Intensive Glucose Lowering Cuts Vascular Risks for Diabetic Patients, Regardless of Age or Duration: ADVANCE Trial

For this purpose, the researchers analyzed data from 11,138 participants in the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial. Participants were grouped into subcategories based on age at diabetes diagnosis (≤50, >50–60, and >60 years) and the duration of their diabetes (≤5, >5–10, and >10 years).

The study revealed the following findings:

• Intensive glucose lowering significantly reduced the risk of the primary composite outcome of major macrovascular and microvascular events (hazard ratio 0.90).
• There was no evidence of differences in treatment effects across subgroups based on age at diagnosis or diabetes duration.
• Similar consistent reductions were observed for all-cause death and cardiovascular death.
• The beneficial effects were also evident across individual components of major vascular events.

The findings suggest that intensive blood sugar management leads to a significant reduction in the risk of serious vascular complications, offering crucial insights for healthcare providers and diabetic patients alike. Notably, the reduction in risks was consistent regardless of whether patients were newly diagnosed or had been living with diabetes for years, and there was no notable difference in outcomes based on the age at diagnosis or the duration of diabetes.

"The ADVANCE trial’s findings signal a shift toward a more inclusive, evidence-based approach to glucose management, emphasizing its benefits across all ages and stages of diabetes. These insights provide a critical tool for healthcare professionals working to improve long-term patient outcomes," the researchers concluded.

Reference:

Toshiaki Ohkuma, Katie Harris, Mark Woodward, Pavel Hamet, Stephen Harrap, Giuseppe Mancia, Michel Marre, Neil Poulter, John Chalmers, Sophia Zoungas, ADVANCE Collaborative Group; Intensive Glucose Lowering and Its Effects on Vascular Events and Death According to Age at Diagnosis and Duration of Diabetes: The ADVANCE Trial. Diabetes Care 2024; dc241516. https://doi.org/10.2337/dc24-1516