Intensive control of glucose vs Hypoglycaemia agents chosen by the treating physician | Right Decisions

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Intensive control of glucose vs Hypoglycaemia agents chosen by the treating physician

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Medication/Intervention

Intensive control of glucose

Included the addition of Gliclazide mr tablets 30 to 120 mg daily, to existing medication (which could also be adjusted) to achieve a glycated haemoglobin (HbA_1c) value of 6.5% or less.

Comparator

Hypo-glycaemia agents chosen by the treating physician

Study population:

Patients with type 2 diabetes mellitus at least 55 years old with a history of major macro-vascular or micro-vascular disease or at least one other risk factor for vascular disease.

Comments:

Mean HbA_1c in control group was 7.3% and intensive (gliclazide mr) arm was 6.5% after 5 years follow up

Microvascular benefits were mostly due to reduction in nephropathy.

No significant effect on major macrovascular events alone.

Severe hypoglycaemia occurred in 2.7% of patients on intensive therapy compared with 1.5% of patients in the standard therapy group (NNH=80)

Outcome	Duration	NNT	Annualised NNT
Major microvascular or macrovascular events (death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke)	5 years (median)	53	263
Major microvascular events (new or worsening nephropathy or retinopathy)	5 years (median)	67	333