Intensive intervention benefits type 2 diabetics

NEW YORK (Reuters Health) - Among high-risk type 2 diabetics, an intensive intervention with multiple drug combinations and behavioral modification has sustained benefits, a Danish study shows. The study involved 160 adults with type 2 diabetes and microalbuminuria - a complication of diabetes marked by small amounts of the protein albumin in urine. It is the first sign of kidney disease and a marker of increased risk of heart disease. Participants were randomly assigned to usual care or to an intensified regimen of tight blood sugar control along with low-dose aspirin, cholesterol-lowering agents and blood pressure medication. They were treated for an average of 7.8 years and then followed for 5.5 years. According to Dr. Oluf Pedersen from the University of Aarhus, and associates, after 13.3 years of follow-up, far fewer individuals in the intensive-therapy group than the usual care group had died (24 versus 40). There were 51 cardiovascular events, including 9 deaths from cardiovascular causes, in 25 patients in the intervention group. By contrast, there were 158 cardiovascular events in the usual care arm, including 19 deaths, in 48 patients. "The reductions in risk -- a 59% reduction in the relative risk and a 29% reduction in the absolute risk -- in the composite of cardiovascular events fit with projections from trials involving single risk factors," the investigators note in this week's issue of The New England Journal of Medicine. Adults who originally received intensive management were significantly less likely to develop diabetic kidney disease, to experience progressive nerve damage, or to require dialysis or eye treatment, Pedersen and his associates report.