United Kingdom Prospective Diabetes Study /UKPDS) - Clinical Aspects

Abstract

Intensive blood-glucose control by either sulphonyloareas or insulin substantially decreases the risk of microvascular complications, but not macrovacsular disease, in patients with type 2 diabetes. None of the individual drugs had an adverse effect on cardiovascular outcomes. All intensive treatment increased the risk of hypoglycaemia. Metformin may be the first line pharmacological therapy of choice in overweight diabetic patients, since intensive glucose control with ofmetformin appears to decrease the risk of diabetes-related endpoints in overweight diabetic patients, and is associated with less weight gain and fewer hypoglycaemic attacks than are insulin and sulphonylureas. Tight blood pressure control in patients with hypertension and type 2 diabetes achieves a clinically important reduction in the risk of deaths related to diabetes, complications related to diabetes and progression of diabetic retinopathy. Blood pressure lowering with captopril or atenolol was similary effective in reducing the incidence of diabetic complications. The study provided no evidence that either drug has any specific beneficial effect, suggesting that blood pressure reduction in itself may be more important than the treatment used.