Lowering your blood sugar reduces CVD risk. If you don’t account for blood sugar lowering as a confounding factor then you cannot conclude that Actos does anything. The study clearly showed that Actos lowered blood sugars but unfortunately the study did not do an analysis that removed lowered blood sugars as a confounding effect. So we are left clueless. Does Actos itself reduce CVD risk or does Actos reduce blood sugars and hence lower risk. This is really disappointing because the study apparently collected all the information needed to do this analysis.