ACCORD demonstrated that targeting an HbA1c below 6.0% in high-risk type 2 diabetes patients with established cardiovascular disease increased all-cause mortality by 22% without significantly reducing cardiovascular events, establishing that very intensive glycaemic targets are harmful in this population and reshaping international guidelines to mandate individualised HbA1c targeting.
Browsing: Cardiovascular Outcomes
Steno-2 demonstrated that intensive multifactorial risk factor intervention targeting glycaemia, blood pressure, lipids, and lifestyle simultaneously reduces all-cause mortality by 46% and cardiovascular events by 59% over 13.3 years in type 2 diabetes with microalbuminuria, providing the defining evidence for comprehensive cardiovascular risk management in high-risk type 2 diabetes.
UKPDS 38 demonstrated that tight blood pressure control targeting below 150/85 mmHg reduces stroke by 44%, diabetes-related endpoints by 24%, and microvascular complications by 37% in hypertensive type 2 diabetes over 8.4 years, establishing blood pressure control as a therapeutic target of at least equal macrovascular importance to glycaemic management.
UKPDS 34 demonstrated that metformin reduces diabetes-related endpoints, death, and all-cause mortality by 32–42% in overweight patients with newly diagnosed type 2 diabetes, with superior cardiovascular outcomes compared with sulphonylurea or insulin, establishing metformin as the preferred first-line pharmacological therapy for type 2 diabetes for the subsequent three decades.
The EDIC study demonstrated that 6.5 years of intensive glycaemic therapy during the DCCT reduced cardiovascular events by 42–57% over 17 years of follow-up despite subsequent HbA1c convergence between groups, establishing the concept of metabolic memory and providing foundational evidence that early intensive glycaemic control produces durable cardiovascular protection extending decades beyond the intervention period.
An RCT finds adding Tai Chi to time-restricted eating improves lipids and endothelial function in postmenopausal women. PICO summary and expert commentary for clinicians.
An RCT finds combining exercise with broccoli sprout supplementation improves apolipoproteins in type 2 diabetes, mainly driven by exercise. PICO summary and expert commentary.
The DAPAHEART follow-up finds 4 years of dapagliflozin improves coronary flow reserve and reduces epicardial fat in type 2 diabetes. PICO summary and expert commentary.
The Swedish Obese Subjects (SOS) study demonstrated that bariatric surgery is associated with a 29% reduction in adjusted all-cause mortality compared with conventional obesity treatment over an average 10.9 years of follow-up, with reductions in both cardiovascular and cancer deaths, providing the first prospective controlled evidence for the long-term survival benefit of surgical weight loss.
The Look AHEAD trial demonstrated that intensive lifestyle intervention targeting weight loss in overweight or obese adults with type 2 diabetes did not reduce cardiovascular events over 9.6 years despite clear differences in weight, fitness, and glycaemic control, establishing a critical negative result that informed the rationale for pharmacological obesity treatment with greater weight loss efficacy.