The study was stopped earlier than planned because of an increase in all-cause mortality in the intensive therapy group with no difference in the numbers of fatal and nonfatal strokes. TheAction in Diabetes andVascular Disease: Preterax and Diamacron MR Controlled Evaluation (ADVANCE) Trial included 11140 patients (mean age, 66.6 years) with type 2 diabetes mellitus and used a number of strategies to reduce glycemia in an intensive treatment group.293 Mean glycated hemoglobin levels were 6.5% versus 7.4% at 5 years, with no effect of more intensive therapy on the risk of CVD events or on the risk of nonfatal strokes between groups. In another study, 1791 US veterans (Veterans Affairs Diabetes Trial) with an average duration of diabetes mellitus of >10 years (mean age, 60.4 years) were randomized to a regimen to decrease glycated hemoglobin by 1.5% or standard care.294 years, the mean levels of glycated hemoglobin were 6.9% versus 8.4%, with no difference in the number of macrovas- cular events, including stroke, between the 2 groups.295 From the available clinical trial results, there is no evidence that reduced glycemia decreases the short-term risk of macrovas- cular events, including stroke, in patients with type 2 diabetes mellitus. A glycated hemoglobin goal of <7.0% has been rec- ommended by the American Diabetes Association to prevent long-term microangiopathic complications in patients with Whether control to this level also reduces the long-term risk of stroke requires further study. 