The trial was formulated in the background of the DCCT(1993) done in Type 1 diabetics which showed Intensive treatment results in improved outcomes more so for the microvascular than macrovascular injury. So it was a must that same hypothesis be tested in the Type 2 diabetics, the majority group. So the United Kindgom Prospective Diabetes Study was started to test the hypothesis.
Summary is as follows:
- Patients with newly diagnosed type 2 diabetes and within the normal weight range were randomly assigned to conventional treatment with diet alone (30%), intensive treatment with insulin (30%) or intensive treatment with a sulphonylurea (chlorpropamide or glipizide, 40%).
- In the conventional group, the aim was the best achievable FPG with diet alone; drugs were added only if there were hyperglycaemic symptoms or FPG greater than 270 mg/dL.
- The Intensive arm had a target FPG of less than 108 mg/dL
- Intensive pharmacologic therapy achieved a significantly lower HbA1c (HbA1c = 7%) than the conventional approach (HbA1c=7.9%) over a follow-up period of 10 years.
- Adverse effects: Increased risk of hypoglycemia and significant increase in weight in Intensive arm (Insulin>SU>Conventional) was observed.
The achievement of tight blood glucose control in type 2 Diabetes is feasible and should become the standard of care. -UKPDS
UKPDS
Original article in The Lancet
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