Intensive, early treatment of patients with diabetes offers no major benefit over standard GP care in reducing their risk of cardiovascular disease, according to a new study.
The research found that aggressive management to keep HbA1c levels below 7 per cent (53mmol/mol), blood pressure below 135/85 mmHg and, cholesterol below 5mmol/l in patients newly diagnosed with diabetes did not significantly reduce their chances of having a cardiovascular event in the short term, compared with routine diabetes care from GP practices.
After five years of intensive cardiovascular risk management, researchers from Denmark, the Netherlands and the UK found that the likelihood of suffering a heart attack, stroke or other cardiovascular event following diabetes diagnosis was cut by a non-significant 23 per cent when compared with usual care.
When restricting cardiovascular events to include mortality, non-fatal myocardial infarction and non-fatal stroke, they found that the drop in risk fell to just 14 per cent.
“Early intensive multifactorial treatment was not associated with a significant reduction in total cardiovascular burden at five years,” the study authors concluded.
“It remains to be seen whether intensification of early treatment in screen-detected individuals might translate into improved outcomes in the longer term.”
Dr Roger Gadsby, a GP in Nuneaton and member of the NICE type 2 diabetes guideline development group, said it can take up to 10 years for benefits to be demonstrated.
He commented: “There is evidence early intensive glycemic control improves cardiovascular outcomes in the long term, but they were looking at 10-plus years of follow-up after the intervention.”

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