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Search Evidence Central Evidence Central Close Please Sign in with your Evidence Central account Username (required) Password (required) Remember Me Forgot your username or password? Home Favorites Notes Prime PubMed Mobile Browse Sign in Evidence-Based Answers Evidence Central ™ is an integrated web and mobile solution that helps clinicians quickly answer etiology, diagnosis, treatment, and prognosis questions using the latest evidence-based research. Search Evidence Central Browse Evidence-Based Medicine Guidelines EE+ POEM Archive Cochrane Abstracts Prime For You Prime Journals Evidence Central for Mobile Devices Evidence Central from Unbound Medicine, available for iOS® and Android™, is optimized for each platform and features superior navigation, so answers are easy to find at the bedside or anywhere they’re needed. Learn More Word of the Day Intensive glucose control increases mortality in T2DM (ACCORD) Clinical Question: Does intensive glucose control in patients with type 2 diabetes improve outcomes more than usual control? Bottom Line: This study confirms the initial findings of the ACCORD study: In middle-aged or older patients with cardiovascular risk factors, the best target for glycated hemoglobin is between 7.0% and 7.9%. (LOE = 1b) Reference: The ACCORD study group. Long-term effects of intensive glucose lowering on cardiovascular outcomes. N Engl J Med 2011;364(9):818-828. [PMID:21366473] Study Design: Randomized controlled trial (double-blinded) Funding: Government Allocation: Concealed Setting: Outpatient (any) Synopsis: The ACCORD study randomized persons aged 40 to 79 years with type 2 diabetes mellitus and known cardiovascular disease or cardiovascular risk factors to either intensive glucose control (glycated hemoglobin target < 6.0%) or usual control (7.0% to 7.9%). The study was stopped after 3.7 years when a significant increase in all-cause mortality was detected in the intensive therapy group. At that time, the median glycated hemoglobin levels were 6.4% and 7.5% in the intensive and usual treatment groups, respectively. At that time, the target for patients in the intensive therapy group was relaxed to a target glycated hemoglobin between 7.0% and 7.9%; follow-up continued for an additional 17 months. This report describes the results at the end of the entire 5 year follow-up period. At that time, the median glycated hemoglobin levels were 7.2% and 7.6%. Essentially, there was little difference between the outcomes of the original study and those at 5 years. Although nonfatal myocardial infarctions were still less common after 5 years (hazard ratio [HR] = 0.82; 95% CI, 0.7 - 0.96), cardiovascular and all-cause deaths (HR = 1.19; 1.03 - 1.38) were more common. RSS FEED Site Licenses Site Licenses are available for schools, universities, hospitals, government agencies, and companies. For more information, contact us . Home Contact Us Privacy / Disclaimer Terms of Service Sign in © 2000–2020 Unbound Medicine, Inc. All rights reserved CONNECT WITH US facebook twitter youtube instagram 6.0-1550...