BMJ 1998;317:703-713 ( 12 September )

Papers

Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38

Editorials by Orchard and Mogensen Papers pp   713 , 720 This paper was prepared for publication by Robert Turner, Rury Holman, Irene Stratton, Carole Cull, Valeria Frighi, Susan Manley, David Matthews, Andrew Neil, Heather McElroy, Eva Kohner, Charles Fox, David Hadden, and David Wright.

UK Prospective Diabetes Study Group. 

Correspondence to: Professor R Turner, UK Prospective Diabetes Study Group, Diabetes Research Laboratories, Radcliffe Infirmary, Oxford OX2 6HE

Objective: To determine whether tight control of blood pressure prevents macrovascular and microvascular complications in patients with type 2 diabetes.
Design: Randomised controlled trial comparing tight control of blood pressure aiming at a blood pressure of <150/85 mm Hg (with the use of an angiotensin converting enzyme inhibitor captopril or a  blocker atenolol as main treatment) with less tight control aiming at a blood pressure of <180/105 mm Hg.
Setting: 20 hospital based clinics in England, Scotland, and Northern Ireland.
Subjects: 1148 hypertensive patients with type 2 diabetes (mean age 56, mean blood pressure at entry 160/94 mm Hg); 758 patients were allocated to tight control of blood pressure and 390 patients to less tight control with a median follow up of 8.4 years.
Main outcome measures: Predefined clinical end points, fatal and non-fatal, related to diabetes, deaths related to diabetes, and all cause mortality. Surrogate measures of microvascular disease included urinary albumin excretion and retinal photography.
Results: Mean blood pressure during follow up was significantly reduced in the group assigned tight blood pressure control (144/82 mm Hg) compared with the group assigned to less tight control (154/87 mm Hg) (P<0.0001). Reductions in risk in the group assigned to tight control compared with that assigned to less tight control were 24% in diabetes related end points (95% confidence interval 8% to 38%) (P=0.0046), 32% in deaths related to diabetes (6% to 51%) (P=0.019), 44% in strokes (11% to 65%) (P=0.013), and 37% in microvascular end points (11% to 56%) (P=0.0092), predominantly owing to a reduced risk of retinal photocoagulation. There was a non-significant reduction in all cause mortality. After nine years of follow up the group assigned to tight blood pressure control also had a 34% reduction in risk in the proportion of patients with deterioration of retinopathy by two steps (99% confidence interval 11% to 50%) (P=0.0004) and a 47% reduced risk (7% to 70%) (P=0.004) of deterioration in visual acuity by three lines of the early treatment of diabetic retinopathy study (ETDRS) chart. After nine years of follow up 29% of patients in the group assigned to tight control required three or more treatments to lower blood pressure to achieve target blood pressures.
Conclusion: Tight blood pressure control in patients with hypertension and type 2 diabetes achieves a clinically important reduction in the risk of deaths related to diabetes, complications related to diabetes, progression of diabetic retinopathy, and deterioration in visual acuity.

Key messages This study showed that tight control of blood pressure based on captopril or atenolol as first agents and aiming for both a systolic blood pressure <150 mm Hg and diastolic pressure <85 mm Hg achieved a mean 144/82 mm Hg compared with 154/87 mm Hg in a control group 29% of patients in the tight control group required three or more hypotensive treatments Tight control of blood pressure reduced the risk of any non-fatal or fatal diabetic complications and of death related to diabetes; deterioration in visual acuity was also reduced Reducing blood pressure needs to have high priority in caring for patients with type 2 diabetes

---

© BMJ 1998
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Articles

Secular decline in mortality from coronary heart disease in adults with diabetes mellitus: cohort study

Ane Cecilie Dale, Lars J Vatten, Tom Ivar Nilsen, Kristian Midthjell, and Rune Wiseth
BMJ 2008 337: a236. [Abstract] [Full Text] [PDF]

Prevention and early detection of vascular complications of diabetes

Sally M Marshall and Allan Flyvbjerg
BMJ 2006 333: 475-480. [Extract] [Full Text] [PDF]

Glycaemia and vascular effects of type 2 diabetes

Brian Budenholzer, J K Cruickshank, R J Jarrett, Irene M Stratton, Carole A Cull, Susan E Manley, Amanda I Adler, H Andrew W Neil, David R Matthews, and Rury R Holman
BMJ 2001 322: 1245. [Extract] [Full Text]

Treating type 2 diabetes

K M Venkat Narayan, Gloria L A Beckles, Edward W Gregg, David F Williamson, J Saaddine, Michael M Engelgau, Frank Vinicor, Evald H Christiansen, Stefan M Groetsch, Joseph T LaVan, John W Epling, Jonathan Richards, Robert Turner, and Rury Holman
BMJ 1999 318: 666. [Extract] [Full Text]

Diabetes and death
BMJ 1998 317: 0. [Full Text]

Good news on diabetes, bad news on nose drops
BMJ 1998 317: 0. [Full Text]

Tight blood pressure control reduces risks of type 2 diabetes and is cost effective
BMJ 1998 317: 0. [Full Text]

Diabetes: a time for excitementand concern

Trevor Orchard
BMJ 1998 317: 691-692. [Extract] [Full Text] [PDF]

Combined high blood pressure and glucose in type 2 diabetes: double jeopardy

Carl Erik Mogensen
BMJ 1998 317: 693-694. [Extract] [Full Text] [PDF]

Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 39

UK Prospective Diabetes Study Group
BMJ 1998 317: 713-720. [Abstract] [Full Text] [PDF]

Cost effectiveness analysis of improved blood pressure control in hypertensive patients with type 2 diabetes: UKPDS 40

UK Prospective Diabetes Study Group
BMJ 1998 317: 720-726. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• Dale, A. C., Vatten, L. J, Nilsen, T. I., Midthjell, K., Wiseth, R. (2008). Secular decline in mortality from coronary heart disease in adults with diabetes mellitus: cohort study. BMJ 337: a236-a236 [Abstract] [Full text]  
• Romero, J. R., Morris, J., Pikula, A. (2008). Review: Stroke prevention: modifying risk factors. Therapeutic Advances in Cardiovascular Disease 2: 287-303 [Abstract]  
• Hietala, K., Forsblom, C., Summanen, P., Groop, P.-H., on behalf of the FinnDiane Study Group, (2008). Heritability of Proliferative Diabetic Retinopathy. Diabetes 57: 2176-2180 [Abstract] [Full text]  
• Pearce, K. A., Love, M. M., Shelton, B. J., Schoenberg, N. E., Williamson, M. A., Barron, M. A., Houlihan, J. M. (2008). Cardiovascular Risk Education and Social Support (CaRESS): Report of a Randomized Controlled Trial from the Kentucky Ambulatory Network (KAN). J Am Board Fam Med 21: 269-281 [Abstract] [Full text]  
• U.S. Preventive Services Task Force, (2008). Screening for Type 2 Diabetes Mellitus in Adults: U.S. Preventive Services Task Force Recommendation Statement. ANN INTERN MED 148: 846-854 [Abstract] [Full text]  
• Bloomgarden, Z. T. (2008). Cardiovascular Disease in Diabetes. Diabetes Care 31: 1260-1266 [Full text]  
• Shen, L. Q., Child, A., Weber, G. M., Folkman, J., Aiello, L. P. (2008). Rosiglitazone and Delayed Onset of Proliferative Diabetic Retinopathy. Arch Ophthalmol 126: 793-799 [Abstract] [Full text]  
• Vallance, J. H., Wilson, P. J., Leese, G. P., McAlpine, R., MacEwen, C. J., Ellis, J. D. (2008). Diabetic Retinopathy: More Patients, Less Laser: A longitudinal population-based study in Tayside, Scotland. Diabetes Care 31: 1126-1131 [Abstract] [Full text]  
• Schocken, D. D., Benjamin, E. J., Fonarow, G. C., Krumholz, H. M., Levy, D., Mensah, G. A., Narula, J., Shor, E. S., Young, J. B., Hong, Y. (2008). Prevention of Heart Failure: A Scientific Statement From the American Heart Association Councils on Epidemiology and Prevention, Clinical Cardiology, Cardiovascular Nursing, and High Blood Pressure Research; Quality of Care and Outcomes Research Interdisciplinary Working Group; and Functional Genomics and Translational Biology Interdisciplinary Working Group. Circulation 117: 2544-2565 [Abstract] [Full text]  
• MacDonald, M. R., Petrie, M. C., Hawkins, N. M., Petrie, J. R., Fisher, M., McKelvie, R., Aguilar, D., Krum, H., McMurray, J. J.V. (2008). Diabetes, left ventricular systolic dysfunction, and chronic heart failure. Eur Heart J 29: 1224-1240 [Abstract] [Full text]  
• Tuerk, P. W., Mueller, M., Egede, L. E. (2008). Estimating Physician Effects on Glycemic Control in the Treatment of Diabetes: Methods, effects sizes, and implications for treatment policy. Diabetes Care 31: 869-873 [Abstract] [Full text]  
• Carrier, J. (2008). Aerobic plus resistance training was more effective than either alone for glycaemic control in type 2 diabetes. Evid. Based Nurs. 11: 48-48 [Full text]  
• Fowler, M. J. (2008). Microvascular and Macrovascular Complications of Diabetes. Clin. Diabetes 26: 77-82 [Full text]  
• Marwick, T H (2008). Diabetic heart disease. Postgrad. Med. J. 84: 188-192 [Abstract] [Full text]  
• Heisler, M. (2008). Actively Engaging Patients in Treatment Decision Making and Monitoring as a Strategy to Improve Hypertension Outcomes in Diabetes Mellitus. Circulation 117: 1355-1357 [Full text]  
• Naik, A. D., Kallen, M. A., Walder, A., Street, R. L. Jr (2008). Improving Hypertension Control in Diabetes Mellitus: The Effects of Collaborative and Proactive Health Communication. Circulation 117: 1361-1368 [Abstract] [Full text]  
• Bakris, G. L., Berkwits, M. (2008). Trials That Matter: The Effect of a Fixed-Dose Combination of an Angiotensin-Converting Enzyme Inhibitor and a Diuretic on the Complications of Type 2 Diabetes. ANN INTERN MED 148: 400-401 [Full text]  
• Kelly, C. J., Booth, G. (2008). Pharmacist-led structured care for patients with diabetic nephropathy. British Journal of Diabetes & Vascular Disease 8: 86-88 [Abstract]  
• Scanlon, P H (2008). The English national screening programme for sight-threatening diabetic retinopathy. J Med Screen 15: 1-4 [Abstract] [Full text]  
• Gaede, P., Lund-Andersen, H., Parving, H.-H., Pedersen, O. (2008). Effect of a Multifactorial Intervention on Mortality in Type 2 Diabetes. NEJM 358: 580-591 [Abstract] [Full text]  
• Turchin, A., Shubina, M., Chodos, A. H., Einbinder, J. S., Pendergrass, M. L. (2008). Effect of Board Certification on Antihypertensive Treatment Intensification in Patients With Diabetes Mellitus. Circulation 117: 623-628 [Abstract] [Full text]  
• Takata, Y., Osawa, H., Kurata, M., Kurokawa, M., Yamauchi, J., Ochi, M., Nishida, W., Okura, T., Higaki, J., Makino, H. (2008). Hyperresistinemia Is Associated With Coexistence of Hypertension and Type 2 Diabetes. Hypertension 51: 534-539 [Abstract] [Full text]  
• Osher, E., Stern, N. (2008). Diastolic Pressure in Type 2 Diabetes: Can target systolic pressure be reached without "diastolic hypotension"?. Diabetes Care 31: S249-S254 [Abstract] [Full text]  
• Dixon, J. B., O'Brien, P. E., Playfair, J., Chapman, L., Schachter, L. M., Skinner, S., Proietto, J., Bailey, M., Anderson, M. (2008). Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes: A Randomized Controlled Trial. JAMA 299: 316-323 [Abstract] [Full text]  
• Swaminathan, K., Davies, J., Struthers, A. (2008). Review: Aldosterone antagonism in type 2 diabetes mellitus -- a new therapeutic approach to diabetic macrovascular disease?. British Journal of Diabetes & Vascular Disease 8: 16-19 [Abstract]  
• Mcgowan, N., Cockburn, A., Strachan, M. W., Padfield, P. L, Mcknight, J. A (2008). Initial and sustained cardiovascular risk reduction in a pharmacist-led diabetes cardiovascular risk clinic. British Journal of Diabetes & Vascular Disease 8: 34-38 [Abstract]  
• Wolever, T. M., Gibbs, A. L, Mehling, C., Chiasson, J.-L., Connelly, P. W, Josse, R. G, Leiter, L. A, Maheux, P., Rabasa-Lhoret, R., Rodger, N W., Ryan, E. A (2008). The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. Am. J. Clin. Nutr. 87: 114-125 [Abstract] [Full text]  
• Wagner, H., Pizzimenti, J. J., Daniel, K., Pandya, N., Hardigan, P. C. (2008). Eye on Diabetes: A Multidisciplinary Patient Education Intervention. The Diabetes Educator 34: 84-89 [Abstract] [Full text]  
• Steigerwalt, S. (2008). Management of Hypertension in Diabetic Patients With Chronic Kidney Disease. Diabetes Spectr. 21: 30-36 [Abstract] [Full text]  
• Ferrara, A., Mangione, C. M., Kim, C., Marrero, D. G., Curb, D., Stevens, M., Selby, J. V., for the Translating Research Into Action for Diabe, (2008). Sex Disparities in Control and Treatment of Modifiable Cardiovascular Disease Risk Factors Among Patients With Diabetes: Translating Research Into Action for Diabetes (TRIAD) Study. Diabetes Care 31: 69-74 [Abstract] [Full text]  
• Dunn, N. (2008). Prevention of coronary heart disease in general practice. InnovAiT 1: 14-25 [Abstract] [Full text]  
• He, Y.-L., Ligueros-Saylan, M., Sunkara, G., Sabo, R., Zhao, C., Wang, Y., Campestrini, J., Pommier, F., Dole, K., Marion, A., Dole, W. P., Howard, D. (2008). Vildagliptin, a Novel Dipeptidyl Peptidase IV Inhibitor, Has No Pharmacokinetic Interactions With the Antihypertensive Agents Amlodipine, Valsartan, and Ramipril in Healthy Subjects. J Clin Pharmacol 48: 85-95 [Abstract] [Full text]  
• Bakris, G. L. (2008). Slowing Nephropathy Progression: Focus on Proteinuria Reduction. CJASN 3: S3-S10 [Abstract] [Full text]  
• American Diabetes Association, (2008). Standards of Medical Care in Diabetes--2008. Diabetes Care 31: S12-S54 [Full text]  
• Dale, A. C., Nilsen, T. I., Vatten, L., Midthjell, K., Wiseth, R. (2007). Diabetes mellitus and risk of fatal ischaemic heart disease by gender: 18 years follow-up of 74 914 individuals in the HUNT 1 Study. Eur Heart J 28: 2924-2929 [Abstract] [Full text]  
• Bebb, C., Coupland, C., Stewart, J., Kendrick, D., Madeley, R., Sturrock, N., Burden, R., for the Nottingham Diabetes Blood Pressure Study, (2007). Practice and patient characteristics related to blood pressure in patients with type 2 diabetes in primary care: a cross-sectional study. Fam Pract 24: 547-554 [Abstract] [Full text]  
• Cull, C. A., Jensen, C. C., Retnakaran, R., Holman, R. R. (2007). Impact of the Metabolic Syndrome on Macrovascular and Microvascular Outcomes in Type 2 Diabetes Mellitus: United Kingdom Prospective Diabetes Study 78. Circulation 116: 2119-2126 [Abstract] [Full text]  
• Kim, C., Kim, H., Nam, J., Cho, M., Park, J., Kang, E., Ahn, C., Cha, B., Lee, E., Lim, S., Kim, K., Lee, H. (2007). Internet Diabetic Patient Management Using a Short Messaging Service Automatically Produced by a Knowledge Matrix System. Diabetes Care 30: 2857-2858 [Full text]  
• Hoerger, T. J., Hicks, K. A., Sorensen, S. W., Herman, W. H., Ratner, R. E., Ackermann, R. T., Zhang, P., Engelgau, M. M. (2007). Cost-Effectiveness of Screening for Pre-Diabetes Among Overweight and Obese U.S. Adults. Diabetes Care 30: 2874-2879 [Abstract] [Full text]  
• Kirsh, S., Watts, S., Pascuzzi, K., O'Day, M. E., Davidson, D., Strauss, G., Kern, E. O, Aron, D. C (2007). Shared medical appointments based on the chronic care model: a quality improvement project to address the challenges of patients with diabetes with high cardiovascular risk. Qual Saf Health Care 16: 349-353 [Abstract] [Full text]  
• Nguyen, T. T., Wang, J. J., Wong, T. Y. (2007). Retinal Vascular Changes in Pre-Diabetes and Prehypertension: New findings and their research and clinical implications. Diabetes Care 30: 2708-2715 [Full text]  
• Huang, E. S., Brown, S. E.S., Ewigman, B. G., Foley, E. C., Meltzer, D. O. (2007). Patient Perceptions of Quality of Life With Diabetes-Related Complications and Treatments. Diabetes Care 30: 2478-2483 [Abstract] [Full text]  
• Trautner, C., Haastert, B., Mauckner, P., Gatcke, L.-M., Giani, G. (2007). Reduced Incidence of Lower-Limb Amputations in the Diabetic Population of a German City, 1990 2005: Results of the Leverkusen Amputation Reduction Study (LARS). Diabetes Care 30: 2633-2637 [Abstract] [Full text]  
• Sauerhofer, S., Yuan, G., Braun, G. S., Deinzer, M., Neumaier, M., Gretz, N., Floege, J., Kriz, W., van der Woude, F., Moeller, M. J. (2007). L-Carnosine, a Substrate of Carnosinase-1, Influences Glucose Metabolism. Diabetes 56: 2425-2432 [Abstract] [Full text]  
• Nagai, N., Izumi-Nagai, K., Oike, Y., Koto, T., Satofuka, S., Ozawa, Y., Yamashiro, K., Inoue, M., Tsubota, K., Umezawa, K., Ishida, S. (2007). Suppression of Diabetes-Induced Retinal Inflammation by Blocking the Angiotensin II Type 1 Receptor or Its Downstream Nuclear Factor-{kappa}B Pathway. IOVS 48: 4342-4350 [Abstract] [Full text]  
• Naik, A. D., Issac, T. T., Street, R. L. Jr, Kunik, M. E. (2007). Understanding the Quality Chasm for Hypertension Control in Diabetes: A Structured Review of "Co-maneuvers" Used in Clinical Trials. J Am Board Fam Med 20: 469-478 [Abstract] [Full text]  
• Saweirs, W. W. M., Goddard, J. (2007). What are the best treatments for early chronic kidney disease?: A Background Paper prepared for the UK Consensus Conference on Early Chronic Kidney Disease. Nephrol Dial Transplant 22: ix31-ix38 [Full text]  
• Bloomgarden, Z. T. (2007). Screening for and managing diabetic retinopathy: Current approaches. Am J Health Syst Pharm 64: S8-S14 [Abstract] [Full text]  
• Mohamed, Q., Gillies, M. C., Wong, T. Y. (2007). Management of Diabetic Retinopathy: A Systematic Review. JAMA 298: 902-916 [Abstract] [Full text]  
• Gregg, E. W., Gu, Q., Cheng, Y. J., Venkat Narayan, K. M., Cowie, C. C. (2007). Mortality Trends in Men and Women with Diabetes, 1971 to 2000. ANN INTERN MED 147: 149-155 [Abstract] [Full text]  
• Taylor, C. R, Hepworth, J. T, Buerhaus, P. I, Dittus, R., Speroff, T. (2007). Effect of crew resource management on diabetes care and patient outcomes in an inner-city primary care clinic. Qual Saf Health Care 16: 244-247 [Abstract] [Full text]  
• Kim, E. S.H., Samuels, T. A., Yeh, H.-C., Abuid, M., Marinopoulos, S. S., McCauley, J. M., Brancati, F. L. (2007). End-Digit Preference and the Quality of Blood Pressure Monitoring in Diabetic Adults. Diabetes Care 30: 1959-1963 [Abstract] [Full text]  
• Farah, V., Elased, K. M., Morris, M. (2007). Genetic and dietary interactions: role of angiotensin AT1a receptors in response to a high-fructose diet. Am. J. Physiol. Heart Circ. Physiol. 293: H1083-H1089 [Abstract] [Full text]  
• Hardy, K. J, Furlong, N. J, Hulme, S. A, O'Brien, S. V (2007). Delivering improved management and outcomes in diabetic kidney disease in routine clinical care. British Journal of Diabetes & Vascular Disease 7: 172-182 [Abstract]  
• Polito, A., Polini, G., Chiodini, R. G., Isola, M., Soldano, F., Bandello, F. (2007). Effect of Posture on the Diurnal Variation in Clinically Significant Diabetic Macular Edema. IOVS 48: 3318-3323 [Abstract] [Full text]  
• McDowell, J., Lindsay, G., McPhail, K. (2007). Development of a questionnaire to determine professionals' attitudes to type 2 diabetes. Journal of Research in Nursing 12: 365-370 [Abstract]  
• Umpierrez, G. E., Cantey, P., Smiley, D., Palacio, A., Temponi, D., Luster, K., Chapman, A. (2007). Primary Aldosteronism in Diabetic Subjects With Resistant Hypertension. Diabetes Care 30: 1699-1703 [Abstract] [Full text]  
• Yazdanpanah, M., Aulchenko, Y. S., Hofman, A., Janssen, J. A.M.J.L., Sayed-Tabatabaei, F. A., van Schaik, R. H.N., Klungel, O. H., Stricker, B. H.C.H., Pols, H. A.P., Witteman, J. C.M., Lamberts, S. W.J., Oostra, B. A., van Duijn, C. M. (2007). Effects of the Renin-Angiotensin System Genes and Salt Sensitivity Genes on Blood Pressure and Atherosclerosis in the Total Population and Patients With Type 2 Diabetes. Diabetes 56: 1905-1912 [Abstract] [Full text]  
• Polonsky, W. (2007). Psychological Insulin Resistance: The Patient Perspective. The Diabetes Educator 33: 241S-244S [Full text]  
• Authors/Task Force Members:, , Mancia, G., De Backer, G., Dominiczak, A., Cifkova, R., Fagard, R., Germano, G., Grassi, G., Heagerty, A. M., Kjeldsen, S. E., Laurent, S., Narkiewicz, K., Ruilope, L., Rynkiewicz, A., Schmieder, R. E., Struijker Boudier, H. A.J., Zanchetti, A., ESC Committee for Practice Guidelines (CPG):, , Vahanian, A., Camm, J., De Caterina, R., Dean, V., Dickstein, K., Filippatos, G., Funck-Brentano, C., Hellemans, I., Kristensen, S. D., McGregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P., Zamorano, J. L., ESH Scientific Council:, , Kjeldsen, S. E., Erdine, S., Narkiewicz, K., Kiowski, W., Agabiti-Rosei, E., Ambrosioni, E., Cifkova, R., Dominiczak, A., Fagard, R., Heagerty, A. M., Laurent, S., Lindholm, L. H., Mancia, G., Manolis, A., Nilsson, P. M., Redon, J., Schmieder, R. E., Struijker-Boudier, H. A.J., Viigimaa, M., Document Reviewers:, , Filippatos, G., Adamopoulos, S., Agabiti-Rosei, E., Ambrosioni, E., Bertomeu, V., Clement, D., Erdine, S., Farsang, C., Gaita, D., Kiowski, W., Lip, G., Mallion, J.-M., Manolis, A. J., Nilsson, P. M., O'Brien, E., Ponikowski, P., Redon, J., Ruschitzka, F., Tamargo, J., van Zwieten, P., Viigimaa, M., Waeber, B., Williams, B., Zamorano, J. L. (2007). 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 0: ehm236v1-75 [Full text]  
• Haussler, B., Fischer, G. C, Meyer, S., Sturm, D. (2007). Risk assessment in diabetes management: how do general practitioners estimate risks due to diabetes?. Qual Saf Health Care 16: 208-212 [Abstract] [Full text]  
• Donnelly, L.A., Morris, A.D., Evans, J.M.M., for the DARTS/MEMO collaboration, (2007). Adherence to insulin and its association with glycaemic control in patients with type 2 diabetes. QJM 100: 345-350 [Abstract] [Full text]  
• Authors/Task Force Members, , Ryden, L., Standl, E., Bartnik, M., Berghe, G. V. d., Betteridge, J., de Boer, M.-J., Cosentino, F., Jonsson, B., Laakso, M., Malmberg, K., Priori, S., Ostergren, J., Tuomilehto, J., Thrainsdottir, I., Other Contributors, , Vanhorebeek, I., Stramba-Badiale, M., Lindgren, P., Qiao, Q., ESC Committee for Practice Guidelines (CPG), , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, J., Dean, V., Deckers, J., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J., Zamorano, J. L., Document Reviewers, , Deckers, J. W., Bertrand, M., Charbonnel, B., Erdmann, E., Ferrannini, E., Flyvbjerg, A., Gohlke, H., Juanatey, J. R. G., Graham, I., Monteiro, P. F., Parhofer, K., Pyorala, K., Raz, I., Schernthaner, G., Volpe, M., Wood, D. (2007). Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: full text: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J Suppl 9: C3-C74 [Full text]  
• Turchin, A., Shubina, M., Pendergrass, M. L. (2007). Relationship of Physician Volume With Process Measures and Outcomes in Diabetes. Diabetes Care 30: 1442-1447 [Abstract] [Full text]  
• Berikai, P., Meyer, P. M., Kazlauskaite, R., Savoy, B., Kozik, K., Fogelfeld, L. (2007). Gain in Patients' Knowledge of Diabetes Management Targets Is Associated With Better Glycemic Control. Diabetes Care 30: 1587-1589 [Full text]  
• Hiss, R. G., Armbruster, B. A., Gillard, M. L., McClure, L. A. (2007). Nurse Care Manager Collaboration With Community-Based Physicians Providing Diabetes Care: A Randomized Controlled Trial. The Diabetes Educator 33: 493-502 [Abstract] [Full text]  
• Jones, D. W., Hall, J. E. (2007). World Hypertension Day 2007. Hypertension 49: 939-940 [Full text]  
• Goldenberg, I., Moss, A. J., McNitt, S., Zareba, W., Hall, W. J., Andrews, M. L., for the MADIT-II Investigators, (2007). Inverse Relationship of Blood Pressure Levels to Sudden Cardiac Mortality and Benefit of the Implantable Cardioverter-Defibrillator in Patients With Ischemic Left Ventricular Dysfunction. J Am Coll Cardiol 49: 1427-1433 [Abstract] [Full text]  
• Kong, A. P.S., Yang, X., Ko, G. T.C., So, W.-Y., Chan, W.-B., Ma, R. C.W., Ng, V. W.S., Chow, C.-C., Cockram, C. S., Tong, P. C.Y., Wong, V., Chan, J. C.N. (2007). Effects of Treatment Targets on Subsequent Cardiovascular Events in Chinese Patients With Type 2 Diabetes. Diabetes Care 30: 953-959 [Abstract] [Full text]  
• Keigher, C., Avalos, G., Dunne, F. (2007). Treating to target in type 2 diabetes. British Journal of Diabetes & Vascular Disease 7: 83-85 [Abstract]  
• Wilcox, R., Bousser, M.-G., Betteridge, D. J., Schernthaner, G., Pirags, V., Kupfer, S., Dormandy, J., for the PROactive Investigators, (2007). Effects of Pioglitazone in Patients With Type 2 Diabetes With or Without Previous Stroke: Results From PROactive (PROspective pioglitAzone Clinical Trial In macroVascular Events 04). Stroke 38: 865-873 [Abstract] [Full text]  
• Phipps, J. A., Wilkinson-Berka, J. L., Fletcher, E. L. (2007). Retinal Dysfunction in Diabetic Ren-2 Rats Is Ameliorated by Treatment with Valsartan but Not Atenolol. IOVS 48: 927-934 [Abstract] [Full text]  
• Aron, D., Rajan, M., Pogach, L. M. (2007). Summary measures of quality of diabetes care: comparison of continuous weighted performance measurement and dichotomous thresholds. Int J Qual Health Care 19: 29-36 [Abstract] [Full text]  
• Meulepas, M. A., Braspenning, J. C., de Grauw, W. J., Lucas, A. E., Harms, L., Akkermans, R. P., Grol, R. P. (2007). Logistic support service improves processes and outcomes of diabetes care in general practice. Fam Pract 24: 20-25 [Abstract] [Full text]  
• Brantsma, A. H., Atthobari, J., Bakker, S. J.L., de Zeeuw, D., de Jong, P. E., Gansevoort, R. T., for the PREVEND Study Group, (2007). What Predicts Progression and Regression of Urinary Albumin Excretion in the Nondiabetic Population?. J. Am. Soc. Nephrol. 18: 637-645 [Abstract] [Full text]  
• Bidani, A. K., Picken, M., Hacioglu, R., Williamson, G., Griffin, K. A. (2007). Spontaneously reduced blood pressure load in the rat streptozotocin-induced diabetes model: potential pathogenetic relevance. Am. J. Physiol. Renal Physiol. 292: F647-F654 [Abstract] [Full text]  
• Hartner, A., Cordasic, N., Klanke, B., Wittmann, M., Veelken, R., Hilgers, K. F. (2007). Renal injury in streptozotocin-diabetic Ren2-transgenic rats is mainly dependent on hypertension, not on diabetes. Am. J. Physiol. Renal Physiol. 292: F820-F827 [Abstract] [Full text]  
• Pinto, E. (2007). Blood pressure and ageing. Postgrad. Med. J. 83: 109-114 [Abstract] [Full text]  
• Dworkin, L. D., Jamerson, K. A. (2007). Case Against Angioplasty and Stenting of Atherosclerotic Renal Artery Stenosis. Circulation 115: 271-276 [Full text]  
• Authors/Task Force Members, , Ryden, L., Standl, E., Bartnik, M., Van den Berghe, G., Betteridge, J., de Boer, M.-J., Cosentino, F., Jonsson, B., Laakso, M., Malmberg, K., Priori, S., Ostergren, J., Tuomilehto, J., Thrainsdottir, I., Other Contributors, , Vanhorebeek, I., Stramba-Badiale, M., Lindgren, P., Qiao, Q., ESC Committee for Practice Guidelines (CPG), , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, J., Dean, V., Deckers, J., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J., Zamorano, J. L., Document Reviewers, , Deckers, J. W., Bertrand, M., Charbonnel, B., Erdmann, E., Ferrannini, E., Flyvbjerg, A., Gohlke, H., Juanatey, J. R. G., Graham, I., Monteiro, P. F., Parhofer, K., Pyorala, K., Raz, I., Schernthaner, G., Volpe, M., Wood, D. (2007). Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J 28: 88-136 [Full text]  
• Choe, H. M., Townsend, K. A., Blount, G., Lo, C. H., Sadowski, L., Standiford, C. J. (2007). Treatment and control of blood pressure in patients with diabetes mellitus. Am J Health Syst Pharm 64: 97-103 [Abstract] [Full text]  
• Nutting, P. A., Dickinson, W. P., Dickinson, L. M., Nelson, C. C., King, D. K., Crabtree, B. F., Glasgow, R. E. (2007). Use of Chronic Care Model Elements Is Associated With Higher-Quality Care for Diabetes. Ann Fam Med 5: 14-20 [Abstract] [Full text]  
• Gagliardino, J. J., Malbran, M. d. C., Clark, C. Jr. (2007). Development and Implementation of Advanced Training Course for Diabetes Educators in Argentina. Diabetes Spectr. 20: 24-30 [Abstract] [Full text]  
• Ruggenenti, P., Remuzzi, G. (2007). Kidney Failure Stabilizes after a Two-Decade Increase: Impact on Global (Renal and Cardiovascular) Health. CJASN 2: 146-150 [Full text]  
• American Diabetes Association, (2007). Standards of Medical Care in Diabetes--2007. Diabetes Care 30: S4-S41 [Full text]  
• Shankar, A., Klein, R., Klein, B. E.K., Nieto, F. J., Moss, S. E. (2007). Relationship Between Low-Normal Blood Pressure and Kidney Disease in Type 1 Diabetes. Hypertension 49: 48-54 [Abstract] [Full text]  
• Ong, K. L., Cheung, B. M.Y., Man, Y. B., Lau, C. P., Lam, K. S.L. (2007). Prevalence, Awareness, Treatment, and Control of Hypertension Among United States Adults 1999-2004. Hypertension 49: 69-75 [Abstract] [Full text]  
• Dzau, V. J., Antman, E. M., Black, H. R., Hayes, D. L., Manson, J. E., Plutzky, J., Popma, J. J., Stevenson, W. (2006). The Cardiovascular Disease Continuum Validated: Clinical Evidence of Improved Patient Outcomes: Part I: Pathophysiology and Clinical Trial Evidence (Risk Factors Through Stable Coronary Artery Disease). Circulation 114: 2850-2870 [Full text]  
• Hicks, P. C., Westfall, J. M., Van Vorst, R. F., Bublitz Emsermann, C., Dickinson, L. M., Pace, W., Parnes, B. (2006). Action or Inaction? Decision Making in Patients With Diabetes and Elevated Blood Pressure in Primary Care. Diabetes Care 29: 2580-2585 [Abstract] [Full text]  

Rapid Responses:

Read all Rapid Responses

diet & exercise control of diabetes

Michael Coulson
bmj.com, 25 Sep 1998 [Full text]

UKPDS -a model in ethics and diabetes public health

K M Venkat Narayan
bmj.com, 25 Sep 1998 [Full text]

Publishing important findings in two journals

Jonathan Richards
bmj.com, 30 Sep 1998 [Full text]

Query regarding numbers needed to treat

Stefan M Groetsch
bmj.com, 15 Oct 1998 [Full text]

Deficiencies of UKPDS

Paul Neeskens
bmj.com, 18 Nov 1998 [Full text]