Australian researchers have discovered that intensive glucose control in patients with type 2 diabetes leads to persistent reductions in renal failure, many years after the return to usual care.
The global study concluded that five and a half years after the end of an intensive regimen of glucose lowering based on gliclazide MR, patients with type 2 diabetes continued to have a much lower risk of renal failure requiring dialysis or transplantation and did not experience any increase or decrease in the risk of death or cardiovascular disease.
The study, ADVANCE-ON, was led by the George Institute for Global Health (The George Institute for Global Health) and performed in 20 countries. It followed 8,500 of the more than 11,000 patients in the ADVANCE clinical trial that began in 2001 it was noted that years after returning to usual care, those whose glucose levels patients were lowered intensively with drug regimen gliclazide MR-based had a lower risk of renal failure. These patients returned to usual care in 2008.
Speaking at the European Association for the Study of Diabetes (EASD, for its acronym in English) in Vienna, lead researcher and first author, Associate Professor Sophia Zoungas, The George Institute for Global Health at the University of Sydney said "The findings highlight the importance of effective management of blood glucose for renal protection in patients with type 2 diabetes."
"By using this more intensive regimen of decreased glucose substantial benefit is obtained in terms of renal protection without compromising cardiac safety.
"It is likely that intensive treatment has produced significant long-term benefits for the kidneys."
The Principal Investigator, Professor John Chalmers, said: "This study adds significant information to other new findings from the ADVANCE-ON clinical trial for patients with diabetes."
The other new findings, from arm blood pressure ADVANCE-ON trial were presented at the Congress of the European Society of Cardiology held in Barcelona two weeks before and were resubmitted in Vienna at the European Association for Study of Diabetes, by Prof. Chalmers.
"The study of blood pressure showed persistent but diminishing returns in all-cause death and cardiac events, with a clear recommendation that both short and long term should be kept active control of blood pressure, using perindopril and indapamide ".
It is estimated that globally 382 million people suffer from diabetes. About 90 per cent of them suffer from diabetes type 2 diabetes being the leading cause of kidney failure.
Diabetes causes heart disease, blindness, kidney failure, limb amputation and stroke, and is one of the ten leading causes of death. It is noteworthy that among these severe complications, end-stage renal disease showed the least improvement in the last 20 years.
ADVANCE was funded by the National Health and Medical Research (NHMRC, for its acronym in English) of Australia , the British Heart Foundation, Diabetes UK and Servier.