The VADT or VA Diabetes Trial is reviewed. There was a series of trials in the years 2005 - 2009 that showed that improved glucose control did NOT slow down heart attacks and strokes. Here's why: there were 11.5 years since the diagnosis of diabetes in this population. And each of us typically has a decade - or more- of hyperglycemia and hyper-insulinemia prior to the actual diagnosis of type 2 diabetes. These studies ( ACCORD, VADT, EDIC, and others) showed no improvement in lifespan due to "tighter" control. One of the studies even had to stop early. Why? the time for prevention of heart attack and stroke is the decades of prediabetes, or insulin resistance, or metabolic syndrome. So, find insulin resistance early. Hit it hard, control it as tightly as possible. THAT will prevent heart attack, stroke, and dementia decades later. We do fail to acknowledge this is our culture. Both doctors and patients are guilty of neglect. And so is the government and standards bodies.
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