Intensive Diabetes Management Adds Years to Life, Study Finds

Aggressive treatment of type 2 diabetes (T2D) before complications set in can keep them at bay and add years to one’s life, according to a study published in the journal Diabetologia.

The study followed 160 Danish people with T2D and microalbuminuria for 21 years. The participants were an average age of 55 when the study began. At the start of the study, they were randomly divided into 2 group for either conventional treatment or an intensive, multi-part treatment that included both behavioral and pharmacological approaches. Treatment lasted for an average of 7.8 years.

After that, the participants were observed in a follow-up period. By the end of the study, 38 patients in the intensive treatment group and 55 in the conventional treatment group had died; researchers found that those in the intensive therapy group lived 7.9 years longer. They also had less heart and kidney disease, as well as less blindness. In fact, the mean time to the first cardiovascular event after randomization was 8.1 years for those receiving the intensive therapy. Both groups had the same risk of neuropathy, however.

In addition, the patients in the conventional treatment group experienced twice as many cardiovascular events per person overall.

The authors note that recent changes to clinical guidelines recognize the benefits of early aggressive treatment of T2D, before the additional loss of beta cell function. Aggressive use of therapy early one has benefits even after treatment ends, they note, as “effects in these trials has been termed ‘metabolic memory’ or ‘legacy effect.’

“In these trials, intensified intervention according to protocol was stopped at the end of the trial and the subsequent risk factor was relaxed or not reported," the authors wrote.

Reference

Gaede P, Oellgaard J, Carstensen B, et al. Years of life gained by multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: 21 years follow-up on the Steno-2 randomized trial. Diabetologia. 2016; doi:10.1007/s00125-016-4065-6.