In major clinical trials, tight control of blood glucose and blood pressure has been demonstrated to reduce the risk of retinopathy and associated blindness (3).
26– 28 However, in the younger cohorts of the United Kingdom Prospective Diabetes Study (UKPDS) 29 and Diabetes Control and Complications Trial/ Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) 3 trials, tighter glycemic control conferred a benefit.
In the randomized trial, for tight as compared with the less-tight control of blood pressure, there were relative risk reductions of 24%% for any diabetes-related endpoint, 32%% for diabetes-related death, 44%% for stroke, and 37 % for microvascular disease [ 37].
He was extradited to Libya and last year went on trial, amid tight security, accused of crimes committed during the revolution.
If the time trial is tight, the race may finally be decided by the time bonuses on offer in the afternoon's circuit race around six laps of the time trial course, and during Sunday's closing leg in central London.
These negative results were recently confirmed by a large prospective clinical trial of tight glycemic control versus conventional glycemic control from Australia, New Zealand and Canada (the NICE-SUGAR Study) [ 8].
Any randomised controlled trial, however tight its inclusion and exclusion criteria, recruits individuals who differ in many observed and unobserved ways.
Our study may enable us to reanalyze our previous published trial on tight blood glucose control, which was characterized by a significant decrease in mean blood glucose with a significant increase in hypoglycemia rate without any impact on mortality [ 7].
In a randomized controlled trial comparing tight glucose control with a computerized decision support system and conventional protocols (post hoc analysis), we tested the hypothesis that hypoglycemia is associated with a poor outcome, even when controlling for initial severity.
Finally, the analysis of trials achieving tight glucose control (four out of eight surgical ICU trials, two out of eight medical ICU trials, and five out of 14 mixed ICU trials) found RR = 0.76 (95% CI = 0.57 to 1.01, P = 0.06; I2 = 10%) in surgical patients and RR = 1.04 (95% CI = 0.71 to 1.53, P = 0.82; I2 = 7%) in medical patients (P = 0.20 for comparison of RRs).
