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Tight control of blood pressure and blood sugar reduces type 2 diabetes risks

By Lilian Anekwe

Combining tight control of blood pressure with tight control of blood sugar reduces the risk of cardiovascular and renal complications in patients with type 2 diabetes, a study has shown.

The analysis suggests that the benefits of tight blood glucose control and blood pressure lowering are independent of each other and are fully additive.

The ADVANCE trial, in which 11,140 patients with type 2 diabetes were treated with a combination of glicazide and perindopril, found combined tight control of both blood pressure and blood sugar lowered the risk of death from heart disease by nearly a quarter and the risk of renal complications by a third.

Patients in the intensive blood glucose lowering arm of ADVANCE had a mean HbA1c level of 6.5%, compared with 7.3% in patients in the standard control arm. Mean blood pressure in the intensive arm was 136/74mm Hg at the end of the follow-up period.

Professor John Chalmers, senior director of The George Institute for International Health in Australia, presented the data at the EASD conference in Rome, concluding:

‘The combination of routine blood pressure lowering and tighter glucose control confers very substantial benefits.'

Professor Cliff Bailey, head of diabetes research at Aston University in Birmingham, said: ‘The intensity of glucose control has to be adapted to the individual. Diabetes is heterogeneous and it's important diabetes care is individualised as recent trials have shown us that lowering glucose can cause problems in vulnerable patients.'

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