Intensified treatment of type 2 diabetes--positive effects on blood pressure, but not glycaemic control

G V Gill; A Woodward; S Pradhan; M Wallymahmed; T Groves; P English; J P Wilding

doi:10.1093/qjmed/hcg143

Intensified treatment of type 2 diabetes--positive effects on blood pressure, but not glycaemic control

G V Gill, A Woodward, S Pradhan, M Wallymahmed, T Groves, P English, J P Wilding

Nursing & Midwifery Education

Research output: Contribution to journal › Article › peer-review

17 Citations (Scopus)

Abstract

BACKGROUND: Since publication of the UK Prospective Diabetes Study (UKPDS) in 1998, there has been a clear evidence base for tight glycaemic (HBA(1c) < 7.0%) and blood pressure (BP < 140/85 mmHg) control.

AIM: To determine the effect of UKPDS-based intensified glycaemic and BP targets on the care of type 2 diabetic patients attending a routine diabetes clinic.

DESIGN: Two surveys, each of 500 consecutively attending type 2 diabetic patients.

METHODS: The first survey was in a 3-month period in 1999, shortly after publication of the UKPDS study. The second was identical, but 2 years later. Glycaemic control (by DCCT-aligned HBA(1c)), BP and treatment details were recorded in both.

RESULTS: BP control was significantly improved in the second survey (mean +/- SD systolic BP from 151 +/- 25 to 146 +/- 26 mmHg, p = 0.001; diastolic from 77 +/- 13 to 72 +/- 12 mmHg, p < 0.0001) and the proportion of patients on anti-hypertensive treatment increased from 33% to 60% (p < 0.0001). Mean HbA(1c) however remained unchanged (8.7 +/- 1.8% in 1999 vs. 8.5 +/- 1.8% in 2001), although there was evidence of more intensive treatment patterns, with declining numbers on diet alone and more on oral agents and/or insulin.

DISCUSSION: Intensified BP control may be achievable within the confines of routine diabetes care, but achievement of optimal glycaemic targets remains problematic.

Original language	English
Pages (from-to)	833-6
Number of pages	4
Journal	QJM - Monthly Journal of the Association of Physicians
Volume	96
Issue number	11
Early online date	1 Nov 2003
DOIs	https://doi.org/10.1093/qjmed/hcg143
Publication status	Published - Nov 2003

Keywords

Administration, Oral
Aged
Antihypertensive Agents/therapeutic use
Blood Glucose/analysis
Blood Pressure/physiology
Diabetes Mellitus, Type 2/blood
Diabetic Angiopathies/drug therapy
Diet
Drug Therapy, Combination
Female
Health Surveys
Hemoglobin A/analysis
Humans
Hypoglycemic Agents/administration & dosage
Insulin/therapeutic use
Male
Middle Aged

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title = "Intensified treatment of type 2 diabetes--positive effects on blood pressure, but not glycaemic control",

abstract = "BACKGROUND: Since publication of the UK Prospective Diabetes Study (UKPDS) in 1998, there has been a clear evidence base for tight glycaemic (HBA(1c) < 7.0%) and blood pressure (BP < 140/85 mmHg) control.AIM: To determine the effect of UKPDS-based intensified glycaemic and BP targets on the care of type 2 diabetic patients attending a routine diabetes clinic.DESIGN: Two surveys, each of 500 consecutively attending type 2 diabetic patients.METHODS: The first survey was in a 3-month period in 1999, shortly after publication of the UKPDS study. The second was identical, but 2 years later. Glycaemic control (by DCCT-aligned HBA(1c)), BP and treatment details were recorded in both.RESULTS: BP control was significantly improved in the second survey (mean +/- SD systolic BP from 151 +/- 25 to 146 +/- 26 mmHg, p = 0.001; diastolic from 77 +/- 13 to 72 +/- 12 mmHg, p < 0.0001) and the proportion of patients on anti-hypertensive treatment increased from 33% to 60% (p < 0.0001). Mean HbA(1c) however remained unchanged (8.7 +/- 1.8% in 1999 vs. 8.5 +/- 1.8% in 2001), although there was evidence of more intensive treatment patterns, with declining numbers on diet alone and more on oral agents and/or insulin.DISCUSSION: Intensified BP control may be achievable within the confines of routine diabetes care, but achievement of optimal glycaemic targets remains problematic.",

keywords = "Administration, Oral, Aged, Antihypertensive Agents/therapeutic use, Blood Glucose/analysis, Blood Pressure/physiology, Diabetes Mellitus, Type 2/blood, Diabetic Angiopathies/drug therapy, Diet, Drug Therapy, Combination, Female, Health Surveys, Hemoglobin A/analysis, Humans, Hypoglycemic Agents/administration & dosage, Insulin/therapeutic use, Male, Middle Aged",

author = "Gill, {G V} and A Woodward and S Pradhan and M Wallymahmed and T Groves and P English and Wilding, {J P}",

year = "2003",

month = nov,

doi = "10.1093/qjmed/hcg143",

language = "English",

volume = "96",

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TY - JOUR

T1 - Intensified treatment of type 2 diabetes--positive effects on blood pressure, but not glycaemic control

AU - Gill, G V

AU - Woodward, A

AU - Pradhan, S

AU - Wallymahmed, M

AU - Groves, T

AU - English, P

AU - Wilding, J P

PY - 2003/11

Y1 - 2003/11

N2 - BACKGROUND: Since publication of the UK Prospective Diabetes Study (UKPDS) in 1998, there has been a clear evidence base for tight glycaemic (HBA(1c) < 7.0%) and blood pressure (BP < 140/85 mmHg) control.AIM: To determine the effect of UKPDS-based intensified glycaemic and BP targets on the care of type 2 diabetic patients attending a routine diabetes clinic.DESIGN: Two surveys, each of 500 consecutively attending type 2 diabetic patients.METHODS: The first survey was in a 3-month period in 1999, shortly after publication of the UKPDS study. The second was identical, but 2 years later. Glycaemic control (by DCCT-aligned HBA(1c)), BP and treatment details were recorded in both.RESULTS: BP control was significantly improved in the second survey (mean +/- SD systolic BP from 151 +/- 25 to 146 +/- 26 mmHg, p = 0.001; diastolic from 77 +/- 13 to 72 +/- 12 mmHg, p < 0.0001) and the proportion of patients on anti-hypertensive treatment increased from 33% to 60% (p < 0.0001). Mean HbA(1c) however remained unchanged (8.7 +/- 1.8% in 1999 vs. 8.5 +/- 1.8% in 2001), although there was evidence of more intensive treatment patterns, with declining numbers on diet alone and more on oral agents and/or insulin.DISCUSSION: Intensified BP control may be achievable within the confines of routine diabetes care, but achievement of optimal glycaemic targets remains problematic.

AB - BACKGROUND: Since publication of the UK Prospective Diabetes Study (UKPDS) in 1998, there has been a clear evidence base for tight glycaemic (HBA(1c) < 7.0%) and blood pressure (BP < 140/85 mmHg) control.AIM: To determine the effect of UKPDS-based intensified glycaemic and BP targets on the care of type 2 diabetic patients attending a routine diabetes clinic.DESIGN: Two surveys, each of 500 consecutively attending type 2 diabetic patients.METHODS: The first survey was in a 3-month period in 1999, shortly after publication of the UKPDS study. The second was identical, but 2 years later. Glycaemic control (by DCCT-aligned HBA(1c)), BP and treatment details were recorded in both.RESULTS: BP control was significantly improved in the second survey (mean +/- SD systolic BP from 151 +/- 25 to 146 +/- 26 mmHg, p = 0.001; diastolic from 77 +/- 13 to 72 +/- 12 mmHg, p < 0.0001) and the proportion of patients on anti-hypertensive treatment increased from 33% to 60% (p < 0.0001). Mean HbA(1c) however remained unchanged (8.7 +/- 1.8% in 1999 vs. 8.5 +/- 1.8% in 2001), although there was evidence of more intensive treatment patterns, with declining numbers on diet alone and more on oral agents and/or insulin.DISCUSSION: Intensified BP control may be achievable within the confines of routine diabetes care, but achievement of optimal glycaemic targets remains problematic.

KW - Administration, Oral

KW - Aged

KW - Antihypertensive Agents/therapeutic use

KW - Blood Glucose/analysis

KW - Blood Pressure/physiology

KW - Diabetes Mellitus, Type 2/blood

KW - Diabetic Angiopathies/drug therapy

KW - Diet

KW - Drug Therapy, Combination

KW - Female

KW - Health Surveys

KW - Hemoglobin A/analysis

KW - Humans

KW - Hypoglycemic Agents/administration & dosage

KW - Insulin/therapeutic use

KW - Male

KW - Middle Aged

U2 - 10.1093/qjmed/hcg143

DO - 10.1093/qjmed/hcg143

M3 - Article

C2 - 14566038

VL - 96

SP - 833

EP - 836

JO - QJM - Monthly Journal of the Association of Physicians

JF - QJM - Monthly Journal of the Association of Physicians

SN - 1460-2725

IS - 11

ER -