Intensive integrated therapy of type 2 diabetes: implications for long-term prognosis.
The macro- and microvascular burden of type 2 diabetes is well established. A number of recent single risk factor intervention trials targeting hyperglycemia, dyslipidemia, hypertension, procoagulation, microalbumuria, and existing cardiovascular disorders have, however, shown major beneficial effects on long-term outcome. The results from these studies are anticipated to change the future management of type 2 diabetes, and most of the updated national guidelines for the treatment of type 2 diabetes recommend a multipronged approach driven by ambitious treatment targets. The outcome of this intensive integrated therapy has, however, only been investigated in a few studies of patients with type 2 diabetes. One of these trials, the Steno-2 Study, showed that intensive intervention for an average of 7.8 years cuts cardiovascular events as well as nephropathy, retinopathy, and autonomic neuropathy by about half when compared with a conventional multifactorial treatment. The challenge for now is to ensure that the trial experiences are widely adopted in daily clinical practice.
Gaede
Peter
P
Steno Diabetes Center, Niels Steensens Vej 2, DK-2820 Gentofte, Copenhagen, Denmark. oluf@steno.dk
Pedersen
Oluf
O
D000465:Algorithms; D001521:Behavior Therapy; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005194:Family Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D011379:Prognosis; D013997:Time Factors
D007004:Hypoglycemic Agents