Joslin Diabetes Center Statement: ACCORD Study
BOSTON -- February 6, 2008 -- Today, the National Heart, Lung, and Blood Institute announced that it has halted the intensive blood glucose (sugar) control arm in one of its studies due to safety concerns.
The study is known as the ACCORD (Action to Control Cardiovascular Risk in Diabetes) Trial. This trial was designed to compare the impact of very tight glucose control (aiming to achieve a normal HbA1c of less than 6%) compared to less-intensive glucose control (aiming to achieve an HbA1c of 7.0% to 7.9%) as well as intensive lipid or blood pressure control. The patients who participated in this study either had existing cardiovascular disease (CVD), or multiple cardiovascular disease risk factors. The study found a small increase in mortality in the very tight glucose treatment group. Importantly, survival for all study participants was better than survival rates for people with type 2 diabetes.
Blood glucose management is one of the primary clinical approaches to managing type 2 diabetes and preventing complications. Joslin Diabetes Center clinical guidelines recommend that patients with type 2 diabetes maintain an HbA1c level of less than 7%, as close to normal as possible if clinically appropriate. The Joslin recommends that the HbA1c target goal should be individualized for each patient.
If you are concerned about your HbA1c level or treatment, you should consult your Joslin Clinic physician at 617-732-2400 or your health care provider. You should not make changes in your medical therapy until you have spoken to your physician.
If you have type 2 diabetes and have cardiovascular disease or risk factors for cardiovascular disease, it is important to ensure your lipids and blood pressure are well controlled. There is strong evidence that good control of all cardiovascular disease risk factors reduces the risk of heart attack and stroke in patients with type 2 diabetes.
The importance of glucose control in diabetes is well established. Evidence from the landmark Diabetes Control and Complications Trial (DCCT), and the United Kingdom Prospective Diabetes Study (UKPDS) show that improved glucose control to an HbA1c level of approximately 7% significantly reduces the microvascular complications of diabetes which impact the eyes, nerves and kidneys.
The ACCORD study findings underscore the importance of additional research to prevent the complications of diabetes.
For more information on the ACCORD study, visit the National Heart Lung and Blood Institute web site: http://www.nhlbi.nih.gov/health/prof/heart/other/accord/q_a.htm