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When to use RX for Diabetes

Comment on the diabetes "megatrials" from Leszek Czupryniak, President of the Polish Diabetes Professional Association:

The results, as you must have heard and you probably might remember, have been conflicting. In some of the studies, intensive glycemic control provided some benefit, especially in terms of microvascular complications. In other trials, especially in the ACCORD study, intensive glycemic control was clearly detrimental in terms of increasing the risk for macrovascular complications.

The first interpretation of these results was basically unfavorable toward intensive diabetes control. And we diabetologists were afraid for a while that perhaps what we were trying to do on an everyday basis was actually harming our patients. However, by looking in more detail at the results -- and this is the issue largely discussed these days in Dubai -- now we know that one [patient with] diabetes is not equal to another [patient with] diabetes. We should no longer adopt one target for [the whole] diabetes population; we should be able to differentiate among patients.

In my opinion -- but not only mine, it has been a shared view during this meeting -- the final interpretation of these studies is rather striking, because now we clearly know that intensive diabetes control is absolutely beneficial for subjects who have just diabetes with no complications, who are relatively young, and who have had diabetes for a shorter time, less than 5 years.

SOURCE
http://www.medscape.com/viewarticle/755416?src=mp&spon=22

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