Comprehensive and intense treatment can extend median lifetime by eight years for people with type 2 diabetes and those suffering microalbuminuria, according to a longitudinal Danish follow-up study released Thursday.
Type 2 diabetes affects more than 29 million Americans and one in four are not aware that they have the chronic condition, according to Centres for Disease Control and Prevention. The disease increases blood glucose, blood lipids, blood platelet aggregation and blood pressure resulting in higher chances of vascular and organ damage. Diabetes can also lower life expectancy of patients.
Those having type 2 diabetes also have increased levels of albumin in the urine resulting in microalbuminuria. This is a marker of vascular damage. If left untreated, diabetic patients have elevated risk of cardiovascular problems and premature death.
Researchers conducted the follow-up study to find the differences in median lifespan of the intensified and conventionally treated patients. For the latest findings, they conducted a follow-up study on the popular Steno-2 study — a randomized trial of intensified vs. standard multifactorial intervention for nearly eight years in patients with type 2 diabetes and microalbuminuria. It included 160 type 2 diabetic patients with microalbuminuria.
“The outcome of our study is very encouraging and emphasises the need for early and intensified treatment of multiple modifiable risk factors for a poor prognosis of patients with type 2 diabetes,” Peter Gaede, one of the authors of the study, said in a statement.
Researchers explained that in the intensive treatment group, therapy was conducted at a specialized diabetes clinic and was target-driven and intensified with continued behavioural education (a green and low fat diet, more daily exercise and instructions on quitting tobacco) and multidrug treatment of blood glucose, blood lipids, blood platelets, blood pressure and microalbuminuria following a structured approach.
Those receiving conventional therapy were seen by their general practitioner. However, they had the opportunity of being referred to specialist treatment if required. The control group was treated in a multifactorial way based on existing guidelines for diabetes care.
The original intervention lasted eight years. During the following 13 years, patients in both original treatment arms were in a post-trial setting. They were told to follow the same multifactorial and intensified treatment.
Throughout the total 21 years of follow-up time, 38 intensive therapy patients and 55 conventional therapy patients passed away. This meant that those who received intense treatment were 45 percent less likely to die. Researchers found that patients in the intensive therapy group survived for a median of eight years longer than those who received conventional therapy.
Also, according to the findings, median time before first cardiovascular problem was also eight years longer among the intensive therapy group.
“This long-term follow-up of the Steno-2 study demonstrates beyond any doubt the sustainability of the intensified and multipronged treatment approach of type 2 diabetes patients with microalbuminuria introduced by us more than 21 years ago. The benefits for the patients in terms of a major extension of life and a halving of new cardiovascular complications speak for themselves,” Hans-Henrik Parving, one of the senior authors, said.
http://www.medicaldaily.com/type-2-diabetes-treatment-intense-therapy-increases-median-lifetime-8-years-396715
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