The U.S. National Institutes of Health (NIH) is studying the best strategies to treat and prevent diabetic cardiovascular disease (CVD) in three trials: Look AHEAD, ACCORD, and BARI2D. As CVD is the leading cause of diabetes-related deaths (65 percent, two to four times higher than non-diabetic adults) this research is of vital importance.
We all grasp that it is beneficial for someone with type 2 diabetes to not be carrying excess weight, but until now, no study had been done to quantify the benefits of voluntary weight loss. The NIH is conducting the largest clinical trial to date to examine the long-term effects of voluntary weight loss through decreased caloric intake and increased exercise.
Five thousand obese type 2 diabetics will participate, and will be "followed" by the researchers for up to 11.5 years. For more information, about the Look AHEAD trial, telephone: 1-866-552-4323, or visit their Web site: www.lookAHEADstudy.org
Although several major studies have shown us the strong link between "tight,"
intensive control of blood glucose and the lowered risk of diabetes complications, there has been no definitive study of the link between tight control and reduced risk of cardiovascular disease events in type 2 diabetes. the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study is designed to compare current practice guidelines with tighter control, and will involve 10,000 type 2 diabetics, including those judged at high risk of cardiac events. Volunteers will be treated and followed from four to eight years. For more information on ACCORD, visit their Web site: www.accordtrial.org.
Some years ago, the BARI (Bypass Angioplasty Revascularization Investigation) studied the question of whether balloon angioplasty or bypass surgery were better, more successful, for type 1 diabetics with severe coronary artery disease. It was found that although for cardiac patients without diabetes, the less invasive balloon angioplasty had a higher success rate, type 1 diabetics had better luck with conventional bypass surgery. The BARI2D trial picks up the question for 2800 type 2 diabetics, and also seeks to examine the effect of the two surgical procedures on a population divided between conventional and "tight" (A1c below 7) control. For information, contact the BARI2D Web site: www.bari2d.org.