Doubts over tight glucose control

INTENSIVE glucose control should be the goal in people with early type 2 diabetes, an expert says, despite the fourth and largest meta-analysis showing it produces no reduction in mortality.

In a meta-analysis of 13 studies in more than 30,000 patients, French researchers showed intensive glucose lowering  did not lower all-cause or cardiovascular mortality compared with standard treatment.

The rate of non-fatal myocardial infarctions was 15% lower with intensive treatment, but not after excluding low quality trials.

Intensive treatment had an effect on only one microvascular outcome, lowering microalbuminuria by 10% compared with standard treatment.

However, the risk of severe hypoglycaemia was more than twice as high in the intensive treatment group compared with the standard treatment group.

Professor Wah Cheung, president of the Australian Diabetes Society, said the study showed little benefit could be expected if all