What are the risks of intensive glucose lowering in type 2 diabetes mellitus (DM)?

Updated: Oct 23, 2019
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

In a meta-analysis of 13 studies, intensive glucose lowering had no significant effect on all-cause mortality or cardiovascular deaths. A reduction in nonfatal myocardial infarction and microalbuminuria was noted. However, patients experienced a 2-fold increased risk of hypoglycemia. [247]

Risks of and considerations in intensive treatment

Risk for hypoglycemia is almost always the limiting factor in achieving the lowest possible HbA1c that does not cause undue harm. Unfortunately, some practitioners and their patients pursue a particular HbA1c value despite uncertain benefit or unacceptable risk, with significant risk for side effects.


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