Cardiovascular Effects

Cardiovascular effects from some diabetes therapies debunked

OmnipodBy Kelly Close

ADA Scientific Sessions 2009, while slightly smaller than last year's conference, was packed with fascinating studies and talks. It was so interesting, in fact, that we attended 401 presentations in total this year! It's tough to identify a particular theme to this conference, since EVERYTHING was covered, but there were certainly a few hot topics that stuck out to us.

Cardiovascular Effects
Cardiovascular disease resulting from diabetes therapies has been one of the most controversial topics in diabetes for the past two years. There were some very important studies released at ADA regarding two of the most divisive subjects of debate: the increased risk of mortality seen in the intensive glucose control arm of ACCORD and whether rosiglitazone increases the risk of heart attacks.

  • A new ACCORD analysis disputed the notion that hypoglycemia was responsible for the excess mortality observed in the intensive glycemic control group of the study. At this conference, Denise Bonds, MD (National Heart, Lung, and Blood Institute, Bethesda, MD) reported that rates of mortality were LOWER in patients with lower baseline A1c or average A1c. Paradoxically, patients with greater reductions in A1c in the intensive arm had lower rates of hypoglycemia.
  • Final results from the RECORD trial were also released. RECORD was designed to detect the cardiovascular effects of rosiglitazone (GlaxoSmithKline's Avandia). It was a large study, including 4,500 patients. The subject of rosiglitazone's cardiovascular safety became a hot-button issue after a meta-analysis of several studies suggested that rosiglitazone might lead to an increased incidence of heart attacks and death from heart attacks. The RECORD results showed that rosiglitazone imparted no increased risk of death from heart attacks, although there was insufficient data to make any conclusions about the total number of heart attacks. The results of this study, while not particularly surprising, vindicated GlaxoSmithKline, who had asserted throughout the entire controversy that there was no real evidence of a cardiovascular signal.

 

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Last Modified Date: April 23, 2013

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