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The lack of a "legacy effect" of intensive glucose lowering at 15 years in the Veterans Affairs Diabetes Trial (VADT) suggests that other cardiovascular risk reduction strategies should be prioritized in patients with advanced type 2 diabetes and established cardiovascular disease.
That is the conclusion of Kasia J. Lipska, MD, Yale School of Medicine, New Haven, Connecticut, and Neda Laiteerapong, MD, University of Chicago, Illinois, in an editorial accompanying the study results, published online June 5 in the New England Journal of Medicine.
In VADT, participants who had been randomized to intensive glycemic control for a median of 5.6 years experienced lower rates of cardiovascular events than those randomized to standard therapy at a 10-year interim analysis. But in the current 15-year follow-up, there was no difference in cardiovascular events, total mortality, or quality of life.