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United Kingdom Prospective Diabetes Study (UKPDS)
Subjects:
- 3277 individuals with newly diagnosed with type 2 diabetes
- participants were assessed annually, in UKPDS clinics for the 1st 5 years & remotely by questionnaire thereafter
Groups:
- intensive therapy group achieved mean HbA1c level of 7.0%
- standard therapy group achieved mean HbA1c level of 7.9%
- subgroups: sulfonylurea-insulin vs metformin vs standard therapy
Results:
- mean body weight, blood pressure, & creatinine levels were similar in the two group
- by year 5 postintervention, between-group differences in medication use were absent
- the between-group difference in HbA1c disappeared after the first postintervention year
- at 10 years postintervention, mortality was 44%
a) the leading causes of death were
1] cardiovascular disease (52%)
2] cancer (24%)
b) sulfonylurea-insulin subgroup had significant reductions in diabetes-related death (by 17%), all-cause death (by 13%), MI (by 15%), & microvascular disease (by 24%), compared with the standard-therapy group
c) the metformin subgroup also had significant reductions in these outcomes (by 30%, 27%, 33%, & 16%, respectively)
Conclusions:
- a period of improved glycemic control early in the course of type 2 diabetes has an extended benefit
- benefit may vary by pharmacologic strategy
General
clinical trial
References
- Holman RR et al.
10-year follow-up of intensive glucose control in type 2
diabetes.
N Engl J Med 2008 Oct 9; 359:1577.
PMID: 18784090