[Critical notes on the results of studies (ACCORD, ADVANCE, VADT) of the efficiency of intensive therapy of type 2 diabetes mellitus].

A brief review of results of prospective randomized studies on the efficacy of reduction of blood glucose levels for the prevention of type 2 diabetes mellitus complications delivered at the 68th Congress of American Diabetic Association (June 2008). They showed that normal glycemia is very difficult to reach and usually at the cost of side effects, in the first place hypoglycemia. Lowering glycemia to the near-normal level prevents development of nephropathy but fails to reduce the frequency of cardiovascular disease. The reduced risk of myocardial infarction was documented only in the ACCORD study. However, this effect was associated with a rise in general mortality that necessitated premature termination of this trial. Causes behind the enhanced mortality are discussed, recommendation are proposed ensuing from the results of the reviewed studies.