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NDT Advance Access originally published online on April 10, 2008
Nephrology Dialysis Transplantation 2008 23(6):1796-1798; doi:10.1093/ndt/gfn200
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


ACCORD and ADVANCE: a tale of two studies on the merits of glycaemic control in type 2 diabetic patients

Janaka Karalliedde and Luigi Gnudi

Unit for Metabolic Medicine, Cardiovascular Division, Department of Diabetes and Endocrinology, King's College London School of Medicine, Guy's Hospital, King's College London, London, UK

Correspondence and offprint requests to: Luigi Gnudi, Unit for Metabolic Medicine, Cardiovascular Division, Department of Diabetes and Endocrinology, King's College London School of Medicine, Guy's Hospital, King's College London, London, UK. Tel: +44-71881939; E-mail: luigi.gnudi@kcl.ac.uk

Keywords: glycaemic control; type 2 diabetes

The first 150 words of the full text of this article appear below.



   Insight from the present: ACCORD and ADVANCE
 
Amid much media interest, preliminary data of the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study were released in view of the unexpected finding that type 2 diabetic (T2DM) patients in the intensive blood glucose-lowering treatment arm [target glycated haemoglobin (HbA1c) <6%] had an increased risk of cardiovascular death compared to those in the conventional treatment arm (target HbA1c 7–7.9%) (http://www.nhlbi.nih.gov/health/prof/heart/other/accord/ index.htm).

The ACCORD study, sponsored by the National Institute of Health, was a large clinical trial of 10 251 T2DM patients designed to determine the best clinical approach to reduce the high rate of cardiovascular morbidity and mortality seen in T2DM patients at a high vascular risk. The main question asked being if an intensive glycaemic target as compared to the conventional one would result in favourable cardiovascular outcomes [1].

In the intensive arm, 257 patients died, compared with 203 within the conventional (standard) treatment arm. This . . . [Full Text of this Article]



   Lessons from recent times: UKPDS and STENO-2
 


   Conclusion
 

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