30-year study shows benefits of glucose control

September 11, 2008

(PhysOrg.com) -- A large-scale, 30-year study by Oxford University has shown improved blood glucose control in type 2 diabetes leads to greater benefits in the longer term. The findings, to be published in the New England Journal of Medicine, show the need to treat blood glucose levels more intensively from the time type 2 diabetes is diagnosed.

The researchers at the Oxford Centre for Diabetes, Endocrinology and Metabolism have found that earlier improved blood glucose control reduces the risk of heart attacks and leads to fewer deaths, in addition to reducing the risk of well-recognised complications from type 2 diabetes, such as kidney and eye disease.

The UK Prospective Diabetes Study (UKPDS) was the first large scale trial to show that the complications of type 2 diabetes, including kidney failure and vision loss from eye disease, were not inevitable but could be prevented, both by more intensive blood glucose control and by tighter blood pressure control. The trial results, published in 1998, changed diabetes management worldwide and now form the basis of all diabetes treatment guidelines. When the UKPDS finished all patients returned to their usual healthcare. Investigators continued to monitor them each year for diabetic complications but were no longer involved in treatment decisions.

New results published today show that although the blood glucose control differences maintained between groups during the trial disappeared rapidly, the advantages of earlier improved blood glucose control with respect to diabetic eye disease and kidney disease were undiminished even after ten years – a legacy effect. In addition, major new benefits emerged with a reduced risk of heart attacks (15%) and fewer deaths (13%).

‘We now know not only that good glucose control from the time type 2 diabetes is diagnosed reduces the rate of diabetic complications but also that this early intervention leads to sustained benefits in the longer term – a legacy effect’, commented Professor Rury Holman of Oxford University, Chief Investigator of the study. ‘These results emphasise the importance of detecting and treating diabetes at the earliest opportunity and the major benefits that can be obtained with good blood glucose control’

The UKPDS post-trial blood pressure results did not show a legacy effect. Blood pressure differences maintained during the trial between the tight and less-tightly controlled groups disappeared rapidly, as for blood glucose control. In this case, however, the risks of diabetic complications also become similar. The investigators concluded that lowering blood pressure remains essential to help minimise the risk of diabetic complications, but unlike glucose lowering, the benefits obtained do not increase over time.

Professor David Matthews, Chairman of the Oxford Centre for Diabetes, Endocrinology and Metabolism, added: ‘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, confirming how essential it is to maintain good blood pressure levels over time if the risk of complications is to be minimised’

Professor Andrew Neil, University of Oxford Division of Public Health & Primary Health Care, stated: ‘UKPDS is a landmark trial that defined the basis for treating type 2 diabetes and has now underscored the need for lifelong good management of blood glucose and blood pressure control.'

Provided by Oxford University

Explore further: Study finds that heart failure is more fatal in patients with type 2 diabetes

Related Stories

Study finds that heart failure is more fatal in patients with type 2 diabetes

November 17, 2017
A new study has found that heart failure patients with pre-existing type 2 diabetes have higher hospitalisation and death rates, but that keeping blood sugars balanced can help lower the risk almost to that of heart failure ...

Like a baby: The vicious cycle of childhood obesity and snoring

November 17, 2017
Poor nutrition and lack of exercise lead to the increasing prevalence of obesity which, in turn, is the major predictor of diabetes and future risk of cardiovascular disease in western societies. Excess weight is also closely ...

New diabetes self-management education course for South Asian population

November 17, 2017
Researchers at King's College London have signed an agreement with three partner organisations to offer a customised type 2 diabetes self-management education programme for the South Asian population in three London Boroughs.

Cardiorespiratory fitness is essential to reduce risk of coronary heart disease

November 17, 2017
Coronary heart disease (CHD) is a leading cause of death for men in the U.S. Both cardiorespiratory fitness (CRF) and the blood triglyceride/high-density lipoprotein ratio (TG:HDL ratio) are strong predictors of death from ...

Better monitoring needed for pregnant women with diabetes

November 14, 2017
Half the babies born to women with diabetes are at risk of suffering complications due to fluctuations in their mothers' glucose levels, say researchers.

A new way to reduce surgery complications stemming from high blood sugar

November 16, 2017
Researchers identified a new way to lower the risk of complications after joint surgery, using a simple blood test. Patients with diabetes are more likely to need joint replacement surgery but also have a greater risk of ...

Recommended for you

Hibernating ground squirrels provide clues to new stroke treatments

November 17, 2017
In the fight against brain damage caused by stroke, researchers have turned to an unlikely source of inspiration: hibernating ground squirrels.

Age and gut bacteria contribute to multiple sclerosis disease progression

November 17, 2017
Researchers at Rutgers Robert Wood Johnson Medical School published a study suggesting that gut bacteria at young age can contribute to multiple sclerosis (MS) disease onset and progression.

Molecular guardian defends cells, organs against excess cholesterol

November 16, 2017
A team of researchers at the Harvard T. H. Chan School of Public Health has illuminated a critical player in cholesterol metabolism that acts as a molecular guardian in cells to help maintain cholesterol levels within a safe, ...

Prototype ear plug sensor could improve monitoring of vital signs

November 16, 2017
Scientists have developed a sensor that fits in the ear, with the aim of monitoring the heart, brain and lungs functions for health and fitness.

Ancient enzyme could boost power of liquid biopsies to detect and profile cancers

November 16, 2017
Scientists are developing a set of medical tests called liquid biopsies that can rapidly detect the presence of cancers, infectious diseases and other conditions from only a small blood sample. Researchers at The University ...

FDA to crack down on risky stem cell offerings

November 16, 2017
U.S. health authorities announced plans Thursday to crack down on doctors pushing stem cell procedures that pose the gravest risks to patients amid an effort to police a burgeoning medical field that previously has received ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.