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Intensive Diabetes Care Brings Long-Term Benefits

Follow-up study finds lower deaths, complications in group receiving intensive interventions

WEDNESDAY, Feb. 6 (HealthDay News) -- Intensive interventions featuring multiple medications and behavior modification can lead to lasting improvements in all-cause and cardiovascular mortality in people with type 2 diabetes, according to research published in the Feb. 7 issue of the New England Journal of Medicine.

Peter Gaede, M.D., of the Steno Diabetes Center in Copenhagen, Denmark, and colleagues analyzed data from a follow-up study that extended observation on 130 patients with type 2 diabetes and microalbuminuria who had been assigned to intensive or conventional therapy. The original study lasted 7.8 years, and the follow-up added another 5.5 years. The primary end point was time to death from any cause; other end points included death from cardiovascular causes, a composite of cardiovascular disease events, diabetic nephropathy, or development or progression of diabetic retinopathy or neuropathy.

Those in the intensive therapy group had a lower risk of death (hazard ratio 0.54) and a lower risk of death from cardiovascular causes (hazard ratio 0.43). Fewer patients in the group progressed to end-stage renal disease (one versus six), and fewer needed retinal photocoagulation (relative risk 0.45).

"Recent surveys have shown very slow progress in achieving treatment goals and in the use of recommended drugs for the prevention of diabetic vascular complications. Therefore, since intensive, multifactorial care of patients with type 2 diabetes leads to reduced rates of death and cardiovascular disorders, the early and meticulous implementation of current treatment guidelines remains a major challenge," the authors conclude.

Two of the study co-authors report financial relationships with pharmaceutical companies.

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