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The U.K. Prospective Diabetes Study. A review

R C Turner1

  • 1University of Oxford, Nuffield Department of Clinical Medicine, Radcliffe Infirmary, U.K.

Diabetes Care
|December 16, 1998
PubMed
Summary

Improved blood glucose control in type 2 diabetes did not prevent complications. Intensive treatments were equally effective initially but beta-cell function deteriorated over time. Cardiovascular disease risk factors were identified.

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Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Clinical Trials

Background:

  • The U.K. Prospective Diabetes Study (UKPDS) began in 1977.
  • Type 2 diabetes management and its long-term complications were key concerns.

Purpose of the Study:

  • To assess if better blood glucose control prevents diabetes complications.
  • To compare conventional diet therapy with intensive treatments (sulfonylurea, metformin, insulin).

Main Methods:

  • A long-term prospective study involving people with type 2 diabetes.
  • Comparison of different glucose-lowering treatment regimens.
  • Monitoring of glucose, HbA1c, and cardiovascular risk factors over time.

Main Results:

  • Intensive policies (sulfonylurea, metformin, insulin) showed equal effectiveness in lowering fasting plasma glucose.
  • Progressive deterioration of beta-cell function was observed, indicated by rising glucose and HbA1c levels.
  • Cardiovascular disease was the primary complication, linked to elevated LDL cholesterol, low HDL cholesterol, high blood pressure, elevated HbA1c, and smoking.

Conclusions:

  • Intensive blood glucose control strategies in type 2 diabetes require ongoing management due to beta-cell decline.
  • Identifying and managing cardiovascular risk factors is crucial for preventing diabetes complications.

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