A key challenge facing healthcare professionals (HCPs) when managing people living with diabetes is reducing risk for cardiovascular (CV) events, which can be a significant concern for patients and cause substantial pressure on healthcare services. However, it’s not always how patients should be managed, which risk factors should be prioritized and why glycaemic control is so important.
There is a wealth of robust literature supporting the importance of early, tight glycaemic control in people living with diabetes. A reduction in risk for micro- and macrovascular events was highlighted in several landmark studies: DCCT (type 1 diabetes), UKPDS, and Steno-2 (both type 2 diabetes), which included people with a diagnosis of diabetes <10 years prior to study initiation. The “legacy effect” (the long-term benefits associated with early, tight glycaemic control despite later increases in blood glucose levels) was clearly demonstrated for microvascular outcomes, but it remains unclear whether variable glycaemic control impacts future macrovascular risk following an early period of glycaemic control.
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