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

@article{UkProspectiveDiabetesStudyGroup1998IntensiveB,
  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)},
  author={Uk-Prospective-Diabetes-Study-Group},
  journal={The Lancet},
  year={1998},
  volume={352},
  pages={837-853}
}
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8,418 Citations
Highly Influential Citations
98
Background Citations
502
Methods Citations
43
Results Citations
42

8,418 Citations

Glycemic Control with Diet, Sulfonylurea, Metformin, or Insulin in Patients with Type 2 Diabetes Mellitus: Progressive Requirement for Multiple Therapies (UKPDS 49)
TLDR
Treatment with diet alone, insulin, sulfonylurea, or metformin is known to improve glycemia in patients with type 2 diabetes mellitus, but which treatment most frequently attains target fasting plasma glucose (FPG) concentration of less than 7.8 mmol/L (140 mg/dL) or glycosylated hemoglobin A1c (HbA1c) below 7% is unknown.
Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial
Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes.
TLDR
A strategy of intensive glucose control, involving gliclazide (modified release) and other drugs as required, that lowered the glycated hemoglobin value to 6.5% yielded a 10% relative reduction in the combined outcome of major macrovascular and microvascular events, primarily as a consequence of a 21%relative reduction in nephropathy.
Effects of intensive glucose control on microvascular outcomes in patients with type 2 diabetes: a meta-analysis of individual participant data from randomised controlled trials.
Effect of intensive diabetes treatment on albuminuria in type 1 diabetes: long-term follow-up of the Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications study.
Comparison of Metformin and Insulin Monotherapy with Combined Metformin and Insulin Therapy in Patients of Type 2 Diabetes with HbA1c > 7%.
TLDR
Therapy with insulin alone or with metformin in patients having poor glycemic control may be a useful and safe therapeutic approach in type 2 diabetes.
Use of insulin in type 2 diabetes: what we learned from recent clinical trials on the benefits of early insulin initiation.
Cost-utility analyses of intensive blood glucose and tight blood pressure control in type 2 diabetes (UKPDS 72)
TLDR
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.
Management of type 2 diabetes with multiple oral hypoglycaemic agents or insulin in primary care: retrospective cohort study.
TLDR
Many people with type 2 diabetes received inadequate monitoring and had poor glycaemic control, and intensive management is required to reduce the risk of microvascular complications.
DIABETIC MICROVASCULAR COMPLICATIONS: AN OVERVIEW *
TLDR
Intensive therapy to achieve near-normal blood glucose and glycosylated hemoglobin A1c (HbA1c) concentrations significantly reduced the risk of microvascular complications of diabetes, when compared with conventional therapy.
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References

SHOWING 1-10 OF 79 REFERENCES
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.
TLDR
The effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk of microvascular and macrovascular complications in patients with type 2 diabetes in a randomised controlled trial were compared.
Combined insulin and sulfonylurea therapy in non-insulin-dependent diabetics with secondary failure to oral drugs: a one year follow-up.
TLDR
It is suggested that combining a sulfonylurea with insulin can be useful in insulin-requiring type-2 diabetics who still secrete some endogenous insulin.
Combination insulin and sulfonylurea therapy in insulin-requiring type 2 diabetes mellitus.
The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long‐Term Complications in Insulin‐Dependent Diabetes Mellitus
TLDR
Intensive therapy effectively delays the onset and slows the progression of diabetic retinopathy, nephropathy, and neuropathy in patients with IDDM.
Effect of troglitazone in insulin-treated patients with type II diabetes mellitus. Troglitazone and Exogenous Insulin Study Group.
TLDR
When given in conjunction with insulin, troglitazone improves glycemic control in patients with type 2 diabetes mellitus.
Effects of Metformin in Patients with Poorly Controlled, Insulin-Treated Type 2 Diabetes Mellitus
TLDR
The probable clinical importance of the combination of metformin and insulin includes improvements in gly glucose control and insulin sensitivity and avoidance of the weight gain that often accompanies improved glycemic control.
A comparison of troglitazone and metformin on insulin requirements in euglycemic intensively insulin-treated type 2 diabetic patients.
TLDR
Metformin has no effect on insulin-stimulated glucose disposal independent of glycemic control in type 2 diabetes, and troglitazone has greater insulin-sparing effects than metformin in CSII-treated euglycemic patients.
Less nocturnal hypoglycemia and better post-dinner glucose control with bedtime insulin glargine compared with bedtime NPH insulin during insulin combination therapy in type 2 diabetes. HOE 901/3002 Study Group.
TLDR
Use of insulin glargine instead of NPH in insulin combination regimens in type 2 diabetes is associated with less nocturnal hypoglycemia and lower post-dinner glucose levels, consistent with peakless and longer duration of action of insulinglargine compared with NPH.
Comparison of Different Insulin Regimens in Elderly Patients With NIDDM
OBJECTIVE To compare the metabolic effects of three different frequently used regimens of insulin administration on blood glucose control and serum lipids, and the costs associated with this…
The Effects of Metformin on Glycemic Control and Serum Lipids in Insulin-Treated NIDDM Patients With Suboptimal Metabolic Control
TLDR
Metformin, when given as adjunctive therapy, was well tolerated and improved glycemic control and lipid concentrations in patients with insulin-treated NIDDM whose diabetes was poorly controlled and these improvements could be maintained over the long term.
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