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Benefit of blood glucose lowering to near-normal levels remains unclear
Date:7/14/2011

Whether patients with type 2 diabetes mellitus benefit from attempts to lower their blood glucose levels to near-normal levels through treatment ("intensive blood glucose control") remains an unanswered question. The studies currently available provide indications of a benefit but also of potential harm. This is the result of a report published by the German Institute for Quality and Efficiency in Health Care (IQWiG).

Epidemiological studies have shown that the risk of vascular disease or death rises with increasing blood glucose levels in people with type 2 diabetes. In order to prevent late complications of diabetes, clinical practice guidelines therefore recommend lowering blood glucose levels to a "near-normal" range. This refers to levels close to those of people without diabetes. In the report now presented (a rapid report), IQWiG investigated whether this treatment strategy, i.e. a strategy aiming to achieve (nearly) normal blood glucose levels, also actually reduces the risk of late complications of diabetes.

Comparison of two treatment strategies

For this purpose IQWiG searched for randomized controlled trials comparing two treatment strategies in patients with type 2 diabetes. In the test group the measures were aimed at long-term lowering of blood glucose to near-normal levels. In the control group there was no such aim or the measure applied was not so intensive. In this context, the main criteria for assessing the benefit or harm of the interventions were mortality (all-cause mortality), late complications of diabetes (heart attacks, strokes, damage to the kidneys or eyes etc.), as well as quality of life.

Three studies conducted after 2000

Overall, IQWiG included seven studies, in which a total of 28,000 patients had participated, in the assessment. The studies differed quite considerably: four studies had already been conducted between the 1960s and 1990s, the others after the year 20
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Contact: IQWiG
info@iqwig.de
49-022-135-6850
Institute for Quality and Efficiency in Health Care
Source:Eurekalert

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