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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UK Prospective Diabetes Study UKPDS was a unique, long-term clinical trial designed to find out how to treat people with Type 2 diabetes to prevent complications and to maintain their health. The results of metformin treatment are the most controversial [ 14 ]. The findings could also be interpreted as indicating that insulin and sulphonylureas are equally harmful in the obese, possibly as a consequence of hyperinsulinaemia.
Type 1, which usually starts in young people and always needs to be treated with insulin.
The Study has shown that insulin is an acceptable treatment when given at an earlier stage of Type 2 diabetes than currently is the practice. Intensive blood-glucose control by either sulphonylureas or insulin substantially decreases the risk of microvascular complications, but not macrovascular disease, in patients with type 2 diabetes. The study showed that intensive blood pressure treatment is acceptable to people with diabetes, and that better blood pressure control than standard management can be obtained.
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This must be remembered when applying the results of the study to clinical practice. 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.
Questionnaires were given to people in the study to assess their quality of life with questions assessing mood, work satisfaction, symptoms and everyday mistakes. estuido
Glycemic control and mortality in diabetic patients. Over 30 papers have been published ykpds the UKPDS database, and many more are in preparation or planned. It was planned inand recruited over newly diagnosed patients in 23 sites in the UK 2 in Scotland, 2 in Northern Ireland and 19 in England. N Engl J Med. In addition, no larger scale studies had been done to show whether improved blood pressure control was effective. 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.
Intensive glycaemic control, particularly with insulin, also leads to morbidity from hypoglycaemia and weight gain. Whether the same holds true in type 2 diabetes remained uncertain. The study was subsequently extended to 23 sites. These results are again reassuring at first sight, but, as with the glucose control study, type 2 errors estudii be excluded; there was a trend in favour of the atenolol treated group. The benefits of treatment?
Treatment of type 2 diabetes in primary health care. The ukpds results establish that retinopathy, nephropathy, and possibly neuropathy are benefited by lowering blood glucose levels in type 2 diabetes with intensive therapy, which achieved a median hba 1c of 7. Intensive bloodglucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes ukpds 33 lancet Effect of intensive blood glucose control with metformin on complications in overweight patients with type 2 diabetes ukpds The fact that benefits are achieved within 2 or 3 years means that all patients should be treated irrespective of age.
Patients with chronic kidney disease ckd face more the united kingdom prospective diabetes study treatment challenges than those with normal kidney func ukpds found that intensive glucose therapy in patients. The insulin treatment of diabetes: Blood pressure, antihypertensive drug treatment and the risks of stroke and coronary heart disease. In modern society, the first statement is far from ukpxs.
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.
UK Prospective Diabetes Study : Protocol
However, for many years the design and conduct of the UGDP were subject to fierce debate which was never satisfactorily resolved; uncertainty continued about treatment and glycaemic targets for type 2 diabetes. Effect ukpdw intensive bloodglucose control with metformin on complications in overweight patients with type 2 diabetes ukpds There is concern that sulphonylureas may increase cardiovascular mortality in patients with type 2 diabetes and that high insulin concentrations may enhance atheroma formation.
That the reduced occurrence of myocardial infarction was not significant may be due to type 2 statistical ukpd.
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. Mortality and survival in type II non-insulin dependent diabetes mellitus. In trials such as this, patients are selected both by investigators and by themselves.
Until the early s, there was no evidence that our management of diabetes had any beneficial impact on the incidence of vascular complications. Esudio uk prospective diabetes study ukpds, diabetologia on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips.