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United Kingdom Prospective Diabetes Study (UKPDS) : 10 years later
Scheen A.J. , Paquot N. , Lefèbvre P.J.
Rev Med Liege 2008, 63(10),624-629Abstract : A 10-year post-trial monitoring of patients with newly diagnosed type 2 diabetes randomised in the “United Kingdom Prospective Diabetes Study” (UKPDS) demonstrated a continued reduction in microvascular risk (- 24%, p = 0.001) and emergent risk reductions for myocardial infarction (- 15%, p = 0.01) and death from any cause (- 13%, p = 0.007), despite an early loss of glycaemic differences (“legacy effect”). A continued benefit after metformin therapy was evident during the ten-year post-trial follow-up among overweight patients (- 33%, p = 0.005 for myocardial infarction and – 27%, p = 0.002 for death from any cause). In contrast, the benefits of previously improved blood pressure control were not sustained when between-groups differences in blood pressure were lost during follow-up, except for a reduced risk for peripheral vascular disease. These observations are strong arguments in favour of an early optimisation of blood glucose control and of a sustained control of blood pressure in patients with type 2 diabetes.