• Get to know about the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial, designed to assess the effects on major vascular outcomes of lowering the glycated hemoglobin value to a target of 6.5% or less in a broad cross-section of patients with type 2 diabetes.

The video above of Prof. David Matthews provides a 5-minute introduction, with an overview of the trial and important key learnings.

The Scientific digest from the ADVANCE Scientific analysis, written by Matthews and accessible via the link below, puts the trial into historic and scientific context:
 

“[...] the ADVANCE trial has significantly improved our understanding of the treatment of diabetes. It established that the lessons of the UKPDS relating to BP control and glycemic control in the newly diagnosed were also applicable to those in a wider geographical context and with established diabetes. It showed beyond reasonable doubt that blood pressure could and should be controlled, and it showed that a controlled and steady reduction of blood glucose would also improve longevity."

"It established that gliclazide MR in particular was an effective sulphonylurea without dangerous side effects and low rates of clinically important hypoglycemia. ADVANCE was a triumph of organization, of perseverance of clinical science and applied wisdom. It deserves its proud place in the annals of diabetes endeavour.”
 

Key learning from a diabetes perspective:

Intensive glucose-lowering, based on gliclazide MR, has a significant impact on outcomes (particularly microvascular outcomes) and thus must remain a cornerstone in the treatment of patients with T2D.

This is an important reminder in the context of modern-day cardiovascular outcome trials (CVOTs), and this 4-article supplement can be used to reinitiate discussions with your doctors, particularly the younger generation who may not be as familiar with ADVANCE and its important findings.