Glycemic control and prevention of microvascular and macrovascular disease in the Steno 2 study.
OBJECTIVE
To review key findings and insights from the Steno 2 trial involving 160 patients with type 2 diabetes in Denmark.


METHODS
The Steno 2 study design, with conventional and intensive treatment arms, is described, and the outcomes are summarized.


RESULTS
Intensive and target-driven behavior modeling and polypharmacy for 7.8 years induced an absolute risk reduction of 20% in cardiovascular disease events in patients with type 2 diabetes and the metabolic syndrome in comparison with a conventional multifactorial treatment. The relative risk reduction found for microvascular events after 4 years was maintained at a similar level after 7.8 years of intervention: nephropathy 61%, retinopathy 58%, and autonomic neuropathy 63%.


CONCLUSIONS
Improving glycemic control in patients with type 2 diabetes may be as important as, or even more important than, treating hypertension and dyslipidemia for the prevention of both microvascular and macrovascular complications, particularly when aggressive treatment is initiated at an early stage of the disease.
Vaag
Allan A
AA
Steno Diabetes Center, Copenhagen, Denmark.
D001786:Blood Glucose / Q000032:analysis*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D004032:Diet; D015444:Exercise; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D014652:Vascular Diseases / Q000517:prevention & control*
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin