Doctors should be cautious about prescribing intensive glucose lowering treatment for patients with type 2 diabetes as a way of reducing heart complications, concludes a new study published on bmj.com today.
French researchers found that intensive glucose lowering treatment, which is widely used for people with type 2 diabetes to reduce their heightened risk of cardiovascular disease, showed no benefit on all-cause or cardiovascular mortality.
Glycaemic lowering therapies are commonly used to treat people with type 2 diabetes to prevent long-term cardiovascular complications and renal and visual impairment, but previous studies have not shown clear and universal benefits of the treatment.
The researchers calculated that over a five-year treatment period, 117 to 150 patients would need to be treated to avoid one heart attack, 32 to 142 to avoid one case of microalbuminuria, and 15 to 52 to avoid one severe hypoglycaemic event.
They conclude: "Intensive glucose lowering treatment of type 2 diabetes should be considered with caution and therapeutic escalation should be limited."
In an accompanying editorial, UK experts state that clinicians should consider the absolute risks and benefits of more intensive therapy carefully on an individual patient basis to determine the most sensible treatment strategy.