CARDIOVASCULAR OUTCOME TRIALS IN TYPE 2 DIABETES: RELIABLE OR BIASED!
*Dr. Udaya M. Kabadi MD
Several recent multinational clinical trials have suggested improvement in cardiovascular outcomes with antihyperglycemic agents in subjects with type 2 diabetes.[1-4] First and foremost, the designs implemented in these trials appear to lack uniformity of methods due to variable management strategies permitted at the discretion of individual investigators in different countries in different parts of the world.[1-8] Moreover, the different ethnic backgrounds, differences in body mass indices or degree of obesity may yield different results since the pathophysiology is apparently dissimilar as well.[9-21] Rise in insulin resistance is a major abnormality in obese subjects with PreDiabetes and diabetes in USA and other western countries in contrast to the decline in insulin secretion as a prime defect in non obese subjects in USA as well as the rest of the world, especially countries in south east Asia documented in several studies.[9-21][Full Text Article]