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More ACCORD data: Bad news, good news?

June 9, 2008

The ACCORD trial (Action to Control Cardiovascular risk in Diabetes Trial) continues to be on physician, educator and patient watch-lists given it's surprising results.

As analysis of this large landmark trial continues, more information comes to light. Although, to be honest, not a great deal of answers about the unfortunate statistics of increased death. However, here is the point you should read on for: there is some very positive news that comes from this most recent analysis.

You may recall that the Action to Control Cardiovascular risk in Diabetes Trial was designed to determine if an intensive treatment program for blood sugar, hypertension and lipids could reduce the risk of cardiovascular disease in type 2 diabetes, and if so, which elements of the program would most be responsible. However, the results showed that there were more deaths in the treatment group aiming for near normal blood sugars than the standard group. You can read a brief overview of the ACCORD diabetes study here .

The Bad News First

Unfortunately, despite very detailed analysis, the specific cause or causes for the increased risk of death have not been identified, says lead researcher Dr. Hertzel Gerstein MD, MSc, Division of Endocrinology & Metabolism and Diabetes Care and Research Program at McMaster University and Hamilton Health Sciences, Hamilton, Ontario. To date, they are unable to point the finger at any one specific medication or combination of medications as being responsible. Analysis will continue.

BUT ...

Some Great News from the ACCORD trial

Despite the negative news, analysis has shown something most positive. Those in the intensive treatment group of this study study who started the study with lower blood sugars to begin with OR who started the study with no history of heart attack or stroke, had fewer cardiovascular events (fatal and nonfatal heart attacks or strokes) compared to the standard group. Good news indeed. We will await further news to see the real statistics.

A few arms of the study continue. They will continue to aggressively treat to lower blood pressure and lipids with the intent of continuing these aspects of the study until June 2009. To read more about updates for this study dated June 9, 2008 please see here.

What does this mean to you?

Physicians and health educators may be more hesitant to push A1c values closer to 6% in those who currently have cardiovascular disease. However, each person's therapy and risk will still be individualized so before you make any changes to your diabetes care based on the ACCORD trial, speak with your physician.


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