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This article originally posted 23 May, 2014 and appeared in  BG ControlType 2 DiabetesNephrologyOphthalmologyNeuropathyInsulinIssue 730

Long-term Diabetes Complications and Intensive Treatment Effects

Compared with routine care, early intensive multifactorial therapy shows little effect.... 

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In an effort to determine the benefit of multifactorial treatment on microvascular complications among people with type 2 diabetes, Annelli Sandbaek, MD, PhD, and colleagues conducted a multicenter cluster randomized controlled trial at four centers in Denmark, the UK, and The Netherlands. Out of 3,057 people with diabetes detected by a screening process, only 2,861 were eligible for follow-ups. They were assigned to either the intensive treatment or routine care group.

The results from the four centers were collected using a fixed-effects meta-analysis. Of the patients who received intensive treatment, 22.7% showed any type of albuminuria, and patients who underwent routine care had 24.4%. Retinopathy was observed in 10.2% of the patients who underwent intensive treatment, whereas 12.1% was seen in routine care patients. When it came to neuropathy, 4.9% was seen in intensive treatment patients, and 5.9% in routine care patients. However, in both groups the estimated glomerular filtration rate increased between baseline and follow-up; 4.31 mL/min was seen in the intensive treatment and 6.44 mL/min in the routine care groups.

According to the results of this study, researchers stated, "Compared with routine care, an intervention to promote target-driven, intensive management of patients with type 2 diabetes detected by screening was not associated with significant reductions in the frequency of microvascular events at five years."

Practice Pearls:
  • Albuminuria was 22.7% in the intensive group compared to 24% in the routine care group.
  • Retinopathy was present in 10.2% of the patients who underwent intensive treatment, whereas 12.1% was seen in routine care patients
  • Neuropathy, 4.9%, was seen in intensive treatment patients, and 5.9% in routine care

Sandbaek A et al. Diabetes Care. 2014; doi: 10.2337/dc13-1544 

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This article originally posted 23 May, 2014 and appeared in  BG ControlType 2 DiabetesNephrologyOphthalmologyNeuropathyInsulinIssue 730

Past five issues: Diabetes Clinical Mastery Series Issue 198 | Issue 738 | Diabetes Clinical Mastery Series Issue 197 | Issue 737 | Diabetes Clinical Mastery Series Issue 196 |

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