Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Original Article from The New England Journal of Medicine — Effects of Intensive Glucose Lowering in Type 2 Diabetes. UKPDS overview. 1. The UK Prospective Diabetes Study ukpds; 2. • year multicenter RCT -Interventional Trial from to • Intensive.
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Prevalence of hypertension in newly presenting type 2 diabetic patients and the association with risk factors for cardio-vascular and diabetic complications.
After an initial treatment with diet alone for three months, people with a raised fasting blood glucose were randomly allocated to one of various treatment policies. Relative efficacy of randomly allocated diet, sulphonylurea, insulin, or metformin in patients with newly diagnosed noninsulin dependent diabetes followed for three years. The study showed that intensive blood glucose treatment is acceptable and that better blood glucose control could be obtained than with conventional management.
Major nutrition recommendations and interventions for diabetes are listed in table 3. Table 1 Absolute risk. At present diabetic complications are often regarded as being a natural outcome from a chronic disease.
The study also assessed effects of intensive treatment on quality of life; no adverse effect was apparent. The “complications” can arise from damage to large arteries that cause heart attacks and strokes. Kluwer Academic publishers; The secondary aim of the study was to compare the effects of different treatments for diabetes, since some have theoretical advantages and disadvantages. These results are again reassuring at first sight, but, as with the glucose control study, type 2 errors cannot be excluded; there was a trend in favour of the atenolol treated group.
Treatment of type 2 diabetes in primary health care. Cost effectiveness analysis of improved blood pressure control in hypertensive patients with type 2 diabetes: The results of UKPDS suggest that a formal screening programme should be set up to identify diabetes before symptoms occur.
The effect of angiotensin-converting enzyme inhibition on diabetic nephropathy.
Read uk prospective diabetes study ukpds, diabetologia on deepdyve, the largest online rental service for ukppds research with thousands of academic publications available at your fingertips. Effect of lowcalorie versus lowcarbohydrate ketogenic diet.
Estudio ukpds diabetes pdf journals
Methods from an outpatient clinic, we recruited 28 overweight participants with type 2 diabetes for a 16week singlearm pilot diet intervention trial. Effect of intensive bloodglucose control with metformin on complications in overweight patients with type 2 diabetes ukpds Effect of intensive bloodglucose control with metformin on.
It was the largest and longest study ever undertaken in diabetes; median follow-up was 10 years. Effect of lisinopril on progression of retinopathy in normotensive people with type 1 diabetes. Specific diabetic complications can also develop, due to closure of small blood vessels that can cause blindness, kidney failure and amputations.
The original diabetes prevention program dpp was a research study funded by the national institutes of health nih and supported by the centers for disease control and prevention cdc. No threshold was seen, i.
In trials such as this, patients are selected both by investigators and by themselves. However, glucose levels usually remain high and these can lead to “diabetic complications”.
Therapeutic implications, study limitations and outstanding questions Figures 5 — 7. People with diabetes usually present with thirst, weight loss and tiredness.
Single clinical endpoints and surrogate subclinical endpoints were also assessed. One aspect of management inadequately addressed by the study is the optimal combination of drugs to be used either for glucose or blood pressure control.
Metabolic control and cardiovascular risk factors in type 2 diabetes mellitus patients according to diabetes duration, family practice, volume 32, issue 1. Improved blood-glucose control decreases the progression of diabetic microvascular disease, but the effect on macrovascular complications is unknown.
Numerous substudies were embedded Figure 2the most notable being the Hypertension in Diabetes Study. On the contrary, the pioneering study of the s, the University Group Diabetes Program UGDP [ 8 ], suggested that treatment with tolbutamide might be harmful.
UK Prospective Diabetes Study : Protocol
ukds There was no difference in HbA1c among agents in the intensive group. There was no difference for any of the three aggregate endpoints between the three intensive agents chlorpropamide, glibenclamide, or insulin. Different agents seemed equally effective, but the possibility of type 2 errors in these subgroup analyses cannot be excluded, as already discussed. The results were primarily expressed in terms of aggregate end points: In addition, some studies have suggested that hyperinsulinaemic states are atherogenic [ 17 ], and the increased incidence of hypoglycaemia with intensive control with estduio could estudlo precipitate a cerebrovascular or cardiovascular event.
The predominant effect of tighter control was a reduction of microvascular disease by a quarter, largely due to a reduction in laser photocoagulation.
Diabetes was first recognized years ago by the Ancient Egyptians.
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Diabetes mellitus or type2 diabetes, is one of the major noncommunicable and fastest growing public health problems in the world, is a condition difficult to treat and expensive to manage. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvasvular complications in type 2 diabetes: Implications of the united kingdom prospective diabetes study.
The numbers involved in this subgroup analysis were very small, with few deaths 26 vs 14 in the group treated with sulphonylureas alone and no difference in the incidence of heart attacks or strokes between the groups, only in the proportion who died.
Others were allocated to an intensive policy group aiming for near-normal glucose control, with two different sulphonylureas tablets or to insulin. These occur two or three times more often in people with Type 2 diabetes than in the general population and can cause death at an earlier age than is usual. Therefore a study to show whether a treatment will prevent complications has to be a long-term study.
Within nine years approximately one-third of patients required three different types of treatment. Their use also reduced the number of treatment comparisons, thus minimizing the chances of false-positive results, but had the disadvantage of concealing the magnitude of effects on individual end points.
People with diabetes may often require three different types of tablet and even then insulin treatment is required by many patients.
Support Center Support Center. The national kidney foundation is the leading organization in the u. Until now there has been little convincing evidence that improved diabetes control will prevent the complications estydio diabetes.