The American Association of Clinical Endocrinologists (AACE) has been closely monitoring the results of two major clinical trials released this week, ADVANCE and ACCORD. The results of the studies highlight controversy concerning the benefits and risks of tight glycemic control. As a result, some patients with type 2 diabetes may be confused about what their treatment goals should be. That is why AACE, the world’s largest association of clinical endocrinologists, is making the following recommendations.

•The recommended A1c target should remain 6.5% for most patients – While the ACCORD study did show increased mortality for some patients in the most intensive glycemic control arm of the study, no conclusions have been made to modify current clinical goals. It is important to note that the number of non-fatal myocardial infarctions was reduced in the intensive treatment arm. AACE supports further research of the high-risk populations included in this study to determine if different therapeutic targets may be appropriate for certain individuals.

•No patient should change their treatment plan without consulting their physician – While ACCORD may suggest a change in treatment goals for some people, it will not affect the treatment plans of most patients with diabetes. Patient who choose to discontinue or alter their prescribed treatment regimens on their own may increase their risk of complications of diabetes including retinopathy, nephropathy, and neuropathy.

•The ADVANCE study confirms evidence of the microvascular benefits of tight glycemic control – The ADVANCE study shows a significant decrease in microvascular complications associated with tight glycemic control. These results confirm the findings in numerous prior studies.

Achieving and maintaining optimal glycemic control is crucial in the prevention of complications associated with type 2 diabetes. But these goals can not be achieved simply with medication alone. Healthy nutrition and physical activity are essential for safely achieving blood sugar control. Patients should monitor their blood sugar regularly as prescribed and see their diabetes professionals regularly.

To access the complete AACE Clinical Practice Guidelines for the Management of Diabetes Mellitus, go to http://www.aace.com/pub/guidelines.

About AACE
AACE is a professional medical organization with more than 6,000 members in the United States and 84 other countries. Founded in 1991, AACE is dedicated to the optimal care of patients with endocrine problems. AACE initiatives inform the public about endocrine disorders. AACE also conducts continuing education programs for clinical endocrinologists, physicians whose advanced, specialized training enables them to be experts in the care of endocrine disease, such as diabetes, thyroid disorders, growth hormone deficiency, osteoporosis, cholesterol disorders, hypertension and obesity.