Клинические ответы Cochrane

Оценка доказательных данных

Результаты исследований A

Reducing cardiovascular risk: there is good-quality evidence that intensive BP lowering (targeting a systolic pressure <120 mmHg over 4.7 years, as compared with targeting <140 mmHg) does not lessen risk (composite outcome: non-fatal MI, non-fatal stroke, or death from cardiovascular cause) in people with type 2 diabetes. Intensive BP lowering increased the risk of adverse events.[44]

Результаты исследований A

Glycaemic control: there is good-quality evidence that insulin plus metformin reduces HbA1c levels at 4 to 6 months more effectively than insulin alone, but with more gastrointestinal side effects.

Результаты исследований A

Prevention of microvascular complications: there is good-quality evidence that intensive glucose therapy lowers risk of microvascular complications of type 2 diabetes.[36][37]

Результаты исследований A

Mortality: there is good-quality evidence that therapy to target very tight glucose control (goal HbA1c 42 mmol/mol to 48 mmol/mol [6% to 6.5%] over 3 to 5 years) was either not beneficial or detrimental to mortality in patients with type 2 diabetes and cardiovascular disease or risk.[38][39][40][41] Very tight control also increased the risk for hypoglycaemia.

Результаты исследований B

Risk of diabetes and cardiovascular disease: there is medium-quality evidence from a large observational study in non-diabetic adults that, compared with fasting blood sugar, HbA1c was comparably associated with a risk of diabetes and more strongly associated with risks of cardiovascular disease and death from any cause.[24]

Результаты исследований B

Maternal and neonatal outcomes: there is medium-quality evidence suggesting that improved glycaemic control before conception and in the first trimester improves outcomes.[2][74]

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