For the reduction of microvascular complications in type 2 diabetes, glycemic control has been shown to be an important and effective intervention. However, considering the findings from several recent, large, randomized controlled trials, the utility of very tight glycemic control in all those with type 2 diabetes, for the reduction of cardiovascular disease remains controversial. The decision to aim for very tight glycemic control must be individualized and the potential benefit of reduced risk of nephropathy must be weighed against the increased risk for hypoglycemia. The results of the 10-year post-trial monitoring of the United Kingdom Prospective Diabetes Study (UKPDS) demonstrated macrovascular benefits of glycemic control in newly diagnosed type 2 diabetes but lengthy follow-up was required to demonstrate the effect. This raises the possibility that benefits of glucose lowering to reduce cardiovascular risk is more evident in those with a shorter duration of diabetes and requires many years to manifest. For the time being, there remains good evidence for targeting A1c < 7% for microvascular protection but attempts to lower A1c beyond this must be considered on an individual basis. Eur J Cardiovasc Prev Rehabil 17 (Suppl 1): S25-S31 (C) 2010 The European Society of Cardiology
机构:
Mayo Clinic, Rochester, MNMayo Clinic, Rochester, MN
Frye R.L.
August P.
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机构:
New York Hospital Queens, Queens, NYMayo Clinic, Rochester, MN
August P.
Brooks M.M.
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机构:
University of Pittsburgh, Pittsburgh, PA
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261Mayo Clinic, Rochester, MN
Brooks M.M.
Hardison R.M.
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机构:
University of Pittsburgh, Pittsburgh, PAMayo Clinic, Rochester, MN
Hardison R.M.
Kelsey S.F.
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机构:
University of Pittsburgh, Pittsburgh, PAMayo Clinic, Rochester, MN
Kelsey S.F.
MacGregor J.M.
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机构:
University of Pittsburgh, Pittsburgh, PAMayo Clinic, Rochester, MN
MacGregor J.M.
Orchard T.J.
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机构:
University of Pittsburgh, Pittsburgh, PAMayo Clinic, Rochester, MN
Orchard T.J.
Chaitman B.R.
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机构:
Saint Louis University, St. LouisMayo Clinic, Rochester, MN
Chaitman B.R.
Genuth S.M.
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机构:
Case Western Reserve University, ClevelandMayo Clinic, Rochester, MN
Genuth S.M.
Goldberg S.H.
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机构:
National Heart, Lung, and Blood Institute, Bethesda, MDMayo Clinic, Rochester, MN
机构:
Univ N Carolina, Sch Med, Dept Med, Div Endocrinol, Chapel Hill, NC 27599 USAUniv N Carolina, Sch Med, Dept Med, Div Endocrinol, Chapel Hill, NC 27599 USA
机构:
Mayo Clinic, Rochester, MNMayo Clinic, Rochester, MN
Frye R.L.
August P.
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New York Hospital Queens, Queens, NYMayo Clinic, Rochester, MN
August P.
Brooks M.M.
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h-index: 0
机构:
University of Pittsburgh, Pittsburgh, PA
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261Mayo Clinic, Rochester, MN
Brooks M.M.
Hardison R.M.
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h-index: 0
机构:
University of Pittsburgh, Pittsburgh, PAMayo Clinic, Rochester, MN
Hardison R.M.
Kelsey S.F.
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h-index: 0
机构:
University of Pittsburgh, Pittsburgh, PAMayo Clinic, Rochester, MN
Kelsey S.F.
MacGregor J.M.
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h-index: 0
机构:
University of Pittsburgh, Pittsburgh, PAMayo Clinic, Rochester, MN
MacGregor J.M.
Orchard T.J.
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h-index: 0
机构:
University of Pittsburgh, Pittsburgh, PAMayo Clinic, Rochester, MN
Orchard T.J.
Chaitman B.R.
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h-index: 0
机构:
Saint Louis University, St. LouisMayo Clinic, Rochester, MN
Chaitman B.R.
Genuth S.M.
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h-index: 0
机构:
Case Western Reserve University, ClevelandMayo Clinic, Rochester, MN
Genuth S.M.
Goldberg S.H.
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h-index: 0
机构:
National Heart, Lung, and Blood Institute, Bethesda, MDMayo Clinic, Rochester, MN
机构:
Univ N Carolina, Sch Med, Dept Med, Div Endocrinol, Chapel Hill, NC 27599 USAUniv N Carolina, Sch Med, Dept Med, Div Endocrinol, Chapel Hill, NC 27599 USA