Aggressive Treatment of Type 2 Diabetes Offers Little Benefit

There is disappointing news in the treatment of type 2 diabetes. A ten-year-long study that included more than 5,500 people with this condition found that making an extra effort to lower triglycerides, fats in the blood, did not result in fewer heart attacks or strokes. All the patients in the study, dubbed ACCORD, took the statin drug Zocor to lower cholesterol. Half of them also took a medicine called TriCor, while the others took a placebo pill. Investigators found that there was no statistically significant advantage among those taking the TriCor.
The ACCORD trial also tested intensive blood pressure therapy. Heart disease, strokes and kidney disease are common complications of diabetes, and all are linked to high blood pressure as well. Among the patients treated to bring systolic blood pressure below 120, there were significantly fewer strokes. There were also fewer events that could be attributed to heart disease, but not so many fewer that the investigators have confidence in the statistics. Getting systolic blood pressure down below 120 instead of 140 also resulted in more side effects. The researchers conclude that aggressive treatment may not produce any additional benefit.

[New England Journal of Medicine, online March 14, 2010]