Abstract
The issue of the efficacy of optimal glycemic control in the prevention of macroangiopathic complications of diabetes has been the subject of recent controversy. Although the facts are clear for microangiopathy, particularly in type 1 diabetes, they appear less certain for the cardiovascular complications of type 2 diabetes. This is due to the involvement of other cardiovascular risk factors that are very common in these patients. However, long-term follow-up studies are in favor of the interest of good glycemic control on macroangiopathic complications. The negative results on the mortality of the ACCORD study and the concerns regarding rosiglitazone led to the establishment of studies on the safety of new molecules. All this work led to the demonstration of the absence of risk of prescription of iDPP-4 and the very positive effect of certain molecules of the class of analogues of GLP-1 and iSGLT2.
It is to be hoped that the recent publication of the Academy of Medicine stressing that complications of type 2 diabetes require multifactorial prevention that necessarily involves an optimized control of the glycemic balance put an end of this unnecessary and dangerous polemic.
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