A manufacturer-sponsored secondary analysis found a digital diabetes logbook nearly doubled the odds of reaching HbA1c 6.5% or below at 3 months, with associated real-world glucose reductions. PICO summary and expert commentary.
Browsing: Diabetes & Glycaemic Control
Diabetes and glycaemic-control evidence summaries covering HbA1c, glucose monitoring, medication comparisons, hypoglycaemia, patient-reported outcomes, and clinical interpretation.
A small single-blind RCT found that a family-centered empowerment program raised illness acceptance and self-management scores at six weeks in adults with type 2 diabetes. PICO summary and expert commentary.
A one-year randomised controlled trial testing whether pharmacist-led collaborative care improves EQ-5D quality of life and HbA1c versus routine care in adults with diabetes. PICO summary and expert commentary.
A 12-week randomised trial in older adults with type 2 diabetes testing whether combined aerobic plus resistance exercise improves sleep and abdominal fat. PICO summary and expert commentary.
CARDS demonstrated that atorvastatin 10 mg reduces major cardiovascular events by 37% and stroke by 48% in patients with type 2 diabetes and normal to mildly elevated LDL-cholesterol without prior CVD, confirming that cardiovascular risk rather than LDL level should determine statin initiation and establishing universal statin use in primary cardiovascular prevention for type 2 diabetes.
HPS demonstrated that simvastatin reduces major vascular events by 24% across all high-risk patients regardless of baseline LDL-cholesterol level, including those with diabetes without established coronary disease, eliminating the treatment threshold concept and establishing absolute cardiovascular risk as the primary criterion for statin therapy — one of the most influential results in preventive cardiology.
VADT demonstrated that intensive glucose control achieving a median HbA1c of 6.9% did not significantly reduce cardiovascular events or mortality in veterans with long-standing type 2 diabetes and high cardiovascular disease prevalence, completing the ACCORD/ADVANCE/VADT triptych that defined the limits of aggressive glycaemic management in advanced disease.
ADVANCE demonstrated that intensive glucose control targeting HbA1c below 6.5% using a gliclazide-based strategy reduces nephropathy by 21% and the microvascular composite by 14% in high-risk type 2 diabetes, without the mortality hazard observed in ACCORD, providing important context for how glycaemic targets and treatment strategies interact with safety outcomes.
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.
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.