Duckworth William C, McCarren Madeline, Abraira Carlos
Veterans Affairs Medical Center and Department of Medicine, University of Arizona, Phoenix, USA.
Endocr Pract. 2006 Jan-Feb;12 Suppl 1:85-8. doi: 10.4158/EP.12.S1.85.
To present a status report on the Veterans Affairs Diabetes Trial (VADT), a multisite long-term study examining the effect of glucose control on cardiovascular (CV) complications in older patients with established, poorly controlled type 2 diabetes.
We review the rationale, objectives, and design of the VADT and summarize the baseline data and the results achieved thus far.
The main objective of this 20-site, 1,792-patient study is to ascertain whether intensive glucose control can reduce major CV events in patients with difficult-to-control type 2 diabetes. The study design consists of a standard treatment arm and an intensive treatment arm, with a goal of 1.5% difference in hemoglobin A1c values between the two groups. The trial is now in its fifth year, with completion expected in December 2007. The planned glucose separation has been achieved and maintained to this point. Blood pressure and hemoglobin A1c levels have been reduced from baseline values, and established CV risk factors are within recommended ranges.
The current results of the VADT show that excellent control of glucose and CV risk factors can be achieved and maintained in the population studied. The results of these interventions on CV outcomes will ultimately have important implications for the clinical care of older patients with advanced type 2 diabetes.
提交一份关于退伍军人事务部糖尿病试验（VADT）的现状报告，这是一项多中心长期研究，旨在探讨血糖控制对患有已确诊、控制不佳的2型糖尿病老年患者心血管（CV）并发症的影响。
我们回顾了VADT的基本原理、目标和设计，并总结了基线数据及迄今取得的结果。
这项涉及20个地点、1792名患者的研究的主要目标是确定强化血糖控制是否能减少难以控制的2型糖尿病患者的主要心血管事件。研究设计包括一个标准治疗组和一个强化治疗组，两组之间糖化血红蛋白值的目标差异为1.5%。该试验目前已进入第五年，预计2007年12月完成。至此，已实现并维持了计划中的血糖分离。血压和糖化血红蛋白水平已从基线值下降，既定的心血管危险因素处于推荐范围内。
VADT目前的结果表明，在所研究的人群中可以实现并维持对血糖和心血管危险因素的良好控制。这些干预措施对心血管结局的结果最终将对晚期2型糖尿病老年患者的临床护理产生重要影响。
