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Lasting effect of immediate intervention in type 2 diabetes

Establishing and maintaining good blood glucose control immediately after patients are diagnosed with type 2 diabetes has long-term benefits, a 30-year UK study reveals.

New results from the UK Prospective Diabetes Study (UKPDS) show intensive treatment of blood glucose immediately after diagnosis has a ‘legacy effect' in reduced cardiovascular events and deaths.

Patients treated with either a sulphonylurea, insulin or metformin saw long-term reductions in macrovascular and microvascular events after being monitored for a further 10 years after the 20-year UKPDS trial ended in 1997.

In patients treated with metformin, there was a 21% reduction in all diabetes-related complications, a 33% reduction in the risk of heart attacks and 27% fewer deaths.

In patients who took a sulphonylurea or insulin, there was a 9% reduction after 10 years in the risk of any diabetes-related endpoint, a 24% reduction in microvascular disease, a 15% reduction in the risk of a heart attack and a 13% fewer deaths from any cause.

The post-trial analysis of blood pressure control did not show a legacy effect. The researchers concluded that though blood pressure control is essential, the benefits are not maintained over time.

Professor David Matthews, chair of the Oxford Centre for Diabetes, Endocrinology and Metabolism and a lead UKPDS researcher, said: ‘With glucose control it matters how well you are treated now and how well you were treated in the past – with blood pressure it seems to be related just to current therapy.

‘This confirms how essential it is to maintain good blood pressure levels over time if the risk of complications is to be minimised', he added.

The results were presented at the European Association for Study of Diabetes conference in Rome last week.

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