Philadelphia—A new analysis offers no support for the hypothesis that insulin dose contributes to cardiovascular mortality, as suggested in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. The report, published online recently by Diabetes Care, notes that the ACCORD investigation was ended early 7 years ago after patients receiving more intensive diabetes therapy were found to have a higher mortality rate compared to standard therapy. With post hoc analyses failing to implicate rapid reduction of glucose, hypoglycemia, or specific drugs as the causes, a study team led by Temple University researchers sought to determine if exposure to injected insulin was quantitatively associated with increased CV mortality. While the initial unadjusted analysis showed that an increase in insulin dose by 1 unit/ kg of body weight increased the risk of cardiovascular death, after appropriate statistical adjustment, the association was not found. Study authors emphasize that their findings are not conclusive and call for more studies.
Published November 13, 2015