Major Clinical Trials

Question 1

ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation)

Answer 1

Decreased risk of nephropathy in treatment group targeting A1c less than 6.5% vs standard approach

Question 2

ACCORD (Action to Control Cardiovascular Risk in Diabetes)

Answer 2

Mortality may have been related to hypoglycemia

Question 3

The Diabetes Control and Complications Trial (DCCT)

Answer 3

• Prospective randomized controlled trial
• Type 1 DM with recent diagnosis
• Intense vs standard glycemic control
• Showed intense group had significant decreased rates of microvascular (retinopathy and kidney disease) and neuropathic complications
• Benefit lasted at follow up even when the intense group’s overall glycemic control eventually matched the previous standard group