Study shows early blood sugar control reduces diabetes complications

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Research from the Universities of Oxford and Edinburgh has demonstrated the long-term benefits of early and intensive blood glucose control in minimizing complications associated with type 2 diabetes.

These complications can include severe health issues like heart attacks, kidney failure, and vision loss. The findings stem from the UK Prospective Diabetes Study (UKPDS), one of the most extended clinical trials ever conducted in the field of diabetes, which utilized comprehensive NHS data.

Professor Rury Holman from Oxford’s Radcliffe Department of Medicine, and the Chief Investigator of the UKPDS, emphasized the importance of early diagnosis and treatment.

“Often, people live with type 2 diabetes for years without a diagnosis because the symptoms might not be apparent until there’s a significant rise in blood sugar levels,” he explained.

The UKPDS began in 1977, randomly assigning newly diagnosed type 2 diabetes patients to either an intensive glucose control regimen using medications like sulfonylureas, insulin, or metformin, or a conventional strategy focused mainly on diet.

The results published in 1998 after 20 years of trial, highlighted that effective blood glucose management significantly lowers the risk of diabetes-related complications, influencing global guidelines towards recommending intensive glucose control for all individuals with the condition.

Professor Holman pointed out that even after the official trial ended, and the treatment strategies among the participants aligned, those who initially received intensive treatment continued to experience better health outcomes. A follow-up study a decade later confirmed these benefits persisted.

The latest results, recently discussed at the 67th Japan Diabetes Society meeting in Tokyo and published in The Lancet, reveal that these advantages, described as a ‘legacy’ effect, extend up to 24 years post-trial.

Participants who started with intensive blood glucose control immediately after diagnosis showed a reduction in mortality and fewer incidents of heart attacks and other complications compared to those on conventional treatment plans.

Those treated with metformin notably had 31% fewer heart attacks and 20% fewer deaths.

“This underscores the critical importance of managing blood glucose early and aggressively,” stated Professor Amanda Adler, Director of the Diabetes Trial Unit at Oxford.

Professor Philip Clarke, who directs Oxford’s Health Economics Research Center, added that the intensive treatment significantly improves life expectancy and quality of life due to reduced complications.

Dr. Will Whiteley, a neurology and epidemiology professor at the University of Edinburgh, highlighted the role of the UK’s comprehensive health data in tracking the long-term health outcomes of the UKPDS participants.

This rich dataset allowed researchers to evaluate the impact of midlife treatments on age-related diseases, including dementia, showcasing the potential of NHS data in clinical trials.

These findings strongly advocate for the early and intensive management of blood glucose levels in type 2 diabetes patients to prevent severe health complications later in life, providing a clearer path for healthcare providers in managing the disease more effectively.

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The research findings can be found in The Lancet.

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