The UK Prospective Diabetes Study - A review

The objective of the U.K. Prospective Diabetes Study (UKPDS), initiated in 1977, was set up to determine whether improved blood glucose control in peo ple with type 2 diabetes will prevent the complications of diabetes. The UK PDS was also designed to determine whether there are differences between co nventional policy (diet therapy) and three different regimens of intensive treatment policy, based on sulfonylurea, metformin, or insulin. Interim eff icacy analyses revealed that the intensive policies with sulfonylurea, insu lin, and metformin were equally effective in reducing fasting plasma glucos e concentrations. However, glucose and HbA(1c) measurements steadily increa sed with time, reflecting ongoing deterioration of beta-cell function. Card iovascular disease was the major cause of complications, and the risk facto rs included raised LDL cholesterol concentrations, low HDL cholesterol conc entrations, elevated blood pressure, elevated HbA(1c), concentrations, and smoking. A final study report was issued in September 1998, when the median duration of therapy was 11 years.