Intensive glucose-lowering in older patients with advanced type 2 diabetes is unlikely to confer lasting cardiovascular benefits or reduce mortality risk compared with standard treatment, a major US trial has shown.

Reporting on a 15-year follow-up of patients in the Veterans’ Affairs Diabetes trial (VADT), researchers said more than five years of intensive therapy did not reduce events, such as MI, stroke or cardiovascular-related death, in the long term.

“There was no evidence of a beneficial legacy effect after the period of improved glucose control,” they said.

In the VADT study of 1800 military veterans, treating to a median HbA1c of 6.9% vs 8.4% in the standard therapy group resulted in a “modest” 17% reduced risk of major CV events after 10 years.