The U.K. Prospective Diabetes Study: A review

The objective of the U.K. Prospective Diabetes Study (UKPDS), initiated in 1977, was set up to determine whether improved blood glucose control in people with type 2 diabetes will prevent the complications of diabetes. The UKPDS was also designed to determine whether there are differences between conventional policy (diet therapy) and three different regimens of intensive treatment policy, based on sulfonylurea, metformin, or insulin. Interim efficacy analyses revealed that the intensive policies with sulfonylurea, insulin, and metformin were equally effective in reducing fasting plasma glucose concentrations. However, glucose and HbA_1c measurements steadily increased with time, reflecting ongoing deterioration of β-cell function. Cardiovascular disease was the major cause of complications, and the risk factors included raised LDL cholesterol concentrations, low HDL cholesterol concentrations, elevated blood pressure, elevated HbA_1c concentrations, and smoking. A final study report was issued in September 1998, when the median duration of therapy was 11 years.