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This letter to the editor argues that referencing the DCCT trial to support managing glucose intolerance in metabolic syndrome is flawed because DCCT studied type 1 diabetes.
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This letter critiques the use of the DCCT trial to support cardiovascular benefits of glucose management in metabolic syndrome, noting DCCT focused on type 1 diabetes.
Letters19 May 2020Altered Risk for Cardiovascular Events With Changes in the Metabolic Syndrome StatusThomas E. Finucane, MDThomas E. Finucane, MDMassachusetts General Hospital, Boston, Massachusetts (T.E.F.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0075 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Park and colleagues (1) studied the relationship between metabolic syndrome (MetS) (which they state includes central obesity, dyslipidemia, glucose intolerance, and hypertension) and major adverse cardiovascular events (MACE). They note, “Management of each MetS component has proven to be effective in reducing the risk for MACE.” To show the effectiveness of managing glucose intolerance, they reference the DCCT (Diabetes Complications and Control Trial) (1). However, there are 3 problems with this assertion.First, the DCCT studied patients with type 1 diabetes. Unlike type 2 diabetes, this condition is not associated with MetS.Second, the DCCT did not ...References1. Park S, Lee S, Kim Y, et al. Altered risk for cardiovascular events with changes in the metabolic syndrome status: a nationwide population-based study of approximately 10 million persons. Ann Intern Med. 2019;171:875-884. [PMID: 31766057]. doi:10.7326/M19-0563 LinkGoogle Scholar2. Nathan DM, Genuth S, Lachin J, et al; Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977-986. [PMID: 8366922] CrossrefMedlineGoogle Scholar3. Rodriguez-Gutierrez R, McCoy RG. Measuring what matters in diabetes. JAMA. 2019;321:1865-1866. [PMID: 30985865] doi:10.1001/jama.2019.4310 CrossrefMedlineGoogle Scholar4. Finucane TE. Translating “tight control”? [Letter]. Ann Intern Med. 2004;141:822. [PMID: 15545688] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital, Boston, Massachusetts (T.E.F.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L20-0075. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAltered Risk for Cardiovascular Events With Changes in the Metabolic Syndrome Status Sehoon Park , Soojin Lee , Yaerim Kim , Yeonhee Lee , Min Woo Kang , Kyungdo Han , Seung Seok Han , Hajeong Lee , Jung Pyo Lee , Kwon Wook Joo , Chun Soo Lim , Yon Su Kim , and Dong Ki Kim Altered Risk for Cardiovascular Events With Changes in the Metabolic Syndrome Status Sehoon Park , Kyungdo Han , and Dong Ki Kim Metrics 19 May 2020Volume 172, Issue 10Page: 707KeywordsGlucose intoleranceHypertensionMetabolic syndromeMortalityMyocardial infarctionObesityObservational studiesRandomized trialsType 1 diabetesType 2 diabetes ePublished: 19 May 2020 Issue Published: 19 May 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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Thomas E. Finucane (2020) conducted a letter in Metabolic syndrome. This letter to the editor argues that referencing the DCCT trial to support managing glucose intolerance in metabolic syndrome is flawed because DCCT studied type 1 diabetes.
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