensive versus standard blood glucose control on major microvascular outcomes in type 2 diabetes
Study Kumamoto study UKPDS 33 UKPDS 80
(post-UKPDS 33)		 ACCORD ADVANCE VADT
Population 110 4209 3277 10,251 11,140 1791
Age
(years)		 47-52 53   62 66 60
BMI
(kg/m2)		 19-21 28   32 28 31
Complications –/+ –/+   ++ ++ ++
Disease duration
(years)		 6-10 0   10 8 11.5
Baseline A1C
(%)		 8.9-9.4 7.1   8.3 7.5 9.4
Post-trial A1C
(intensive versus standard; %)		 7.1 versus 9.4 7.0 versus 7.9   6.3 versus 7.5 6.5 versus 7.3 7.0 versus 8.5
Microvascular endpoints
Retinopathy

0.31 (0.13-0.76)

≥2-step cumulative change

0.75 (0.60-0.98)

Any microvascular outcome

0.76 (0.64-0.89)

Any microvascular outcome

0.67 (0.51-0.87)*

3-step progression

0.72 (0.44-1.17)*

3-step progression

0.77 (0.58-1.02)

2-step progression
Nephropathy

0.30 (0.11-0.86)

New or worsening nephropathy		    

0.72 (0.61-0.84)

Incident macroalbuminuria

0.79 (0.66-0.93)

New or worsening nephropathy

0.65 (0.49-0.89)

Any increase in albuminuria
Neuropathy      

0.92 (0.86-0.99)

Neuropathy (MNSI>2)		  

0.99 (0.87-1.14)

Any new neuropathy
UKPDS: United Kingdom Prospective Diabetes Study; ACCORD: Action to Control Cardiovascular Risk in Diabetes; ADVANCE: Action in Diabetes and Vascular Disease; VADT: Veterans Affairs Diabetes Trial; BMI: body mass index; A1C: glycated hemoglobin; MNSI: Michigan Neuropathy Screening Instrument.
* Data are relative risk (95% confidence interval) or odds ratio.
Modified from: Pozzilli P, Strollo R, Bonora E. One size does not fit all glycemic targets for type 2 diabetes. J Diabetes Investig 2014; 5(2):134-141. https://onlinelibrary.wiley.com/doi/10.1111/jdi.12206. Copyright © 2014 The Authors. Journal of Diabetes Investigation published by Asian Association of the Study of Diabetes (AASD) and Wiley Publishing Asia Pty Ltd. Reproduced with permission of John Wiley & Sons Inc. This image has been provided by or is owned by Wiley. Further permission is needed before it can be downloaded to PowerPoint, printed, shared or emailed. Please contact Wiley's permissions department either via email: permissions@wiley.com or use the RightsLink service by clicking on the 'Request Permission' link accompanying this article on Wiley Online Library (https://onlinelibrary.wiley.com/).
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