Two other meta-analyses, which added additional randomized studies to the large trials, concluded that available data show limited and inconclusive evidence of risk reduction for CV end points but confirmed a substantial increase of severe hypoglycemia (11,12). The persistent effect of early treatment also suggests that prior poor metabolic control may result in anatomic changes that are not easily reversed. [...]late-stage, high-risk patients of the kind selected for ADVANCE, ACCORD, and VADT may be less likely to benefit from glycémie control after years of hyperglycemia.
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