• Corpus ID: 74479699

Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group.

  title={Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group.},
  author={Robert C. Turner and C Fox and Matthews and Helen Mcelroy and Carole A. Cull and Rury R. Holman and Patel Neil and D. R. Hadden and David W. Wright and {\'E}abha Manley and Irene M. Stratton and Uk Prospective Diabetes and Eva M. Kohner and Frighi and Michael Gnant},
  journal={The Lancet},
Background Improved blood-glucose control decreases the progression of diabetic microvascular disease, but the effect on macrovascular complications is unknown. There is concern that sulphonylureas may increase cardiovascular mortality in patients with type 2 diabetes and that high insulin concentrations may enhance atheroma formation. We compared the effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk of microvascular and… 

Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group.

The proportion of patients who maintained target glycemic levels declined markedly over 9 years of follow-up, and the progressive deterioration of diabetes control was such that after 3 years approximately 50% of patients could attain this goal with monotherapy, and by 9 years this declined to approximately 25%.

Sulfonylurea inadequacy: efficacy of addition of insulin over 6 years in patients with type 2 diabetes in the U.K. Prospective Diabetes Study (UKPDS 57).

Early addition of insulin when maximal sulfonylurea therapy is inadequate can significantly improve glycemic control without promoting increased hypoglycemia or weight gain.

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The results provide an economic rationale for ensuring that care of patients with type 2 diabetes corresponds at least to the levels of these interventions, and each of the three policies evaluated has a lower cost per quality-adjusted life year gained than that of many other accepted uses of healthcare resources.

Combination therapies with insulin in type 2 diabetes.

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Biphasic Insulin Aspart 30 (BIAsp 30) is Safe and Improves Glycaemic Control in Insulin Naïve Patients with Type 2 Diabetes

The UKPDS and other studies have shown that intensive glycaemic control in type 2 diabetes significantly reduces the risk of development and/or deterioration of microvascular complications, and current data suggest that postprandial hyperglycaemia is associated with an increased risk of macrovascular disease.



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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, progression of diabetic retinopathy, and deterioration in visual acuity.

UKPDS 26: sulphonylurea failure in non‐insulin‐dependent diabetic patients over six years

Sulphonylureas fail as a therapeutic agent at rates which are dependent both on the phenotype at presentation and perhaps on the agent used initially, particularly in those with higher glucose concentrations, those who were younger, those with lower beta‐cell reserve and those randomized to glibenclamide compared with chlorpropamide.

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Intensive therapy effectively delays the onset and slows the progression of diabetic retinopathy, nephropathy, and neuropathy in patients with IDDM.

U.K. Prospective Diabetes Study 16: Overview of 6 Years' Therapy of Type II Diabetes: A Progressive Disease

Sulfonylurea, metformin, and insulin therapies were similarly effective in improving glucose control compared with a policy of diet therapy and whether any specific therapy is advantageous or disadvantageous.

Intensive Conventional Insulin Therapy for Type II Diabetes: Metabolic effects during a 6-mo outpatient trial

Intensive CIT, when combined with CBG measurements, can be used to rapidly improve glycemic control in type II diabetes without development of unacceptable hypoglycemia, however, this degree of metabolic improvement requires large doses of exogenous insulin to overcome peripheral insulin resistance and results in greater hyperinsulinemia with progressive weight gain.

UKPDS 28: A Randomized Trial of Efficacy of Early Addition of Metformin in Sulfonylurea-Treated Type 2 Diabetes

Early addition of metformin improved gly glucose control in patients with suboptimal glycemic control while taking maximum sulfonylurea therapy, irrespective of obesity or baseline FPG concentrations.

NIDDM: a rapid progressive disease Results from a long-term, randomised, comparative study of insulin or sulphonylurea treatment

In conclusion, insulin was more effective than glibenclamide treatment in obtaining control over hyperglycaemia in these patients, and once improved, glycaemic control did not deteriorate over 42 months in the insulin-treated group.

United Kingdom Prospective Diabetes Study 17: A 9-Year Update of a Randomized, Controlled Trial on the Effect of Improved Metabolic Control on Complications in Non-Insulin-dependent Diabetes Mellitus

The prospective data in patients with NIDDM suggest that hyperglycemia is a risk factor for cardiovascular disease, but insufficient data exist to determine whether there is a glycemic threshold for macrovascular disease.