The full study
http://content.nejm.org/cgi/content/full/NEJMoa0808431
The subjects, mean age 60.4, were selected from men (ex military)
with poor control ie an inadequate response to either oral medicaments or insulin therapy. Subjects were excluded if they had an HbA1c of less than 7.5%, recent cardiovascular event,(
but 40% had already had one) had a BMi over 40 or had a life expectancy less than 7 years. There were 2 conditions one standard therapy, the other intensive control.
At a mean follow up time of 5.6 years, normal control group had an average HbA1c of 8.4%, intensive of 6.9%. Outcomes were defined as 'major cardiovascular event, a composite of myocardial infarction, stroke, death from cardiovascular causes, congestive heart failure, surgery for vascular disease, inoperable coronary disease, and amputation for ischemic gangrene'
There was no significant difference in outcomes between groups.
They state that the study was limited to men so not necessarily applicable to women. and that newer drugs have become available and they might have different effects.
They note similar results in the ACCORD and ADVANCE studies
They note that other factors ' levels of HDL cholesterol, weight gain, systolic blood pressure, and pharmacologic agents could play a role in the observed lack of benefit of intensive glucose control and need to be examined in detail.'
In conclusion they say 'the results of this and other studies do not indicate that intensive glucose control in this population decreased the rate of cardiovascular events. In addition, it appears that intensive glucose control had minimal effects on microvascular complications during a period of 5 to 6 years.
Intensive glycemic control earlier in the disease course may produce benefit, especially if severe hypoglycemia is avoided. For now, appropriate management of hypertension, dyslipidemia, and other cardiovascular risk factors appears to be the most effective approach to preventing cardiovascular morbidity and mortality.'(
my underlinings)
To me it is sad that the people in the intensive condition were in fact able to reduce their BG levels, however they had already had damaging BG levels for an average of 11 years.