THE METABOLIC MEMORY IN ACTION - UKPDS FOLLOW UP DATA - THE LEGACY EFFECT
THE ORIGINAL UKPDS STUDY
The United Kingdom prospective diabetes Study (UKPDS) was a randomized, prospective, multicenter trial launched in 1977, enrolling patients until 1991 and completed by 1997, with final results published in 1998.
Here researchers randomly assigned 4,209 patients to either conventional therapy in the form of dietary restriction or intensive therapy with sulfonylurea, insulin or, in overweight patients metformin only,
The study showed a reduced risk of microvascular complications, a nonsignificant reduction in MI, and no improvement in all-cause mortality with intensive glucose lowering using a sulfonylurea or insulin, instead of conventional glucose control through diet.
It is generally said that the Original UKPDS study have formed the "cornerstone" for diabetes management:
They first about the need for intensive glucose control.
THE 10 YEARS FOLLOW UP DATA
In post-trial monitoring, 3277 patients were asked to attend annual UKPDS clinics for 5 years from 1997.
No attempts were made to maintain their previously assigned therapies.
Annual questionnaires were used to follow patients who were unable to attend the clinics.
All patients in years 6 to 10(2002 to 2005) were assessed through questionnaires.
Diabetes is a disease for a lifetime.The question was when intervening was stopped, would the impact of good early control disappear or would there be a continuing benefit, what is being called THE LEGACY EFFECT.
Between-group differences in glycemic control were lost in the first year after the trial closed.
At 10 years, patients assigned to intensive control with sulfonylurea and insulin had reduced risk for microvascular disease (24%), MI (15%), death from any cause (13%) and any diabetes-related end point (9%) compared with patients assigned to conventional therapy.
Patients assigned to metformin experienced significant risk reductions for MI (33%), death...