Intensive glucose-lowering and the risk of vascular events and premature death in patients with decreased kidney function: The ADVANCE trial.

Ohkuma T., Zoungas S., Jun M., Lisheng L., Mancia G., Marre M., Rodgers A., Williams B., Woodward M., Chalmers J., ADVANCE Collaborative Group .

To assess the effects of intensive glucose control on the risk of major clinical outcomes according to estimated glomerular filtration rate (eGFR) levels in people with type 2 diabetes. Of 11 140 ADVANCE trial participants, 11 096 with baseline eGFR measurements were included, and classified into three eGFR groups: ≥90 mL/min/1.73 m2 ; 60 to 89 mL/min/1.73 m2 ; and < 60 mL/min/1.73 m2 . Relative risk reduction of randomized intensive glucose control with regard to the composite outcome of major macro- and microvascular events, all-cause death and cardiovascular death did not significantly vary by eGFR level (P for heterogeneity ≥0.49). The risk of severe hypoglycaemia increased with intensive glucose control; however, this risk did not vary across eGFR groups (P for heterogeneity = 0.83). The risk-benefit profile of intensive glucose control in patients with type 2 diabetes and impaired kidney function appears similar to that observed in those with preserved kidney function.

DOI

10.1111/dom.13878

Type

Journal article

Publication Date

2020-03-01T00:00:00+00:00

Volume

22

Pages

452 - 457

Total pages

5

Keywords

cardiovascular disease, clinical trial, glycaemic control, hypoglycaemia, type 2 diabetes, Diabetes Mellitus, Type 2, Glucose, Humans, Hypoglycemia, Kidney, Mortality, Premature

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