Intensive Integrated Therapy of Type 2 Diabetes
Abstract
The macro- and microvascular burden of type 2 diabetes is well established. A number of recent single risk factor intervention trials targeting hyperglycemia, dyslipidemia, hypertension, procoagulation, microalbumuria, and existing cardiovascular disorders have, however, shown major beneficial effects on long-term outcome. The results from these studies are anticipated to change the future management of type 2 diabetes, and most of the updated national guidelines for the treatment of type 2 diabetes recommend a multipronged approach driven by ambitious treatment targets. The outcome of this intensive integrated therapy has, however, only been investigated in a few studies of patients with type 2 diabetes. One of these trials, the Steno-2 Study, showed that intensive intervention for an average of 7.8 years cuts cardiovascular events as well as nephropathy, retinopathy, and autonomic neuropathy by about half when compared with a conventional multifactorial treatment. The challenge for now is to ensure that the trial experiences are widely adopted in daily clinical practice.
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In secondary interventions, individual therapy with aspirin, antihypertensive agents, and lipid-lowering drugs each reduced the relative risk of cardiovascular events by about 25%, and the effects appeared to be additive.
“hypertensive agents, and lipid-lowering drugs each reduced the relative risk of cardiovascular events by about 25%, and the effects appeared to be additive.21,22”
From Effect of a multifactorial intervention on mortality in type 2 diabetes (2008) · cites this paper as [21]
The reductions in risk in the composite of cardiovascular events (59% relative, 29% absolute) fit with projections from trials involving single risk factors.
“Therefore, the reductions in riska 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.21”
From Effect of a multifactorial intervention on mortality in type 2 diabetes (2008) · cites this paper as [21]
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References 67 · Cited by 108
- Authors
- Gæde, P., & Pedersen, O.
- Affiliations
- Steno Diabetes Center Copenhagen (DK)
- Aarhus University (DK)
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2004-12-01
- Volume
- 53
- Issue
- suppl_3
- Pages
- S39-S47
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2165379936
- Cited by
- 108
- References
- 67
- Citations by year
- 2025: 3 · 2024: 8 · 2023: 2 · 2022: 2 · 2021: 6 · 2020: 4 · 2019: 1 · 2018: 9 · 2017: 4 · 2016: 7 · 2015: 5 · 2014: 12 · 2013: 2 · 2012: 5
- FWCI
- 0.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, multifactorial treatment, cardiovascular risk reduction, microvascular complications, kidney disease, retinopathy, autonomic neuropathy, glycemic control, dyslipidemia, hypertension, microalbuminuria, treatment goals, clinical adoption
- MeSH terms
- Algorithms, Behavior Therapy, Diabetes Mellitus, Type 2, Family Practice, Humans, Hypoglycemic Agents, Prognosis, Time Factors
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