Trial Details:

Acronym: Action to Control CardiOvascular Risk in Diabetes

Purpose: Evaluate intensive glucose controll in type II diabetic patients on cardiovascualr risk

Format: Double blind, multicenter, randomized controlled trial

Treatment Group: Intensive glucose control with hemoglobin A1c < 6.0%

Control Group: Standard glycemic control with hemoglobin A1c 7.0-7.9%

Number of Patients: 10,251

Inclusion Criteria: 

  • Diabetes mellitus type II
  • Hemoglobin A1C ≥ 7.5
  • Age 40-79 with coronary artery disease


  • Age 55-79 with any of the following:
    • Atherosclerosis (including PAD)
    • Albuminuria
    • Left ventricular hypertrophy
    • ≥ 2 cardiovascular risk factors.

Exclusion Criteria: 

  • Frequent or recent serious hypoglycemic events
  • Unwillingness to perform home glucose monitoring or inusulin
  • BMI > 45
  • Cr > 1.5 mg/dL
  • Serious illness

Primary Endpoint: Composite annual rate of non-fatal MI, non-fatal stroke or cardiovascular death

Secondary Endpoints:

  • Annual rate of all-cause mortality
  • Annual rate of cardiovascular mortality
  • Annual rate of non-fatal MI
  • Annual rate of non-fatal stroke
  • Annual rate of heart failure


The ACCORD trial evaluated cardiovascular risk in type II diabetes patients with intensive glycemic control (hemoglobin A1c < 6.0%) versus standard glycemic control (hemoglobin A1c 7.0-7.9%). The primary endpoint of annual rate of all-cause mortality including cardiovascular mortality was significantly increased in the intensive glycemic control arm and thus the trial was stopped early. 

Original Publication:

Gerstein HC, et al. N Engl J Med. 2008;doi:10.1056/NEJMoa0802743.