Most diabetic patients die of cardiovascular disease (CVD), with CVD rates in diabetic persons two to four times those of the non-diabetic population. This increased CVD risk, along with the increasing prevalence of obesity and increasing numbers of elderly in the U.S. population, means that diabetes-associated CVD will become an even greater public health problem in the future. Diabetes mellitus is a complex metabolic disorder with generally evaluated levels of insulin resistance and variable levels of circulating insulin, which is often accompanied by abnormalities in carbohydrate, lipid, and protein metabolism and elevated blood pressure. While glucose control appears important for Type 2 patients, it is critical not to overlook treatment of associated CVD risk factor abnormalities. The effects on prevention of cardiovascular disease events of intensive control of established CVD risk factors (blood pressure and blood lipids), and intensive control of blood glucose, in Type 2 diabetes are unknown. The study is a multi-center randomized clinical trial of about 10,000 adult patients with Type 2 diabetes mellitus followed for four to seven years. The primary objective of this research program is to assess whether the rate of major cardiovascular disease events can be reduced by: (1) intensive control of blood sugar compared with conventional control; (2) intensive control of blood pressure compared with conventional control; and (3) intensive control of blood lipids compared with conventional control. Other objectives include the comparative cost effectiveness of the above interventions and their impact on health-related quality of life.

Project Start
1999-09-30
Project End
2008-09-29
Budget Start
1999-09-30
Budget End
2000-09-29
Support Year
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Case Western Reserve University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
Gower, Emily W; Lovato, James F; Ambrosius, Walter T et al. (2018) Lack of Longitudinal Association Between Thiazolidinediones and Incidence and Progression of Diabetic Eye Disease: The ACCORD Eye Study. Am J Ophthalmol 187:138-147
Drake, T C; Hsu, F-C; Hire, D et al. (2016) Factors associated with failure to achieve a glycated haemoglobin target of <8.0% in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Diabetes Obes Metab 18:92-5
Siraj, Elias S; Rubin, Daniel J; Riddle, Matthew C et al. (2015) Insulin Dose and Cardiovascular Mortality in the ACCORD Trial. Diabetes Care 38:2000-8
Espeland, Mark A; Probstfield, Jeffery; Hire, Donald et al. (2015) Systolic Blood Pressure Control Among Individuals With Type 2 Diabetes: A Comparative Effectiveness Analysis of Three Interventions. Am J Hypertens 28:995-1009
Schwartz, Ann V; Chen, Haiying; Ambrosius, Walter T et al. (2015) Effects of TZD Use and Discontinuation on Fracture Rates in ACCORD Bone Study. J Clin Endocrinol Metab 100:4059-66
Soliman, Elsayed Z; Byington, Robert P; Bigger, J Thomas et al. (2015) Effect of Intensive Blood Pressure Lowering on Left Ventricular Hypertrophy in Patients With Diabetes Mellitus: Action to Control Cardiovascular Risk in Diabetes Blood Pressure Trial. Hypertension 66:1123-9
Isakova, Tamara; Craven, Timothy E; Scialla, Julia J et al. (2015) Change in estimated glomerular filtration rate and fracture risk in the Action to Control Cardiovascular Risk in Diabetes Trial. Bone 78:23-7
Chow, Lisa S; Chen, Haiying; Miller, Michael E et al. (2015) Biomarkers related to severe hypoglycaemia and lack of good glycaemic control in ACCORD. Diabetologia 58:1160-6
Hempe, James M; Liu, Shuqian; Myers, Leann et al. (2015) The hemoglobin glycation index identifies subpopulations with harms or benefits from intensive treatment in the ACCORD trial. Diabetes Care 38:1067-74
Isakova, Tamara; Craven, Timothy E; Lee, Jungwha et al. (2015) Fibroblast growth factor 23 and incident CKD in type 2 diabetes. Clin J Am Soc Nephrol 10:29-38

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