[Type 2 diabetes: new therapeutic perspectives].
UKPDS: The results of the United Kingdom Prospective Diabetes Study (UKPDS) were reported in 1998. This multi-center, prospective, randomized, intervention trial of 5102 newly-diagnosed patients with type 2 diabetes mellitus was aimed at determining whether improved blood glucose control can prevent complications and reduce associated morbidity and mortality.


RESULTS
Improved blood glucose control was shown to reduce the number of complications, mainly by reducing the effect of microangiopathy. There was however no reduction in the number of diabetes-related deaths nor in the risk of myocardial infarction or sudden death.
Calcium antagonists are suspected of increasing the risk of cardiovascular disease. On the basis of published reports, the JNC VI guidelines are recommended: calcium antagonists should not be used as first line treatment in diabetics.
Acarbose, an alpha-glucosidase inhibitor, lowers post-prandial blood glucose level. It has marketing approval for single-drug regimens in France. Miglitol, another alpha-glucosidase inhibitor, would have the same therapeutic effect. Orliatort, an gastro-intestinal lipase inhibitor, is indicated in obese patients but long-term results are lacking to evaluate effects in diabetics.
Bouhanick
B
B
Service de Médecine B, Centre Hospitalier et Universitaire d'Angers. BeBouhanick@chu-angers.fr
Berrut
G
G
Fressinaud
P
P
Marre
M
M
D020909:Acarbose; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000145:classification*; D008297:Male; D009765:Obesity; D011446:Prospective Studies; D014312:Trisaccharides / Q000627:therapeutic use
D002121:Calcium Channel Blockers; D004791:Enzyme Inhibitors; D007004:Hypoglycemic Agents; D014312:Trisaccharides; D020909:Acarbose