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Evidence summaries

Intensive Insulin Therapy and Early Macrovascular Disease in Young Individuals with Type 1 Diabetes

Intensive insulin therapy decreases the number of macrovascular events in young individuals with type 1 diabetes, but the effect on the number of patients affected or macrovascular mortality has to be shown. Level of evidence: "A"

A systematic review 1 including 6 RCTs with a total of 1732 subjects aged 18 - 50 years was abstracted in DARE. The outcomes assesses were angina pectoris, myocardial infarction, angioplasty, CABG, cerebrovascular events, intermittent claudication, peripheral artery bypass, and macrovascular death. Intensive insulin therapy (with multiple daily injections or insulin pump) decreased the number of macrovascular events (OR 0.55, 95% CI 0.35 to 0.88) but had no significant effect on the number of patients developing macrovascular disease (OR 0.72, 95% CI 0.44 to 1.17) or on macrovascular mortality (OR 0.91, 95% CI 0.31 to 2.65).

    References

    • Lawson ML, Gerstein HC, Tsui E, Zinman B. Effect of intensive therapy on early macrovascular disease in young individuals with type 1 diabetes. A systematic review and meta-analysis. Diabetes Care 1999 Mar;22 Suppl 2:B35-9. [PubMed][DARE]

Primary/Secondary Keywords