Thursday, 9 October 2014

Study finds that blood pressure lowering therapy may be more effective in patients with type 2 diabetes than controlling glucose levels

School of Public Health and Preventive Medicine's Dr Sophia Zoungas has co authored a study published in The New England Journal of Medicine which found that controlling glucose levels in patients with type 2 diabetes had little effect compared with blood-pressure–lowering therapy with respect to death or major macrovascular events.


According to the study, which looked at The Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE), the trial assessed the effects of routine blood-pressure lowering and intensive glucose control in a broad cross section of patients with type 2 diabetes. Routine administration of a single-pill combination of perindopril and indapamide was associated with a reduction in the risk of the primary composite end point of major macrovascular or microvascular events. Reductions in the risks of death from any cause, death from cardiovascular causes, and nephropathy were also observed. Intensive glucose control was associated with a reduction in the risk of the primary composite end point of major macrovascular or microvascular events, owing primarily to a reduction in the incidence of new or worsening nephropathy. This benefit with respect to nephropathy included a reduction in the incidence of end-stage renal disease but not of death from renal disease. No clear protective or harmful effects of intensive glucose control with respect to death from any cause or major macrovascular events were identified.

The study reports the results from the post-trial follow-up of the ADVANCE-Observational Study (ADVANCE-ON), which was designed to test the hypotheses that there would be long-term benefits of the two active interventions.

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