Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). We investigated whether intensive therapy to target normal glycated hemoglobin levels would reduce cardiovascular events in patients with type 2 diabetes who. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study.

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Antihypertensive therapy in type 2 diabetes: In the last 2 years, the results of several other studies of hypertension which have included patients with diabetes have been published.

The observation that UKPDS patients had a lower mortality than the general population with type 2 diabetes may be a reflection of this. Economic evaluations of Ukpde II diabetes. This article has been cited by other articles in PMC. Sixteen year follow-up study. Cloning and functional expression of a rat heart K-ATP channel. UKPDS was a unique, long-term study. However, glucose levels usually remain high and these can ukpde to “diabetic complications”.

The study has also shown that after 10 years one third have a complication that requires clinical attention, including heart attacks, strokes, laser treatment of the eyes, treatment for siabetes failure or amputations. In trials such as this, patients are selected both by investigators and by themselves. That the reduced occurrence of myocardial infarction was not significant may be due to type 2 statistical error.

One thousand one diiabetes and forty-eight patients took part. Over 30 papers have been published from the UKPDS database, and many more are in preparation or planned.

When diet failed to achieve these targets, subjects were randomized to sulphonylureas, insulin or metformin, the latter in obese patients only. The results of metformin treatment are the most controversial [ 14 ].


The emphasis on aggregate end-points allowed the study outcomes to be presented in a clinically meaningful way, i.

Each of these treatments has now been shown to be advantageous. In people with Type 2 diabetes that is usually diagnosed in middle age, symptoms can often be controlled by diet or tablet therapy. 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.

Collins R, Macmahon S.

People with raised blood pressure as well as diabetes were randomly allocated to diabefes policy aiming for tight blood pressure control, using two treatments that might be thought to be particularly beneficial, an ACE inhibitor or beta-blocker or to a less tight blood pressure control.

There are two common types of diabetes. There is concern that sulphonylureas may increase cardiovascular mortality in patients with type 2 diabetes and that high insulin concentrations may enhance atheroma formation.

UK Prospective Diabetes Study

This has been an acceptable clinical ukpss, in view of the lack of reliable evidence to show that intensive treatment of blood glucose or blood pressure will prevent complications, and thus help to maintain the health of patients. It is therefore frequently called “mild diabetes”.

Metformin use was associated with fewer aggregate end-points including overall mortality in obese patients. In spite of insulin therapy, after a few years it can be difficult to maintain good blood glucose control.

UKPDS, sadly, confirmed that patients with Type 2 diabetes have a high incidence of heart attacks and strokes, and have a greater likelihood of early death than the general population. Myocardial infarction was reduced by a fifth, but this was not statistically significant.


To date, the effectiveness of insulin and oral hypoglycaemic agent combinations is not known, although there are unpublished data from the study on the combination of insulin and sulphonylureas. People with diabetes may often require three different types of tablet and even then eetudio treatment is required by many patients.

In the world wide prevalence of type 2 non-insulin dependent diabetes was 99 million 1. The secondary aim of the study was to compare the effects of different treatments for diabetes, since ukpss have theoretical advantages and disadvantages. Three aggregate endpoints were used to assess differences between conventional and intensive treatment: Until now there has been little convincing evidence that improved diabetes control will prevent the complications of diabetes.

Prevention would be the ideal solution, but is currently a remote prospect. The rates of major hypoglycaemic episodes per year were 0.

UK Prospective Diabetes Study : Protocol

The results were primarily expressed in terms of aggregate end points: People with diabetes usually present with thirst, weight loss and tiredness. On the diabetee, the pioneering study of the s, the University Group Diabetes Program UGDP [ 8 ], suggested that treatment with tolbutamide might be harmful.

There was also a trend, just short of statistical significance, towards a reduction in macrovascular disease.