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.
|Number of pages||4|
|Journal||QJM - Monthly Journal of the Association of Physicians|
|Early online date||1 Nov 2003|
|Publication status||Published - Nov 2003|
- Administration, Oral
- Antihypertensive Agents/therapeutic use
- Blood Glucose/analysis
- Blood Pressure/physiology
- Diabetes Mellitus, Type 2/blood
- Diabetic Angiopathies/drug therapy
- Drug Therapy, Combination
- Health Surveys
- Hemoglobin A/analysis
- Hypoglycemic Agents/administration & dosage
- Insulin/therapeutic use
- Middle Aged