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

Journal article

To assess effects of intensive glucose‐control on the risk of major clinical outcomes according to estimated glomerular filtration rate (eGFR) levels in type 2 diabetes. Among 11,140 ADVANCE trial participants, 11,096 participants with baseline eGFR measurements were included, classified into three groups: eGFR ≥90, 60‐89, and <60 ml/min/1.73m². Relative risk reduction of randomised intensive glucose‐control on the composite of major macro‐ and microvascular events, all‐cause death, and cardiovascular death did not significantly vary by eGFR levels (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 comparable to that observed in those with preserved kidney function.

Authors: Ohkuma, T; Zoungas, S; Jun, M; Lisheng, L; Mancia, G

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Wiley
• Journal: Diabetes, Obesity and Metabolism
• Volume: 22
• Issue: 3
• Pages: 452-457
• Publication date: 2019-09-04
• Acceptance date: 2019-08-31
• DOI: 10.1111/dom.13878
• EISSN: 1463-1326
• ISSN: 1462-8902
• Language: English