What's new in the other general journalsBMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7533.105 (Published 12 January 2006) Cite this as: BMJ 2006;332:105
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Martyn (1), in his shortcut regarding the conclusions of a study on
intensive diabetes treatment and cardiovascular disease in patients with
type 1 diabetes, published in the New England Journal of Medicine (2),
states that the data from the trial support the evidence that intensive
diabetes therapy reduces cardiovascular risk in patients with type 1
diabetes. Furthermore, it is also reported that the author of the
accompanying editorial wishes that these findings are adopted into
On the basis of the study results, we agree that cardiovascular mortality
is significantly reduced, but we are concerned because in the trial,
mortality for all causes has not been taken into account and in general,
safety of intensive therapy is not discussed at all in the paper. It
should be pointed out that previous studies (3,4) report that intensive
therapy may cause more severe hypoglycaemic reactions and is associated
with an increased incidence of diabetic ketoacidosis.
The evaluation of the therapeutic role of intensive diabetes therapy
should include also the discussion of safety aspects and their analysis is
essential before recommending of a widespread use of intensive therapy in
type 1 diabetes in clinical practice .
1. Martyn C. What's new in the other general journals. BMJ
2. The Diabetes Control and Complications Trial/Epidemiology of
Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group.
Intensive diabetes treatment and cardiovascular disease in patients with
type 1 diabetes. N Engl J Med 2005;353:2643-2653.
3. Wang PH, Lau J, Chalmers TC. Meta-analysis of effects of intensive
blood-glucose control on late complications of type I diabetes. Lancet.
1993 May 22;341(8856):1306-9.
4. Egger M, Smith GD, Stettler C, et al. Risk of adverse effects of
intensified treatment in insulin-dependent diabetes mellitus: a meta-
analysis. Diabet Med 1997;14:919-928
Competing interests: No competing interests