Chapter 14. Does Tight Control of Hyperglycaemia Limit Morbidity and Mortality in Type 2 Diabetes?

  1. R. Williams2,
  2. W. Herman3,
  3. A.-L. Kinmonth5 and
  4. N. J. Wareham4
  1. Amanda Adler

Published Online: 9 APR 2003

DOI: 10.1002/0470846585.ch14

The Evidence Base for Diabetes Care

The Evidence Base for Diabetes Care

How to Cite

Adler, A. (2002) Does Tight Control of Hyperglycaemia Limit Morbidity and Mortality in Type 2 Diabetes?, in The Evidence Base for Diabetes Care (eds R. Williams, W. Herman, A.-L. Kinmonth and N. J. Wareham), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846585.ch14

Editor Information

  1. 2

    Nuffield Institute for Health, University of Leeds, 71-75 Clarendon Road, Leeds LS2 9PL, UK

  2. 3

    Department of Internal Medicine and Epidemiology, 1500 East Medical Center Drive, 3920 Taubman Center, Box 0345, Ann Arbor, MI 48109, USA

  3. 4

    Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

  4. 5

    General Practice and Primary Care Research Unit, Dept. of Public Health & Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Author Information

  1. Diabetes Trials Unit, Radcliffe Infirmary, Woodstock Road, Oxford OX2 6EH, UK

Publication History

  1. Published Online: 9 APR 2003
  2. Published Print: 27 AUG 2002

ISBN Information

Print ISBN: 9780471988762

Online ISBN: 9780470846582

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Keywords:

  • microvascular complication;
  • cardiovascular disease;
  • retinopathy;
  • nephropathy;
  • neuropathy;
  • glycaemic control;
  • microalbuminuria;
  • obesity;
  • hypertension;
  • glucose threshold

Summary

Although hyperglycaemia defines diabetes and is in turn associated with the risk of its complications, this is not sufficient to justify the treatment of hyperglycaemia in order to avert complications. The justification for treating hyperglycaemia comes from trials that address whether glucose lowering reduces the risk of complications. This chapter reviews the evidence from observational studies and from clinical trials. These include the University Group Diabetes Program, the Kumamoto Study, the Veterans Affairs Cooperative Study in Type II Diabetes, the UK Prospective Diabetes Study and studies with multiple interventions. The trials support lowering blood glucose as a way of reducing the risk of diabetic complications and justify treating blood glucose as part of the overall care of patients with diabetes.