brief history of the UK Prospective Diabetes Study

IF 0.4 Q4 ENDOCRINOLOGY & METABOLISM
R. Holman
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引用次数: 2

Abstract

The UK Prospective Diabetes Study (UKPDS) epidemiological findings confirmed that T2DM is not a “mild” disease, with roughly 50% of patients having clinically evident complica- tions at diagnosis, emphasising the need for its early detection and treatment. Hyperglycaemia was identified as an independent coronary heart disease risk factor, with progressive hyperglycaemia shown to be a major pathophysiological feature of T2DM, driven by declining beta-cell function. People with T2DM and hypertension were found to be at double jeopardy for any diabetes endpoint, and worsening kidney function was shown to increase the risk of death substantially. The UKPDS 20-year trial results were the first to demon- strate that diabetic complications are not inevitable but can be prevented by more intensive blood glucose control and by metformin therapy, changing T2DM management guide- lines worldwide. The UKPDS also showed that tighter blood pressure control prevents diabetic complications; the benefits of the glucose and blood pressure interventions are additive. The UKPDS 10-year post-trial monitoring study was the first to identify the T2DM glycaemic and metformin legacy effects, with early more intensive therapy having continuing benefits long after the trial terminated. The trial demon- strated the need to achieve good glycaemic control as early as possible to minimise the risk of future complications.
英国前瞻性糖尿病研究简史
英国前瞻性糖尿病研究(UKPDS)的流行病学结果证实,T2DM不是一种“轻度”疾病,大约50%的患者在诊断时有临床明显的并发症,强调了早期发现和治疗的必要性。高血糖被确定为一种独立的冠心病风险因素,进展性高血糖被证明是T2DM的主要病理生理特征,由β细胞功能下降驱动。研究发现,T2DM和高血压患者在任何糖尿病终点都面临双重危险,肾功能恶化会大大增加死亡风险。UKPDS 20年的试验结果首次证明,糖尿病并发症并非不可避免,但可以通过更严格的血糖控制和二甲双胍治疗来预防,从而改变了世界范围内的T2DM管理指南。UKPDS还表明,更严格的血压控制可以预防糖尿病并发症;葡萄糖和血压干预的益处是相加的。UKPDS的10年试验后监测研究首次确定了T2DM的血糖和二甲双胍遗留影响,早期更强化的治疗在试验终止后很长一段时间内都具有持续的益处。该试验表明,需要尽早实现良好的血糖控制,以将未来并发症的风险降至最低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
British Journal of Diabetes
British Journal of Diabetes ENDOCRINOLOGY & METABOLISM-
自引率
16.70%
发文量
15
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