ADVANCE Study provides contrast to ACCORD results
February - 13 - 2008
Investigators in the ADVANCE Study, an international study involving 11,140 high-risk patients with type 2 diabetes, announced today that their study provides no evidence of an increased risk of death among those patients receiving intensive treatment to lower blood glucose (sugar). These findings contrast with those reported last week by the US National Heart Lung and Blood Institute suggesting that intensive glucose lowering treatment levels had increased the death rate compared to standard glucose lowering in patients with type 2 diabetes recruited to the ACCORD trial.The ADVANCE interim results were based on more than twice as much data and similar levels of glucose control as in ACCORD. The ADVANCE trial was 5 years in duration and is currently ending. More definitive and final outcome results from ADVANCE should be available later in the spring.
The American Diabetes Association believes that the information from ADVANCE is very important and further magnifies the uncertainty over whether intensive glucose control may harm some people with diabetes. Of note, the studies were not identical, and it is unclear whether their differences can explain the discrepancy in results. ADA eagerly awaits the full reports from ACCORD and ADVANCE, along with the results of a third trial, the VA Diabetes Trial, which also examined the relationship between intensive glycemic control and cardiovascular outcomes (CVD) in type 2 diabetes. We plan to critically examine the final data from these studies once they are publicly available later this year, and will issue further recommendations at that time. In the meantime, the American Diabetes Association continues to advise most people with diabetes to strive for an A1C (a measure of long-term blood glucose control) of less than 7 percent, but as always stresses individualization of treatment goals. People with type 2 diabetes who have existing CVD or multiple CVD risk factors should consult with their health care team about their treatment goals.
Statement from the ADVANCE Study.