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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.

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The results of metformin treatment are the most controversial [ 14 ].

The study finished at the end of Renal protective effects in diabetic nephropathy. McCarty D, Zimnet P. When single treatments failed, combinations were used.

Cost effectiveness analysis of improved blood pressure control in hypertensive patients with type 2 diabetes: These results are again reassuring at first sight, but, as with the glucose diabetrs study, type 2 errors cannot be excluded; there was a trend in favour of the atenolol treated group.

In the last 2 years, the results of several other studies of hypertension which have included patients with diabetes have been published. Antihypertensive therapy reduces the risk of both cardiovascular and cerebrovascular disease in the general population [ 12 estudko, but to what extent these findings apply to type 2 diabetes was again not clear.

Over 10 years, haemoglobin A1c HbA1c was 7. This article has been cited by other articles in PMC. Diabet Res Clin Pract.

The secondary aim of the study was to compare the effects of different ukpdd for diabetes, since some have theoretical advantages and disadvantages. The study was set up so that physicians could have a sound basis for deciding which treatments they should prescribe to patients. In addition, the few clinical trials that have been done have raised the possibility that some of the commonly used treatments may aggravate damage to large arteries.


This has been an acceptable clinical practice, in view of the lack of reliable evidence to show that intensive treatment of blood glucose or blood pressure will prevent complications, and thus help to maintain the health of patients. In The social and cost implications of Type II diabetes. University Group Diabetes Programme. Please review our privacy policy. For example, sulphonylureas close myocardial ATP-sensitive potassium channels, which could impair ischaemia induced vasodilatation [ 16 ], perhaps explaining the results of the UGDP.

It also needs to be on a large scale, studying large numbers of uukpds, to obtain a reliable answer. Thus there is no doubt of the significance of blood pressure control in type 2 diabetes, but there remains the question whether particular drugs have advantages or disadvantages.

UK Prospective Diabetes Study : Protocol

Within nine years approximately one-third of patients required three different types of treatment. That the reduced occurrence of myocardial infarction was not significant may be due to type 2 statistical error. Since medicine is the art estucio the feasible, a high priority could be given to ensuring good control of blood pressure. Any patients unable to attend clinics were sent EQ-5D and health resource questionnaires, with additional questionnaires to their general practitioners to esgudio possible endpoints.

Numerous substudies were embedded Figure 2the most notable being the Hypertension in Diabetes Study. The main questions were:. Both ACE inhibitors and beta-blockers have now been shown to be advantageous. There was also a trend, just short of statistical significance, towards a reduction in macrovascular disease. No threshold was seen, i. A study on the effects of hypoglycaemic agents on vascular complications in patients with adult-onset diabetes.


In a large American study DCCT was published which showed fstudio close relationship between control of Type 1 diabetes and the risk of complications from small vessel disease. Improving blood diabettes is sometimes easier than improving blood glucose levels, and needs to have a high priority.

UK Prospective Diabetes Study

One thousand one hundred and forty-eight patients took part. Whether the same holds diabetee in type 2 diabetes remained uncertain. If not fatal they can seriously affect the quality of life. UKPDS, sadly, confirmed that patients with Type 2 diabetes have a high incidence of heart attacks and strokes, and have a greater likelihood of early death than the general population.

Antihypertensive therapy in type 2 diabetes: In the meantime any way of significantly reducing the burden of diabetes-related complications will have a major impact on patient well-being and on cost effectiveness of management. Effects of estusio blood-pressure lowering and low-dose aspirin in patients with hypertension: Weight gain was significantly higher in the intensive group mean 2.

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.