Intensive Glucose Control Has Cardiovascular Benefits强化血糖控制有益于心血管

A nearly 10 years of extended follow-up of a randomized study in the US revealed that patients with type 2 diabetes who had been assigned to intensive glucose control for 5.6 years had 8.6 fewer major cardiovascular events per 1000 person-years than those assigned to standard therapy, but not mortality. The difference in glycated hemoglobin levels between the intensive-therapy group and the standard-therapy group averaged 1.5 percentage points during the trial (median level, 6.9% vs. 8.4%) and declined to 0.2 to 0.3 percentage points by 3 years after the trial ended. Over a median follow-up of 9.8 years, the intensive-therapy group had a significantly lower risk of the primary outcome than did the standard-therapy group, but did not have reduced cardiovascular and total mortality. This is the first time cardiovascular benefit has been shown for more intensive glucose control. The benefits need to be weighed against potential harm due to aggressive management, such as weight gain and hypoglycemia. It is known that intensive glycemic control is important for microvascular disease. Source: http://www.nejm.org/对美国一个随机研究近10年的延长随访发现，2型糖尿病患者经5.6年的强化血糖控制，每1000人中主要心血管事件比那些给予标准疗法者少8.6例，而非死亡率。试验期间强化治疗组和标准治疗组之间的糖化血红蛋白水平差异平均1.5个百分点（中位数6.9％和8.4％），试验结束后3年下降到0.2至0.3个百分点。在中位随访9.8年间，强化治疗组比标准治疗组的主要预后风险显著降低，但并没有减少心血管病和总死亡率。这还是第一次证明强化血糖控制有益于心血管。强化血糖控制的益处需要与其潜在的危害相权衡，如体重增加和低血糖。已知强化血糖控制对微血管病很重要。来源：http://www.nejm.org/