TY - JOUR
T1 - Intensive glucose-lowering and the risk of vascular events and premature death in patients with decreased kidney function
T2 - The ADVANCE trial
AU - on behalf of the ADVANCE Collaborative Group
AU - Ohkuma, Toshiaki
AU - Zoungas, Sophia
AU - Jun, Min
AU - Lisheng, Liu
AU - Mancia, Giuseppe
AU - Marre, Michel
AU - Rodgers, Anthony
AU - Williams, Bryan
AU - Woodward, Mark
AU - Chalmers, John
N1 - Funding Information:
The ADVANCE trial was funded by the grants from the National Health and Medical Research Council (NHMRC) of Australia and Servier. T.O. is supported by the John Chalmers Clinical Research Fellowship of the George Institute. M.J. is supported by a Scientia Fellowship from UNSW Sydney. B.W. is a National Institute for Health Research (NIHR) Senior Investigator. M.W. is a NHMRC of Australia Principal Research Fellow (1080206).
Funding Information:
The ADVANCE trial was funded by the grants from the National Health and Medical Research Council (NHMRC) of Australia and Servier. T.O. is supported by the John Chalmers Clinical Research Fellowship of the George Institute. M.J. is supported by a Scientia Fellowship from UNSW Sydney. B.W. is a National Institute for Health Research (NIHR) Senior Investigator. M.W. is a NHMRC of Australia Principal Research Fellow (1080206).
Publisher Copyright:
© 2019 John Wiley & Sons Ltd
PY - 2020/3/1
Y1 - 2020/3/1
N2 - 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.
AB - 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.
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U2 - 10.1111/dom.13878
DO - 10.1111/dom.13878
M3 - Article
C2 - 31486188
AN - SCOPUS:85074608565
SN - 1462-8902
VL - 22
SP - 452
EP - 457
JO - Diabetes, Obesity and Metabolism
JF - Diabetes, Obesity and Metabolism
IS - 3
ER -
