@article{db0d0c664c5b4f38bdfa7cb770687e0e,
title = "Differences in glycemic control between the treatment arms in cardiovascular outcome trials of type 2 diabetes medications do not explain cardiovascular benefits",
abstract = "Hyperglycemia is an undisputed epidemiological risk factor for microvascular complications in both type 1 and type 2 diabetes, integral in their causal pathways. Importantly, interventions that reduce the hyperglycemic burden in patients with either type of diabetes reduce the risk of microvascular complications (e.g., retinopathy, nephropathy, neuropathy). Hence, for microvascular risk, hyperglycemia is a proven risk factor and a proven treatment target, as reflected by treatment recommendations and guidelines across most scientific societies world-wide. However, although reducing the hyperglycemic burden to reduce microvascular risk remains a cornerstone of care for patients with type 2 diabetes, this therapeutic imperative does not apply to cardiovascular risk mitigation. This latter aspect is important in the context of interpreting therapeutic impact of treating hyperglycemia on risk for macrovascular complications in patients with type 2 diabetes. This letter, in response to a previous paper, discuss how modest differential glucose control contribute little if anything to the results observed of contemporary cardiovascular outcome trials in type 2 diabetes.",
keywords = "Bias, Cardiovascular outcome trials, Epidemiology, Medication, Risk reduction, SGLT-2 inhibitor, Type 2 diabetes",
author = "McGuire, {Darren K.} and Inzucchi, {Silvio E.} and Johansen, {Odd Erik} and Julio Rosenstock and George, {Jyothis T.} and Nikolaus Marx",
note = "Funding Information: DKM has received personal fees from Afimmune, Boehringer-Ingelheim, Janssen Research and Development LLC, Sanofi-Aventis Group, Merck Sharp and Dohme, Merck & Co., Lilly USA, Novo Nordisk, GlaxoSmithKline, AstraZeneca, Lexicon, Eisai Inc.Pfizer, Metavant, Applied Therapeutics, Esperion. SEI has served on clinical trial executive, steering or publications committees or has consulted or lectured for Boehringer Ingelheim, AstraZeneca, Novo Nordisk, Sanofi/Lexicon Pharmaceuticals, vTv Therapeutics, Merck, and Abbott (Alere). OEJ was employed by Boehringer Ingelheim at the time of writing of this manuscript, but is now employeed by Nestl{\'e} Health Science. JR has served on scientific advisory boards and received honoraria or consulting fees from Eli Lilly, Sanofi, Novo Nordisk, Janssen, Oramed, Boehringer Ingelheim and Intarcia; he has also received grants/research support from Merck, Pfizer, Sanofi, Novo Nordisk, Eli Lilly, GlaxoSmithKline, Genentech, Janssen, Lexicon, Boehringer Ingelheim, Oramed and Intarcia. JTG was employed by Boehringer Ingelheim at the time of writing of this manuscript, but is now employeed by Novo Nordisk. NM has given lectures for Amgen, Boehringer Ingelheim, Sanofi-Aventis, MSD, BMS, AstraZeneca, Lilly, NovoNordisk; has received unrestricted research grants from Boehringer Ingelheim, and has served as an advisor for Amgen, Bayer, Boehringer Ingelheim, Sanofi-Aventis, MSD, BMS, AstraZeneca, NovoNordisk. In addition, served in trial leadership for Boehringer Ingelheim and Novo Nordisk. I decline all personal compensation from pharma or device companies. Funding Information: We thank Prof Bernard Zinman, MD, Toronto, Canada, for constructive comments. All authors are Steering Committee Members in one or all of: CARMELINA; CAROLINA and EMPA-REG-OUTCOME Publisher Copyright: {\textcopyright} 2021, The Author(s).",
year = "2021",
month = dec,
doi = "10.1186/s40545-020-00295-3",
language = "English (US)",
volume = "14",
journal = "Journal of Pharmaceutical Policy and Practice",
issn = "2052-3211",
publisher = "BioMed Central",
number = "1",
}