6/27/23, 11:46 PM ACCORD Pathway Feedback Search Clinical Topics Home Studies ACCORD ACCORD Disease Diabetes mellitus type 2 Trial question What is the role of intensive glycemic control therapy in high-risk patients with T2DM? Study design Multi-center Open label RCT Population Characteristics of study participants 38.0% female N = 10251 62.0% male 10251 patients (3895 female, 6356 male) Inclusion criteria: patients with T2DM who had either established CVD or additional cardiovascular risk factors Key exclusion criteria: frequent or recent serious hypoglycemic events, unwillingness to do home glucose monitoring or inject insulin, a body-mass index > 45, a serum creatinine level > 1.5 mg/dL (133 mol/L), or other serious illness Interventions N=5128 intensive glycemic control (targeting an HbA1C < 6.0%) N=5123 standard glycemic control (targeting an HbA1C 7.0-7.9%) Primary outcome https://web.pathway.md/studies/rechvkJj93MFBnwtm 1/2 6/27/23, 11:46 PM ACCORD Pathway Nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes 7.2 % 7.2 6.9 5.4 % 3.6 % 1.8 % No significant difference 0.0 % Intensive glycemic control Standard glycemic control No significant difference in nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes (6.9% vs. 7.2%; HR 0.9, 95% CI 0.78 to 1.04) Secondary outcomes Significant increase in the rate of death at a mean follow-up of 3.5 years (5% vs. 4%; HR 1.22, 95% CI 1.01 to 1.46) Safety outcomes Significant differences in hypoglycemia requiring assistance (16.2% vs. 5.1%, p < 0.001) and weight gain > 10 kg (27.8% vs. 14.1%, p < 0.001). Conclusion In patients with T2DM who had either established CVD or additional cardiovascular risk factors, intensive glycemic control was not superior to standard glycemic control with respect to nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes. Reference Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008 Jun 12;358(24):2545- 59. Open reference URL https://web.pathway.md/studies/rechvkJj93MFBnwtm 2/2