Ohkuma, T; Zoungas, S; Jun, M; Lisheng, L; Mancia, G; Marre, M; Rodgers, A; ... ADVANCE Collaborative Group; + view all Ohkuma, T; Zoungas, S; Jun, M; Lisheng, L; Mancia, G; Marre, M; Rodgers, A; Williams, B; Woodward, M; Chalmers, J; ADVANCE Collaborative Group; - view fewer (2020) Intensive glucose lowering and the risk of vascular events and premature death in patients with decreased kidney function: the ADVANCE trial. Diabetes, Obesity and Metabolism , 22 (3) pp. 452-457. 10.1111/dom.13878.

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Abstract

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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