The UKPDS and its global impact.

Aim To review the world-wide impact of the United Kingdom Prospective Diabetes Study (UKPDS) on diabetes health care since publication of the main study results in 1998. Methods The major papers published by the UKPDS were reviewed, e-mails and faxes were sent to diabetes associations in various regions of the world seeking information on trends in HbA1c over the past decade and similar information was obtained from a major USA laboratory. Results The UKPDS extended to type 2 diabetes and brought to completion the case for linking the microvascular vascular complications of diabetes to control of blood glucose initially demonstrated by the Diabetes Control and Complications Trial (DCCT). This helped set the standard of care for diabetes to seek an HbA1c goal of at least < 7.0% with intensive glycemic treatment and formed a fundamental part of continuing medical education. This also helped stimulate new hypoglycemic drug development and the preferential use of metformin as first line therapy was supported by UKPDS results. In many areas of the world, including the United Kingdom and the USA, a national trend to lower HbA1c levels has been seen. Economic analyses have shown UKPDS intensive treatment to be cost-effective at 6028 Ibs. per quality life year gained, imposing a reasonable burden on the British National health care budget. Conclusions The UKPDS was a landmark study in the treatment of type 2 diabetes from the time of diagnosis that has influenced standards of care and treatment guidelines throughout the world.