Review confuses tight glycaemic control picture

A COCHRANE review showing similar rates of mortality for people with type 2 diabetes whether they have intensively controlled glucose or conventional management is not helpful to clinical practice, an expert says.

Danish reviewers analysed 20 trials of nearly 30,000 patients with type 2 diabetes and found there was no difference in all-cause mortality or cardiovascular mortality in patients targeted with intensive or conventional glucose control.

However, targeting intensive glycaemic control did reduce the risk of amputation by 35%, retinopathy by 21%, and nephropathy by 22%, but increased severe hypoglycaemia by 30%, compared with conventional control. 

Professor Wah Cheung, president of the Australian Diabetes Society, said the meta-analysis confused the picture by putting heterogeneous studies together into one analysis.

“I’m not sure this meta-analysis adds to our knowledge,” he said. 

He said