ACCORD Glycemia Results Continue to Puzzle
2010; American Diabetes Association; Volume: 33; Issue: 5 Linguagem: Inglês
10.2337/dc10-0432
ISSN1935-5548
Autores Tópico(s)Metabolism, Diabetes, and Cancer
Resumo“If I had a world of my own, everything would be nonsense. Nothing would be what it is, because everything would be what it isn't. And contrary wise, what is, it wouldn't be. And what it wouldn't be, it would.” This quote by Alice from the Disney film version of Alice in Wonderland by Lewis Carroll may make sense in the world she experiences. In our world, Alice's wish is usually not fulfilled, but some findings of the Action to Control Cardiovascular Disease in Diabetes (ACCORD) glycemic control study may be an exception. The report by Riddle et al. (1) in this issue of Diabetes Care attempts to explain in an observational post hoc analysis of the ACCORD trial whether features of glucose control explain the higher observed death rate in the intensive compared with the standard glycemic control treatment arms (2). All the provisos associated with observational research must be kept in mind when interpreting this analysis, which does not have the same high standard of evidence as testing prespecified hypotheses of a randomized controlled trial. The ACCORD trial assessed the effects of several interventions directed at blood pressure, dysipidemia, and hyperglycemia on diabetes outcomes. The results of the glucose control aspect of the trial defied expectations when it was announced that the intensive glucose control arm was prematurely terminated due to higher mortality associated with assignment to this treatment. …
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