Strict glycemic control: a literature review

Abstract

Diabetes mellitus is a disease that is difficult to control worldwide. Since the better understanding of the pathophysiology of the disease by modern medicine, several ways to control the evolution of the pathology in question have been proposed. As an example, we can mention a study published in 1993 by the Diabetes Control and Complications Trial (DCCT) and, later, in 1998, validated by the United Kingdom Prospective Diabetes Study (UKPDS), which established glycated hemoglobin as one of the main markers evolution and prognosis of the disease. Since the publication of these studies, goals such as: strict glycemic control (corresponding to glycated hemoglobin goals less than or equal to 6.5 mg/dL), have been accepted by the world medical community as references in the control and follow-up of the disease. In this context, the present article has as its guiding question: should strict glycemic control be desired for all patients? Aiming to find out, through literature review, whether glycemic control should be required for all patients. Therefore, a literature review was carried out on published articles on the subject in question, aiming to focus on quaternary prevention and the importance of good clinical practice collaborated by evidence-based medicine. The results indicate that, in the case of strict glycemic control, there is no evidence of benefits in general in its use, being reported in the literature that, in certain populations, especially those over 80 years of age, its use is linked to increased effects. adverse effects and morbidity caused by the disease.