THE Effect of Tight Glycemic Control on Microvascular Complications in Type 2 Diabetes Mellitus

The goal of this clinical trial is to learn the impact of tight versus less tight glycemic control on microvascular complications among Egyptian adults with uncontrolled T2DM. The main question it aims to answer is: Does tight glycemic control improve or worsens microvascular complications of diabetes compared to less tight glycemic control? Participants will: * Be divided to two groups according to their HbA1c group A tight glycemic control and less tight glycemic control. * Be followed for 6 months with clinical, laboratory, and fundoscopic evaluations performed at baseline and endpoint.

Background: Tight glycemic control is widely promoted in the management of type 2 diabetes mellitus (T2DM) to reduce microvascular complications, yet the extent and speed of HbA1c reduction may paradoxically exacerbate certain outcomes. Objective: To assess the impact of tight versus less tight glycemic control on microvascular complications among Egyptian adults with uncontrolled T2DM. Methods: In this randomized controlled trial, 80 patients with poorly controlled T2DM (HbA1c \>7.5%) were randomized into two groups: Group A (tight control, HbA1c \<7.0%) and Group B (less tight control, HbA1c \<7.5%). Participants were followed for 6 months with clinical, laboratory, and fundoscopic evaluations performed at baseline and endpoint.