Does intensive glycemic control for type 2 diabetes mellitus have long-term benefits for cardiovascular disease risk?

This Practice Point commentary discusses the findings of the 10-year follow-up of the United Kingdom Prospective Diabetes Study, which was a multicenter, randomized, controlled trial in which patients with newly diagnosed type 2 diabetes mellitus received conventional or intensive glycemic control. The follow-up study by Holman et al. suggests that intensive glycemic control can have long-lasting benefits in reducing the incidence not only of diabetes-related end points and microvascular complications (as shown in the original UKPDS study) but also of myocardial infarction and death from any cause. These benefits occurred despite the early loss of within-trial differences in HbA_1c levels between the intensive and conventional treatment groups. The findings of Holman et al. support the notion of a sustained, legacy effect of intensive glycemic control, which was originally suggested in the Epidemiology of Diabetes Interventions and Complications study.