Intensive care no better than routine care to stave off type 2 diabetes complications

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1413150_59052775If not well-controlled, diabetes either type 1 or type 2 can result in a number of debilitating complications. Some or these are due to negative effects on small blood vessels or microvasculature throughout the body. Thus, problems with vessels in the eyes (retinopathy), kidneys (nephropathy) and nervous system (neuropathy), can result in blindness, kidney damage, and/or pain and numbness in the legs and feet, respectively.

It has long been conjectured that if blood sugar was better controlled, these effects on the microvasculature might be prevented. Unfortunately for diabetics, a recent study published in the journal Diabetes Care does not support this.

Dr. Annelli Sandbaek of the University of Aarhus in Denmark and a multinational group of colleagues followed approximately 2900 people with type 2 diabetes for 5 years. These patients were part of a randomized trial in which they received either intensive treatments or standard care. After 5 years, the researchers assessed whether there were differences in the occurrence of retinopathy, nephropathy, or neuropathy based on the type of treatment each group had received.

The news was all bad; there were no significant differences in the occurrence of these diabetic complications between the two groups. Comparing intensive care to routine care, they found the prevalence of nephropathy was 23 percent versus and 24 percent in each group; for retinopathy the prevalence was 10 percent versus 12 percent, and for neuropathy the prevalence was 5 percent and 6 percent, respectively. They concluded that the intensive treatment was not associated with significant reductions in the frequency of microvascular events at 5 years.

ACSH s Dr. Ruth Kava said Certainly these results are disappointing, since such diabetes complications are leading causes of blindness, kidney failure and neuropathy. We must continue to advocate for prevention and treatment of obesity, which is one of the leading risk factors for type 2 diabetes.