By Tom Moberly, 25 November 2011
Researchers also concluded that there is no evidence that intensive control reduces cardiovascular mortality, non-fatal MI, microvascular complications or retinopathy.
Leicester GP Professor Kamlesh Khunti, professor of primary care diabetes at the University of Leicester, said the data supported other studies showing the need to avoid blanket targets for patients.
?We should individualise HbA1c target, as per NICE guidelines,? he said. ?We should be aiming for a lower target early on a patient?s disease trajectory and than going for a less tight target later on a patient?s disease journey, for instance after 10 years.
?QOF targets unfortunately do not allow individualisation of therapy.?
Dr Jorn Wetterslev and colleagues from Copenhagen University analysed data from 14 clinical trials involving 28,614 patients.
They found that intensive glycaemic control did not significantly affect the relative risks of all-cause or cardiovascular mortality. However, the risk of severe hypoglycaemia was increased by 30%.
Commenting on their findings, the researchers said: ?We found evidence to refute the suggestion that intensive compared with conventional glycaemic control reduces all cause mortality with a relative risk reduction of 10% or more.
?Accordingly, treatment and choice of a glycaemic target for patients with type-2 diabetes need to take both harms and benefits into account.'
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