Intensive glucose-lowering and the risk of vascular events and premature death in patients with decreased kidney function: The ADVANCE trial

ADVANCE Collaborative Group, Toshiaki Ohkuma, Sophia Zoungas, Min Jun, Liu Lisheng, Giuseppe Mancia, Michel Marre, Anthony Rodgers, Bryan Williams, Mark Woodward, John Chalmers

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

To assess the effects of intensive glucose control on the risk of major clinical outcomes according to estimated glomerular filtration rate (eGFR) levels in people with type 2 diabetes. Of 11 140 ADVANCE trial participants, 11 096 with baseline eGFR measurements were included, and classified into three eGFR groups: ≥90 mL/min/1.73 m2; 60 to 89 mL/min/1.73 m2; and < 60 mL/min/1.73 m2. Relative risk reduction of randomized intensive glucose control with regard to the composite outcome of major macro- and microvascular events, all-cause death and cardiovascular death did not significantly vary by eGFR level (P for heterogeneity ≥0.49). The risk of severe hypoglycaemia increased with intensive glucose control; however, this risk did not vary across eGFR groups (P for heterogeneity = 0.83). The risk–benefit profile of intensive glucose control in patients with type 2 diabetes and impaired kidney function appears similar to that observed in those with preserved kidney function.

Original languageEnglish
Pages (from-to)452-457
Number of pages6
JournalDiabetes, Obesity and Metabolism
Volume22
Issue number3
DOIs
Publication statusPublished - Mar 2020
Externally publishedYes

Keywords

  • cardiovascular disease
  • clinical trial
  • glycaemic control
  • hypoglycaemia
  • type 2 diabetes

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    ADVANCE Collaborative Group, Ohkuma, T., Zoungas, S., Jun, M., Lisheng, L., Mancia, G., Marre, M., Rodgers, A., Williams, B., Woodward, M., & Chalmers, J. (2020). Intensive glucose-lowering and the risk of vascular events and premature death in patients with decreased kidney function: The ADVANCE trial. Diabetes, Obesity and Metabolism, 22(3), 452-457. https://doi.org/10.1111/dom.13878