Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 Diabetes mellitus : Progressive requirement for multiple therapies (UKPDS 49).
Context Treatment with diet alone, insulin, sulfonylurea, or metformin is known to improve glycemia in patients with type 2 diabetes mellitus, but which treatment most frequently attains target fasting plasma glucose (FPG) concentration of less than 7.8 mmol/L (140 mg/dL) or glycosylated hemoglobin A1c (HbA1c) below 7% is unknown.
Objective To assess how often each therapy can achieve the glycemic control target levels set by the American Diabetes Association.
Design Randomized controlled trial conducted between 1977 and 1997.
Patients were recruited between 1977 and 1991 and were followed up every 3 months for 3,6, and 9 years after enrollment.
Setting Outpatient diabetes clinics in 15 UK hospitals.
Patients A total of 4075 patients newly diagnosed as having type 2 diabetes ranged in age between 25 and 65 years and had a median (interquartile range) FPG concentration of 11.5 (9.0-14.4) mmol/L [207 (162-259) mg/dL], HbA1c levels of 9.1% (7.5% - 10.7%), and a mean (SD) body mass index of 29 (6) kg/m2.
Interventions After 3 months on a low-fat, high-carbohydrate, high-fiber diet, patients were randomized to therapy with diet alone, insulin, sulfonylurea, or metformin.
Main Outcome Measures Fasting plasma glucose and HbA1c levels, and the proportion of patients who achieved target levels below 7% HbA1c or less than 7.8 mmol/L (140 mg/dL) FPG at 3,6, or 9 years following diagnosis. (...)
Mots-clés Pascal : Diabète, Randomisation, Essai thérapeutique contrôlé, Régime alimentaire, Insuline, Sulfonylurées, Metformine, Etude longitudinale, Analyse biochimique, Glycémie, Analyse multivariable, Analyse statistique, Efficacité traitement, Homme, Royaume Uni, Europe, Biguanides, Endocrinopathie, Nutrition, Hypoglycémiant, Biologie moléculaire
Mots-clés Pascal anglais : Diabetes mellitus, Randomization, Controlled therapeutic trial, Diet, Insulin, Sulfonylureas, Metformin, Follow up study, Biochemical analysis, Glycemia, Multivariate analysis, Statistical analysis, Treatment efficiency, Human, United Kingdom, Europe, Biguanides, Endocrinopathy, Nutrition, Hypoglycemic agent, Molecular biology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0335814
Code Inist : 002B02N. Création : 16/11/1999.