Allan A Vaag1. 1. Steno Diabetes Center, Copenhagen, Denmark.
Abstract
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%. CONCLUSION: 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.
RCT Entities:
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%. CONCLUSION: 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.
Authors: Diana V Do; Xue Wang; Satyanarayana S Vedula; Michael Marrone; Gina Sleilati; Barbara S Hawkins; Robert N Frank Journal: Cochrane Database Syst Rev Date: 2015-01-31
Authors: Francisco Arrieta; Pedro Iglesias; Juan Pedro-Botet; Francisco Javier Tébar; Emilio Ortega; Andreu Nubiola; Jose Luis Pardo; Gonzálo Fernando Maldonado; Juan Carlos Obaya; Pablo Matute; Romina Petrecca; Nuria Alonso; Elena Sarabia; Victor Sánchez-Margalet; José Juan Alemán; Jorge Navarro; Antonio Becerra; Santiago Duran; Manuel Aguilar; Fernando Escobar-Jiménez Journal: Aten Primaria Date: 2015-05-29 Impact factor: 1.137