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

00. They partly included patients of a specific ethnic origin (Japan) and in some studies drugs were widely applied that are no longer on the market (rosiglitazone).

IQWiG finds no differences for important treatment outcomes

In the analysis of the studies, IQWiG found no differences between the two groups for relevant aspects of treatment. Proof or indications that one of the two treatment strategies offered more advantages or disadvantages were found neither for all-cause mortality nor for fatal heart attacks, (fatal and non-fatal) strokes, end-stage renal disease (and its pre-stages), amputations, or pre-stages of blindness. Insufficient data were available for the outcomes "quality of life" and "blindness".

Indications that patients with type 2 diabetes benefit from intensive blood glucose control were found only for the outcome "non-fatal heart attacks". However, at the same time the data provide indications that severe hypoglycaemic episodes as well as other serious events in part occurred considerably more often in the intensive-therapy group than in the group with less intensive lowering of blood glucose levels.

Overall, the results of the current IQWiG report are consistent with those of reviews and meta-analyses recently conducted and presented by other researchers.

Question as to which treatment strategy is better still remains unanswered

The IQWiG Director Jrgen Windeler comments on the current report: "It is quite astonishing: individual interventions, particularly drugs, have in part been well investigated in studies; however, we know relatively little about the advantages and disadvantages of treatment strategies. If doctors are faced with the question as to what they can specifically offer to their diabetes patients, whether they should lower blood glucose levels as much as possible, and in which patients this a promising (or less promising) approach, they still do not receive sat
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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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