ADVANCE Trial Summary: Intensive Glucose Control in Diabetes Type 2
2008 ADVANCE TRIAL Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes Multicenter, factorial, randomized trial Objective: To evaluate vascular effects of intensive glycemic therapy targeting a HbA1c <6.5% in patients with type II diabetes 11,140 Patients with DMII diagnosed at ≥30 years of age and hx of major macrovascular or microvascular disease or risk factor for vascular disease 18.1 8.9 5.6 Intensive glucose control VS (n=5571) Standard glucose control (n=5569) PRIMARY OUTCOME Combined macrovascular and microvascular events % HR 0.90; 95% CI 0.82-0.98; P=0.01 SECONDARY OUTCOME Death from any cause % P = 0.28 Major coronary events (death due to CAD or nonfatal MI) % P = NS 20.0 9.6 6.1 Conclusion: Intensive glycemic control targeting HbA1c ≤ 6.5% improves microvascular outcomes but has no impact on macrovascular outcomes in patients with T2DM. Patel A, et al. NEJM, 2008. 358(24):2560-2572.