Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). We investigated whether intensive therapy to target normal glycated hemoglobin levels would reduce cardiovascular events in patients with type 2 diabetes who. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study.

Author: Vunos Goltimuro
Country: Fiji
Language: English (Spanish)
Genre: Medical
Published (Last): 1 May 2010
Pages: 387
PDF File Size: 14.59 Mb
ePub File Size: 19.53 Mb
ISBN: 190-2-82202-661-8
Downloads: 45794
Price: Free* [*Free Regsitration Required]
Uploader: Kajimi

The findings could also be interpreted as indicating that insulin and sulphonylureas are equally harmful in diabefes obese, possibly as a consequence of hyperinsulinaemia. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes UKPDS 33 Lancet. The UKPDS found that captopril and atenolol were equally effective as antihypertensive agents, in preventing macrovascular complications and in reducing the progression of retinopathy and albuminuria.

They were seen annually until in UKPDS clinics with continued standardized collection of endpoint, biochemical and clinical data.

These also demonstrated a reduction in macrovascular risk, including myocardial infarction [ 2021 ]. On the other hand, the questionnaire showed that when people had diabetic complications, these adversely affected quality of life. The study finished at the end of There was no difference for any of the three aggregate endpoints between the three intensive agents chlorpropamide, glibenclamide, or insulin.

The incidence of diabetes has doubled every 20 years since [ 2 ]. Specific diabetic complications can also develop, due to closure of small blood vessels that can cause blindness, kidney failure and amputations. Clearly, achieving this goal will require aggressive follow up patients in the UKPDS were seen 3 monthlyand this may not be acceptable to all patients.

Sixteen year follow-up study. In the world wide prevalence of type 2 non-insulin dependent diabetes was 99 million 1.

Some of the treatments, including insulin, had the downside of giving the risk of ‘hypos’ — episodes of low blood glucose — and of greater weight gain of approximately 8 lbs 4 kg.


The secondary esstudio of the study was to compare the effects of different treatments for diabetes, since dianetes have theoretical advantages and disadvantages.

The results of UKPDS suggest that a formal screening programme should be set up to identify diabetes before symptoms occur. When single treatments failed, combinations were used. Although apparently a “mild form of diabetes” major complications occur, including death from heart attacks and disability including blindness, amputations and kidney failure.

People with diabetes usually present with thirst, weight loss and tiredness. Over 30 papers have been published from the UKPDS database, and many more are in preparation or planned. The umpds statement is as true today as it was almost years ago.

UK Prospective Diabetes Study

Antihypertensive therapy reduces the risk of both cardiovascular and cerebrovascular disease in the general population [ 12 ], but to what extent these findings apply to type 2 diabetes was again not clear.

Hypertension in Diabetes Study [ 1819 ] One thousand one hundred and forty-eight patients took part. There was no difference in HbA1c among agents in the intensive group.

The study showed that intensive blood glucose treatment is acceptable and that better blood glucose control could be obtained than with conventional management. The UKPDS showed no difference in outcome between treatments, which is at first sight reassuring, but the study was powered to assess the effects of intensive therapy in general and it is unclear whether there is adequate power in this subgroup analysis.

Numerous substudies were embedded Figure 2the most notable being the Hypertension in Diabetes Study. Over 10 years, haemoglobin A1c HbA1c was 7.

UK Prospective Diabetes Study : Protocol

Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: One thousand one hundred and forty-eight patients took part. Blood pressure, antihypertensive drug treatment and the risks of stroke and coronary heart disease.


With one third requiring 3 or more agents to maintain target blood pressures, compliance will certainly be a problem in some. Thus, unlike blood pressure control, intensive glycaemic control is not suitable for all patients, particularly the elderly, or those with existing severe complications. We compared the effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk dibaetes microvascular and macrovascular complications in patients with type 2 diabetes dibetes a randomised controlled trial.

In the study, patients were reviewed 3 monthly, rather than 6—12 monthly as in routine clinical practice, which has considerable resource implications. Nevertheless, the available data suggest that if more care is given to obtain both near-normal blood glucose and near-normal blood pressure levels, the benefit from each therapy would combine to give a greater reduced risk of complications than either treatment on its own. Intensive treatment often results in hyperinsulinaemia, with weight gain and an increase in hypoglycaemia [ 9 ], both of which have theoretical adverse effects on macrovascular disease, the major life threatening complication of type 2 diabetes.

People with raised blood pressure as well as diabetes were randomly allocated to a policy aiming for tight blood pressure control, using two treatments that might be thought to be particularly beneficial, an ACE inhibitor or beta-blocker or to a less tight blood pressure control.

Br J Clin Pharmacol. A study on the effects of hypoglycaemic agents on vascular complications in patients with adult-onset diabetes.

These occur two or three times more rstudio in people with Type 2 diabetes than in the general population and can cause death at an earlier age than is usual.