Objectives To systemically review and investigate the efficacy of intensive glucose control in Type 2 diabetes mellitus. Methods Database searches of MEDLINE, EMBASE, Cochrane Controlled Trials Register, VIP Database, CNKI, and CBM disc (from the date of establishment of the databases to June 2009) were conducted. Additional studies were retrieved via references of articles and direct contact with the authors to retrieve relevant data. Prospective, randomized controlled trials of intensive glucose control compared with standard therapy in diabetic patients were selected. We accessed the quality of included trials and extracted the relevant data. Statistical analysis was performed using The Cochrane Collaboration’s software RevMan 5.0. Results Eight trials with a total of 37 004 participants were included. The Meta-analysis showed: intensive glucose therapy was associated with a significant 9% reduction in the odds of cardiovascular events [OR=0.91, 95%CI (0.85, 0.98), P=0.007], and a 26% reduction in the microvascular events [OR=0.74, 95%CI (0.60, 0.91), P=0.005]. For the peripheral vascular events, no statistical difference was found between intensive therapy and standard therapy [OR=0.94, 95%CI (0.83, 1.07), P=0.35]. No statistical difference could be found in total mortality [OR=1.00, 95%CI (0.92, 1.08), P=0.98] and cardiovascular mortality [OR=1.03, 95%CI (0.83, 1.28), P=0.77]. Intensive therapy could increase more than 1.1-fold odds of hypoglycemia compared with standard-therapy [OR=2.12, 95%CI (1.24, 3.60), P=0.006]. Conclusions Findings from this meta-analysis suggest that intensive glucose control significantly reduces the risk of cardiovascular events and microvascular events, and increases the risk of hypoglycemia, while no prominent difference is found in mortality.
