Mortality signal still showing at five years in ACCORD

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Five-year results of the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial of intensive glucose lowering in patients with diabetes at high risk of cardiovascular disease continue to show signs of increased mortality in the intensive group. The latest results, published in the March 3rd 2011 issue of the New England Journal of Medicine, are consistent with the main results reported at 3.5 years follow-up. Although there is a definite reduction

in myocardial infarction with intensive glucose lowering, a mortality increase is still apparent.

The authors note that other trials looking at intensive treatment have not shown such a mortality increase, but because of the ACCORD results, they do not recommend aiming for glucose levels in the normal range in patients with diabetes. They advise a HBA1c level of “below 7%” as reasonable.

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