title: Long-term multiple risk factor interventions in Japanese elderly diabetic patients: the Japanese Elderly Diabetes Intervention Trial--study design, baseline characteristics and effects of intervention.
abstract: OBJECTIVE
  To evaluate long-term, multiple risk factor intervention on physical, psychological and mental prognosis, and development of complications and cardiovascular disease in elderly type 2 diabetes patients.
  
  
  METHODS
  Our randomized, controlled, multicenter, prospective intervention trial included 1173 elderly type 2 diabetes patients who were enrolled from 39 Japanese institutions and randomized to an intensive or conservative treatment group. Glycemic control, dyslipidemia, hypertension, obesity, diabetic complications and atherosclerotic disease were measured annually. Instrumental activity of daily living, cognitive impairment, depressive symptoms and diabetes burden were assessed at baseline and 3 years.
  
  
  RESULTS
  There was no significant difference in clinical or cognitive parameters at baseline between the two groups. The prevalence of low activities of daily living, depressive symptoms and cognitive impairment was 13%, 28% and 4%, respectively, and was similar in the two groups. A small, but significant difference in HbA1c between the two groups was observed at 1 year after the start of intervention (7.9% vs 8.1%, P < 0.05), although this significant difference was not observed after the second year. With the exception of coronary revascularization, there was no significant difference in fatal or non-fatal events between the two groups. Composite events were also similar in the two groups.
  
  
  CONCLUSIONS
  This study showed no significant differences in fatal or non-fatal events between intensive and conventional treatment. The present study might clarify whether treatment of risk factors influences function and quality of life in elderly diabetic patients.
authors.affiliation: Department of Diabetes Mellitus, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan. aaraki@tmghig.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Araki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iimuro
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakurai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Umegaki
authors.forename: Katsuya
authors.initials: K
authors.lastname: Iijima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakano
authors.forename: Kenzo
authors.initials: K
authors.lastname: Oba
authors.forename: Koichi
authors.initials: K
authors.lastname: Yokono
authors.forename: Hirohito
authors.initials: H
authors.lastname: Sone
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yamada
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
authors.forename: Koichi
authors.initials: K
authors.lastname: Kozaki
authors.forename: Hisayuki
authors.initials: H
authors.lastname: Miura
authors.forename: Atsunori
authors.initials: A
authors.lastname: Kashiwagi
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kikkawa
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yoshimura
authors.forename: Tadasumi
authors.initials: T
authors.lastname: Nakano
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Ito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D048909:Diabetes Complications / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids