The results of the
the long-awaited
UK Prospective Diabetes Study
(UKPDS),
have been announced.
As one might expect, based on the
DCCT (which showed that tight control decreases complications in
people with type 1
diabetes),
the UKPDS shows that the risk of complications
of diabetes can be reduced dramatically in people with type 2 diabetes.
The results of the UKPDS were presented at the
34th Annual Meeting of the
European Association for the Study of Diabetes (EASD) in Barcelona on
September 10, 1998, and have been published in the Lancet and the British Medical Journal on
September 12, 1998.
The UK Prospective Diabetes Study (UKPDS), the largest clinical study of diabetes ever attempted, has shown for the first time that the
life-threatening complications of type 2 (non-insulin dependent) diabetes, often regarded as inevitable, can be reduced by more intensive management
using existing treatments.
The 20-year study recruited over 5,000 patients with type 2 diabetes in 23 clinical centres based in England, Northern Ireland and Scotland. It
was co-ordinated by the Diabetes Research Laboratories at Oxford and cost £23M.
The UKPDS has revealed that:
- better blood glucose control reduces the risk of
- better blood pressure control, in the many patients who have high blood pressure, reduces the risk of:
- death from long-term complications of diabetes by a third,
- strokes by more than a third, and
- serious deterioration of vision by more than a third.
In the study, blood glucose and blood pressure levels were measured more frequently than usual. If either blood glucose or blood pressure
were above an agreed target, the treatment dose was increased or other treatments were added. Over 20 years, the study clearly demonstrated
the benefits of this intensive strategy. Intensive therapy did not impair quality of life, although some patients gained weight and some had more
frequent "hypos" (episodes of low blood sugar).
A cost-effectiveness analysis showed that cost savings from the reduction in diabetic complications outweighed the cost of the additional
medication required, but not the extra staff costs involved.
Also see
Landmark
study shows risk of complications
of diabetes can be reduced dramatically.
From the
Diabetes Trials Unit
at the University of Oxford.
The
British Medical Journal for
12 September 1998 (Volume 317, Issue 7160)
has several articles on the UKPDS, mainly about the effects of blood pressure control.
PubMed
has links to the articles about the UKPDS. For example, see
Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. This link will in turn link to the full-text article at
The Lancet
has the title of the paper ("Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and
risk of complications in patients with type 2 diabetes (UKPDS 33)";
Volume 352, Number 9131, 12 September 1998) but the text is not available
on-line
unless you already subscribe to the journal.
(The Lancet
does, however, make available a
Commentary about the study.)
(Note: You will have to sign up with a username and password, and supply some information,
before being permitted to access the website.)
The
UKPDS
By David Mendosa.
At the ADA website, March 4, 2002.
UKPDS - Implications for the care of people with Type 2 diabetes
"The United Kingdom Prospective Diabetes Study (UKPDS), the largest clinical research study of diabetes ever conducted, has provided conclusive evidence that the life threatening complications of Type 2 diabetes (non insulin dependent diabetes) can be significantly reduced by appropriate treatment."
Position Statement of the Diabetes UK.
Research:
The UK Prospective Diabetes Study
at the DIABETES REGISTRY
Diabetes Control and Complications Trial
(A study showing lessened complications in type 1 diabetes when tight control is implemented.)
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