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through diet.
It is generally said that the Original UKPDS study have formed the "cornerstone" for
diabetes management:
They first about the need for intensive glucose control.
In post-trial monitoring, 3277 patients were asked to attend annual UKPDS clinics for
clinics.
All patients in years 6 to 10(2002 to 2005) were assessed through questionnaires.
Diabetes is a disease for a lifetime.The question was when intervening was stopped,
would the impact of good early control disappear or would there be a continuing
benefit, what is being called
RESULTS
Between-group differences in glycemic control were lost in the first year after the trial
closed.
At 10 years, patients assigned to intensive control with sulfonylurea and insulin had
reduced risk for microvascular disease (24%), MI (15%), death from any cause (13%)
and any diabetes-related end point (9%) compared with patients assigned to
conventional therapy.
Patients assigned to metformin experienced significant risk reductions for MI (33%),
death from any cause (27%) and any diabetes-related end point (21%) that
Persisted over time compared with controls.
DISCUSSION
Thus the UKPDS follow up data not only conclusively showed the benefit of intensive
glycemic control in reducing the microvascular complication , but showed benefit in
reducing macrovascular complications like MI , stroke , and reduction of death from
The significance of this early control will be more evident if we consider 3 more landmark
studies presented in 2008.
DISCUSSION CAN YOU FIND OUT HOW METABOLIC MEMORY HAS PLAYED
ITS PART HERE ?
See none of these 3 trials showed significant reduction in macrovascular outcome why ? All
these trials included patients on whom macrovascular complication would have already set
in to some extent.
THUS YOU CANNOT STOP A MOVING TRAIN, ITS BETTER TO NOT TO LET THE TRAIN START,
Thus , we are seeing a continued benefit of earlier intervention. The message is very clear
early intensive glucose control leads to increased benefits over time, and waiting and
treating later leads to disappointing results. The emphasis has to be on keeping blood
glucose normal from day one, rather than trying to rescue it from some high value later on.
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