In a recent study of over 3,000 type 2 diabetes patients diagnosed through screening, intensive multifaceted treatment led to a small but statistically significant reduction in risk factors, compared to a usual care treatment group. However, the study published in The Lancet and led by UK professor Nick Wareham and Dr. Simon J. Griffin found only a small, non-statistically significant decrease in mortality among patients in the intensive treatment arm. The key, it seems, is to screen for undiagnosed diabetes in primary care and treat a variety of risk factors especially hypertension and elevated lipids with intensive methods. While patients given only routine care had an incidence of a first cardiovascular event of 8.5 percent and of all-cause mortality of 6.7 percent, the intensive treatment group had an incidence of 7.2 and 6.2 percent, respectively.
ACSH s Dr. Gilbert Ross thinks these improvements are fairly impressive. He also notes that it s important to keep the term non-statistically significant in perspective, given that the current standard of diabetes treatment is so good.
One reason for the small difference in mortality and cardiovascular outcomes between the two treatment groups may be attributed to the routine prescribing of statins and blood pressure-lowering drugs as usual care for diabetics; these treatments, according to Dr. David Preiss and Professor Naveed Sattar of the British Heart Foundation and Glasgow Cardiovascular Research Centre, may limit the additional benefits of more intensive ones.
