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. In patients with recent-onset type I diabetes mellitus, intensive diabetes therapy aimed at achieving near-normal glycemia can be accomplished with good adherence but with more fre- quent episodes of severe hypoglycemia.297 Although glyce- mia was similar between the groups over a mean 17 years of follow-up in the Diabetes Control and Complications Trial/ Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study, intensive treatment reduced the risk of any CVD event by 42% (95% CI, 9 63; P=0.02) and the com- bined risk nonfatal MI, stroke, or death from CVD events by The decrease in glycated hemoglobin was associated with the positive effects of inten- sive treatment on the overall risk of CVD. There were too few strokes, however, to evaluate the effect of improved glycemia during the trial, and as with type 2 diabetes mellitus, there remains no evidence that tight glycemic control reduces risk of stroke. Despite the lack of convincing support from any individual clinical trial for intensified glycemic control to reduce stroke incidence in patients with diabetes mellitus, a recent meta- analysis provided some supportive evidence in a subgroup of patients with diabetes mellitus. From 649 identified studies, the authors identified 9 relevant trials, which provided data Overall, inten- sive control of glucose compared with usual care had no effect however, in a stratified analyses, a beneficial effect was seen in patients with diabetes mellitus and a BMI >30 kg/m2 (RR, 0.86; 95% CI, 0.75 0.99; P=0.041). 