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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What was achievable and acceptable to a trial population cannot be necessarily translated to everyone with type 2 diabetes. In spite of insulin therapy, after a few years it can be difficult to maintain good blood glucose control. Single clinical endpoints and surrogate subclinical endpoints were also assessed.
From the point of view of their age and racial mix, these people were representative of the typical British patient with Type 2 diabetes. The predominant effect of tighter control was a reduction of microvascular disease by a quarter, largely due to a reduction in laser photocoagulation.
Economic evaluations of Type II diabetes. Metabolic control and cardiovascular risk factors in type 2. The “complications” can arise from damage to large arteries that cause heart attacks and strokes. Thus, unlike blood pressure control, intensive glycaemic control is not suitable for all patients, particularly the elderly, or those with existing severe complications. These two approaches have now been shown to be the key to maintaining the health of patients.
In ukpss, the study of treatment of hypertension was started.
Intensive bloodglucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with estuudio 2 diabetes ukpds 33 lancet Questionnaires were given to hkpds in the study to assess their quality of life with questions assessing mood, work satisfaction, symptoms and everyday mistakes.
All analyses were by intention to treat and frequency of hypoglycaemia was also analysed by actual therapy. Improving blood pressure is sometimes easier than improving blood glucose levels, and needs to have a high priority. 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.
This must be remembered when applying the results of the study to clinical practice. Epidemiology, complications and costs of diabetes mellitus.
Treatment of type 2 diabetes in primary health care. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: 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. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes UKPDS 34 Lancet.
In The social and cost implications of Type II diabetes. Protocol amendments were made to add topics not originally included. Diabetes prevention program dpp what is the diabetes prevention program.
Estudio ukpds diabetes pdf journals
An unexpected finding was that the addition of metformin to sulphonylureas in both obese and nonobese patients was associated with increased mortality. 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.
The small absolute risk reduction also needs to be compared with the possible effects of other risk factor interventions, e. The rates of major hypoglycaemic episodes per year were 0. 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. Some people were allocated to a conventional policy, primarily with diet alone. Prescott-Clarke P, Primatesa P. Patients returned to community or hospital-based diabetes care, according to their clinical needs, but with no attempt to maintain previously randomized therapies.
Diabetic nephropathy dn is a leading cause of endstage renal disease esrd in estudlo and hong kong. Since medicine is the art of the feasible, a high priority could be given to ensuring good control of blood pressure.
Intensive glucose control significantly reduced any diabetes-related end point, but had no effect on mortality. 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.
What was achievable and acceptable to a trial population cannot be necessarily translated to everyone with type 2 diabetes. On the other hand, the questionnaire showed that when people had diabetic complications, these adversely affected quality of life.
Over subjects at 23 centres across the UK were considered for inclusion; took part. The united kingdom prospective diabetes study ukpds recruited 5, patients with newly diagnosed type 2 diabetes in 23 centers within the u.
Both ACE inhibitors and beta-blockers have now been shown to be advantageous.
UK Prospective Diabetes Study : Protocol
The study showed that intensive blood glucose treatment is acceptable and that better blood glucose control could be obtained than estudii conventional management. Over 30 papers have been published from the UKPDS database, and many more are in preparation or planned. The observation that UKPDS patients had a lower mortality than the wstudio population with type 2 diabetes may be a reflection of this. We compared the effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk of microvascular and macrovascular complications in patients with type 2 diabetes in a randomised controlled trial.
Welcome to the national diabetes prevention program. Furthermore, the mortality in the group eztudio by sulphonylureas alone was unexpectedly low. Rosiglitazone evaluated for cardiovascular outcomes in oral.