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Researchers Find Improved Treatment For Diabetes Complications LONDON, ENGLAND -- February 19, 1999 -- In this week’s Lancet, Dr Peter Gaede and colleagues from Copenhagen, Denmark, report that intensive multifactorial treatment (simultaneous treatment of several risk factors) of patients with type 2 diabetes and microalbuminuria slows the development of kidney disease and the progression of eye and nerve problems by about 50 percent. Most complications of diabetes are the result of not one, but several risk factors. There are usually several methods of managing each risk factor. For example, high blood glucose concentrations can be affected by changes in diabetic medication and exercise levels. Similarly, the management of one risk factor may affect others-ie, exercise may benefit not only high blood glucose but also high blood pressure (hypertension). In the Danish study, 160 patients with type 2 diabetes and very small amounts of protein in their urine (microalbuminuria) were randomly assigned to either standard treatment or intensive treatment. The 80 patients in the standard-treatment group received treatment according to Danish guidelines for patients with diabetes. The intensive-treatment group received stepwise (accumulating over time) interventions of behaviour modification-exercise, low-fat diet, stopping smoking-and drug treatment for high blood glucose concentrations, high blood pressure, and raised cholesterol. Patients were followed up for about four years. At the end of the study, patients in the intensive-treatment group had significantly lower blood glucose concentrations, lower systolic blood pressure, and less protein in their urine than those in the standard-treatment group. However, patients in the intensive-treatment group had gained more weight than those in the standard-treatment group. In his commentary (p 606), Hertzel C Gerstein from Ontario, Canada, says that the improvements probably result from a combination of the interventions, and that it is not possible to attribute the benefits to any one component. Overall, he argues, this study adds to the growing consensus that the best possible management of diabetes is based on a multifactorial approach. E-mail this page to a friend or colleague! To print, use this version