Intensive sulphonylurea with insulin to achieve fasting plasma glucose less than 6.0mmol/

Medication/Intervention

Intensive sulphonylurea with insulin to achieve fasting plasma glucose less than 6.0mmol/

(Sulphonylureas: chlorpropamide, glibenclamide or glipizide)

(Insulins: Ultratard or Humulin Zn or isophane insulin)

Comparator

Conventional treatment with diet to aim for fasting blood glucose less than 15mmol/l

(Metformin and sulphonylurea could be added or patients changed to insulin if target not achieved)

Study population:

Newly diagnosed type 2 diabetes patients  - between 25-65 years.

Comments:

Mean age of patients was 54 years

Any diabetes-related endpoint was defined as sudden death, death from hyperglycaemia or hypoglycaemia, fatal or non-fatal myocardial infarction, angina, heart failure, stroke, renal failure, digital amputation, vitreous haemorrhage, retinopathy requiring photocoagulation, blindness in one eye, or cataract extraction.

Diabetes-related death was death due to myocardial infarction, stroke, peripheral vascular disease, renal disease, hyperglycaemia or hypoglycaemia, and sudden death.

Median HbA_1c over 10 years 7.0% in intensive group versus 7.9% in conventional group

Intensive group had more hypo-glycaemic episodes per year and higher weight gain than conventional group.

Reduction in micro-vascular events were mostly retinal.