Exogenous Insulin Administration and Cardiovascular Risk in Non-Insulin-dependent and Insulin-dependent Diabetes Mellitus
Annals of Internal MedicinePublished 1 January 1996
Saul Genuth
Citations88
SJR quartileQ1
SJR score3.38
SNIP3.27
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TL;DR
The primary emphasis in this review is on the conclusions that may be derived from the original intention-to-treat analysis plan of the UGDP investigators so as to avoid the bias inherent in post hoc data dredging.
Abstract
The UGDP trial was flawed by inadequate power, insufficient separation of glycemic levels, and ignorance of smoking history as a possible confounder. In the DCCT, the number of cardiovascular events was few because the patients were young and had a relatively short duration of diabetes at baseline. In addition, total daily insulin doses were similar in the two DCCT treatment groups. For these reasons, neither trial provides a definitive answer to the question about the effects of intensive insulin therapy. A better designed clinical trial is needed to determine whether insulin treatment has beneficial or adverse effects, or even offsetting beneficial and adverse effects, on the risk for cardiovascular disease in NIDDM and IDDM.
Keywords
Medicine
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