Type 2 Study Reveals Benefits of Tight Blood Sugar Control

The United Kingdom Prospective Diabetes Study (UKPDS) is the largest study on type 2 diabetes completed to date.  UKPDS evaluated whether intensive blood sugar control results in reduction of complications among those with type 2 diabetes. 

Newly diagnosed subjects were randomly put in 2 groups - a conventional group and an intensive group.  The conventional group had a goal of a fasting blood sugar of less than 270 mg/dl.  The intensive group had a goal of a fasting blood sugar of less than 108 mg/dl and were given oral hypoglycemic medications or insulin.

The following outlines some of the UKPDS findings.

• The conventional group was able to maintain a median A1c of 7.9% over a 10 year period.  The intensive group was able to maintain a median A1c of 7.0%.
• UKPDS found those with better blood sugar control reduced risk of eye disease due to diabetes by 25% and reduced risk for early kidney disease by 33%.
• For each percentage point reduction in A1c (for example 8% to 7%), there was a 35% decrease in risk for microvascular complications.  Microvascular complications are those occurring in small blood vessels such as the nerves, eyes, and kidneys.
• For every percentage point reduction in A1c, there was a 25% decrease in risk for diabetes related death and an 18% decrease in risk for fatal or non-fatal heart attack.
• UKPDS found no evidence of a specific elevated blood sugar level in which onset of complications occur and therefore blood sugar goals should be as close to normal as possible.

The American Diabetes Association indicate these findings support their position that an active, intensive treatment can reduce complications from diabetes.  The UKPDS shows better blood sugar control can reduce microvascular complications.

Notes:  Diabetes treatment and care is specific.  Talk to your doctor about treatment and blood sugar goals that are right for you.  Discuss how you can reduce risk for diabetes related complications.

The American Diabetes Association.  Standards of Medical Care for Patients with Diabetes Mellitus.  Diabetes Care, Volume 26, Supplement 1.

Oxford Centre for Diabetes, Endocrinology & Metabolism:  Diabetes Trials Unit.