{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T20:00:33Z","timestamp":1789934433073,"version":"4.0.1"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,7,25]],"date-time":"2017-07-25T00:00:00Z","timestamp":1500940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:p>\n                    Type 2 diabetes is a leading cause of cardiovascular disease (\n                    <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n                    ). Observational studies have consistently shown an association between glycaemic level and risk of major adverse cardiovascular events (\n                    <jats:styled-content style=\"fixed-case\">MACE<\/jats:styled-content>\n                    ); however, intervention studies have provided limited evidence supporting a reduction in the cardiovascular burden of diabetes through intensive glucose control. In the present review, we aimed to examine the concept of cumulative glycaemic exposure with regard to protection against\n                    <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n                    in diabetes. We address how we can move from a binary approach in trials, to a more quantitative approach based on differences in cumulative glycaemic exposure. We plotted the association between differing glycaemic exposures between study arms and the hazard ratio for\n                    <jats:styled-content style=\"fixed-case\">MACE<\/jats:styled-content>\n                    in randomized controls trials comparing intensive with conventional glycaemic control in type 2 diabetes. We found a strikingly strong correlation between differential exposure and cardiovascular risk reduction. Similar results were obtained for trials comparing antidiabetes drugs with placebo. The results suggest that a minimum study duration and a minimum gain in glycated haemoglobin (\n                    <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content>\n                    ) reduction are necessary to drive a relevant risk reduction in\n                    <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n                    risk, and we provide a quantitative perspective in that respect. The present analysis underlines that the duration of the intensification of glycemic control, and the amplitude of the resulting reduction in\n                    <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content>\n                    , are important notions for clinical decision\u2010making.\n                  <\/jats:p>","DOI":"10.1111\/dom.13033","type":"journal-article","created":{"date-parts":[[2017,6,9]],"date-time":"2017-06-09T04:08:54Z","timestamp":1496981334000},"page":"238-244","source":"Crossref","is-referenced-by-count":61,"title":["Prevention of cardiovascular disease through reduction of glycaemic exposure in type 2 diabetes:\n                    <scp>A<\/scp>\n                    perspective on glucose\u2010lowering interventions"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2292-8363","authenticated-orcid":false,"given":"Ronan","family":"Roussel","sequence":"first","affiliation":[{"name":"INSERM, U\u20101138 Centre de Recherche des Cordeliers  Paris France"},{"name":"Sorbonne Paris Cit\u00e9, UFR de M\u00e9decine Universit\u00e9 Paris Diderot  Paris France"},{"name":"Assistance Publique H\u00f4pitaux de Paris H\u00f4pital Bichat, DHU FIRE  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe Gabriel","family":"Steg","sequence":"additional","affiliation":[{"name":"Sorbonne Paris Cit\u00e9, UFR de M\u00e9decine Universit\u00e9 Paris Diderot  Paris France"},{"name":"Assistance Publique H\u00f4pitaux de Paris H\u00f4pital Bichat, DHU FIRE  Paris France"},{"name":"INSERM U\u20101148, LVTS French Alliance for Cardiovascular Clinical Trials  Paris France"},{"name":"National Heart and Lung Institute ICMS, Imperial College, Royal Brompton Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamel","family":"Mohammedi","sequence":"additional","affiliation":[{"name":"Assistance Publique H\u00f4pitaux de Paris H\u00f4pital Bichat, DHU FIRE  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Marre","sequence":"additional","affiliation":[{"name":"INSERM, U\u20101138 Centre de Recherche des Cordeliers  Paris France"},{"name":"Sorbonne Paris Cit\u00e9, UFR de M\u00e9decine Universit\u00e9 Paris Diderot  Paris France"},{"name":"Assistance Publique H\u00f4pitaux de Paris H\u00f4pital Bichat, DHU FIRE  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Potier","sequence":"additional","affiliation":[{"name":"INSERM, U\u20101138 Centre de Recherche des Cordeliers  Paris France"},{"name":"Sorbonne Paris Cit\u00e9, UFR de M\u00e9decine Universit\u00e9 Paris Diderot  Paris France"},{"name":"Assistance Publique H\u00f4pitaux de Paris H\u00f4pital Bichat, DHU FIRE  Paris 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