Glycaemic separation and risk factor control in the Veterans Affairs Diabetes Trial

An interim report

Carlos Abraira, W. C. Duckworth, T. Moritz

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objective: The Veterans Affairs Diabetes Trial (VADT) will assess the effect of intensive (INT) vs improved standard (STD) glycaemic control on major cardiovascular (CV) events, treating other risk factors equally in both arms. Four-year results of main metabolic parameters are presented. Research design and methods: VADT is a 7.5 years prospective randomized study of 1791 patients, 20 centres, of men and women of age 60.5 ± 8.7 years, diagnosed for 11.5 ± 7.5 years. Their body mass index (BMI) at baseline was 31 ± 4 kg/m2 and mean A1C 9.4 ± 1.5% after maximum dose of oral agents or insulin treatment. Step treatment consists of glimepiride or metformin, rosiglitazone, insulin and other agents; A1C goals are 8-9% in STD and <6% in INT. Lifestyle, blood pressure and lipids are treated uniformly in both arms. Results: A1C improved in both arms. INT kept median A1C <7% all years, A1C separation is 1.5-1.7%. From year 1 to 4, mean blood pressure is <129/74 mmHg, similar throughout. Median LDL-C was <97 mg/dl by year 1 and triglycerides 150 or less by 2 years. Triglycerides were lower in INT (12-16 mg/dl; p < 0.01). By 4 years, 88% are on lipid-lowering agents and 93% are on antiplatelet/anticoagulant agents. BMI is higher in INT every year (0.9-1.6 kg/m2; p < 0.01). Conclusion: VADT is maintaining the expected A1C in both STD and INT, and LDL-C, triglycerides and blood pressure are at target. The trial is continuing to June 2008. It will be the first long-term completed type 2 diabetes study of the role of glycaemia on CV disease with modern treatments.

Original languageEnglish
Pages (from-to)150-156
Number of pages7
JournalDiabetes, Obesity and Metabolism
Volume11
Issue number2
DOIs
StatePublished - Jan 14 2009

Fingerprint

Veterans
rosiglitazone
glimepiride
Blood Pressure
Triglycerides
Body Mass Index
Insulin
Lipids
Metformin
Platelet Aggregation Inhibitors
Anticoagulants
Type 2 Diabetes Mellitus
Life Style
Research Design
Cardiovascular Diseases
Therapeutics
Prospective Studies

Keywords

  • Blood pressure
  • Cardiovascular disease
  • Glycaemic control
  • Lipids

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Glycaemic separation and risk factor control in the Veterans Affairs Diabetes Trial : An interim report. / Abraira, Carlos; Duckworth, W. C.; Moritz, T.

In: Diabetes, Obesity and Metabolism, Vol. 11, No. 2, 14.01.2009, p. 150-156.

Research output: Contribution to journalArticle

Abraira, Carlos ; Duckworth, W. C. ; Moritz, T. / Glycaemic separation and risk factor control in the Veterans Affairs Diabetes Trial : An interim report. In: Diabetes, Obesity and Metabolism. 2009 ; Vol. 11, No. 2. pp. 150-156.
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