Pivotal Trials

Question 1

DCCT purpose

Answer 1

evaluated effects of intensive insulin treatment in T1DM

Question 2

Outcomes of DCCT

Answer 2

Intensive therapy reduces microvascular complications

The lower you keep A1C, the lower the risk for developing microvascular complications

Question 3

DDCT CV outcomes

Answer 3

Weren’t recognized until 10 years out

Question 4

UKPDS purpose

Answer 4

determine whether improved glucose control of T2DM would prevent clinical complications

Question 5

UKPDS outcomes

Answer 5

To reduce complications of DM, it’s necessary to control BG, A1C, BP

Every percentage point reduction in A1C lead to a decrease in microvascular complications, DM-related death, and MI

Question 6

UKPDS intensive therapy outcomes

Answer 6

decreased DM-related death, MI, death from any cause

Question 7

ACCORD purpose

Answer 7

determine whether improved glucose control in T2DM will prevent clinical complications (same as UKPDS!)

Question 8

ACCORD outcomes

Answer 8

Intensive glucose treatment strategy was associated with a higher risk of death

Question 9

A higher risk of death from the ACCORD trial was associated with these 3 factors:

Answer 9

1. A1C ≥8.5%
2. Hx of neuropathy
3. Hx of ASA use

Question 10

ADVANCE purpose

Answer 10

evaluate whether or not micro and macrovascular events would decrease in an intensive treatment group in patients with T2DM

Question 11

ADVANCE outcomes

Answer 11

Decrease in micro and macrovascular complications with intensive therapy

Question 12

VADT purpose

Answer 12

evaluate intensive glucose control and its effect on complications in T2DM

Question 13

VADT outcomes

Answer 13

lower threshold to start insulin decreased major MACROvascular complications

severe hypoglycemia in the last 90 days was a strong predictor of mortality

Question 14

CVD outcome for DDP4is

Answer 14

no effect on CVD outcomes

Question 15

CVD outcome for SGLT2is and GLP-1RAs

Answer 15

provide CV protection/benefit