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ADVANCE
About the Trial
ADVANCE randomized 11,140 type 2 diabetes patients to intensive gliclazide based glucose control or standard therapy. Intensive control to HbA1c 6.5 percent reduced combined macro and microvascular events by 10 percent, mainly through a 21 percent reduction in nephropathy, without excess mortality, unlike ACCORD. The slower, gentler glucose lowering proved safer. The parallel blood pressure arm showed routine perindopril based therapy reduced death and renal events even in non hypertensive patients. ACCORD versus ADVANCE remains a textbook contrast in how aggressive therapy targets interact with patient population and speed of intervention.
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