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Review: UKPDS odyssey — 2001
Jonathan C Levy
Diabetes Research Laboratories, Oxford Centre for Diabetes, Endocrinology and Metabolism, The Radcliffe Infirmary, Woodstock Road, Oxford 0X2 6HE, jonathan.levy{at}drl.ox.ac.uk
The United Kingdom Prospective Diabetes Study, the most ambitious single study of the treatment and nature of type 2 diabetes to date has two and nature of type 2 diabetes to date has two aspects: (i) as a clinical trial it has established that intensified glucose and blood pressure control significantly reduce the micro- and macrovascular complications of type 2 diabetes; (ii) in addition, because of its size and duration and the density of the data collected, it provides unparalleled information on the nature and natural history of the disease. It has defined the major importance of hyperglycaemia and hypertension as risk factors for complications and with the trial results provides the rationale and the goals for therapy. However, identification of the progressive deterioration of beta-cell function and the relative inefficacy of currently available therapies has posed major challenges to the achievement of these goals. Like all classic studies it raises more questions for further investigation.
Key Words: type II diabetes complications microvascular macrovascular randomised controlled trial.
References
- Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998;352:837-53.[CrossRef][Web of Science][Medline]
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- Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998; 352:854-65.[CrossRef][Web of Science][Medline]
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- Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ 1998;317:703-13.[Abstract/Free Full Text]
- 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;317:713-20.[Abstract/Free Full Text]
- Turner R., Cull C., Holman R. United Kingdom Prospective Diabetes Study 17: a 9-year update of a randomized, controlled trial on the effect of improved metabolic control on complications in non-insulin-dependent diabetes mellitus. Ann Intern Med 1996;12:136-45.
- Turner RC, Mann JI, Peto R. UK prospective study of therapies of maturity-onset diabetes. Diabetologia 1984;27:419.[Web of Science][Medline]
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- University Group Diabetic Programme. A study of the effects of hypoglycaemic agents on vascular complications in patients with adult-onset diabetes. Diabetes 1976;25:1129-53.[Web of Science][Medline]
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- Holman RR, Cull CA, Turner RC A randomized double-blind trial of acarbose in type 2 diabetes shows improved glycemic control over 3 years (U.K. Prospective Diabetes Study 44). Diabetes Care 1999;22:960-64.[Abstract]
- United Kingdom Prospective Diabetes Study. III. Prevalence of hypertension and hypotensive therapy in patients with newly diagnosed diabetes. A multicenter study. Hypertension 1985;7:118-13.[Abstract/Free Full Text]
- Hypertension in Diabetes Study (HDS): I. Prevalence of hypertension in newly presenting type 2 diabetic patients and the association with risk factors for cardiovascular and diabetic complications. J Hypertens 1993;11:309-17.[CrossRef][Web of Science][Medline]
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- UK Prospective Diabetes Study. IV. Characteristics of newly presenting type 2 diabetic patients: male preponderance and obesity at different ages. Multi-centre Study. Diabetic Med 1988;5:154-9.[Web of Science][Medline]
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- UK Prospective Diabetes Study. V. Characteristics of newly presenting type 2 diabetic patients: estimated insulin sensitivity and islet 4-cell function. Multi-centre study. Diabetic Med 1988;5:444-8.[Web of Science][Medline]
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- UK Prospective Diabetes Study (UKPDS). IX: Relationships of urinary albumin and N-acetylglucosaminidase to glycaemia and hypertension at diagnosis of type 2 (non-insulin-dependent) diabetes mellitus and after 3 months diet therapy. Diabetologia 1993;36:835-42.[CrossRef][Web of Science][Medline]
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- UK Prospective Diabetes Study (UKPDS). XI: Biochemical risk factors in type 2 diabetic patients at diagnosis compared with age-matched normal subjects. Diabetic Med 1994;11:534-44.[Web of Science][Medline]
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- UK Prospective Diabetes Study 6. Complications in newly diagnosed type 2 diabetic patients and their association with different clinical and biochemical risk factors. Diabetes Res 1990;13:1-11.[Medline]
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- UK Prospective Diabetes Study 16. Overview of 6 years' therapy of type II diabetes: a progressive disease. U.K. Prospective Diabetes Study Group. Diabetes 1995;44:1249-58.[Abstract]
- Matthews DR, Cull CA, Stratton IM, Holman RR, Turner RC UKPDS 26: Sulphonylurea failure in non-insulin-dependent diabetic patients over six years. UK Prospective Diabetes Study (UKPDS) Group. Diabetic Med 1998;1:297-303.
- Turner R., Stratton I., Horton V. et al. UKPDS 25: autoantibodies to islet-cell cytoplasm and glutamic acid decarboxylase for prediction of insulin requirement in type 2 diabetes. UK Prospective Diabetes Study Group. Lancet 1997;350:1288-93.[CrossRef][Web of Science][Medline]
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- Horton V., Stratton I., Bottazzo GF et al. Genetic heterogeneity of autoimmune diabetes: age of presentation in adults is influenced by HLA DRB1 and DQB1 genotypes (UKPDS 43). UK Prospective Diabetes Study (UKPDS) Group. Diabetologia 1999;42:608-16.[CrossRef][Web of Science][Medline]
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- Stratton IM, Adler AI, Neil HA et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321:405-12.[Abstract/Free Full Text]
- Adler AI, Stratton IM, Neil HA et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ 2000;321:412-19.[Abstract/Free Full Text]
- Turner RC, Millns H., Neil HA et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ 1998;316:823-8.[Abstract/Free Full Text]
- Kohner EM, Stratton IM, Aldington SJ, Holman RR, Matthews DR Relationship between the severity of retinopathy and progression to photocoagulation in patients with Type 2 diabetes mellitus in the UKPDS (UKPDS 52). Diabetic Med 2001;18:178-84.[CrossRef][Web of Science][Medline]
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- Stratton IM, Kohner EM, Aldington SJ et al. UKPDS 50: risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis. Diabetologia 2001;44:156-63.[CrossRef][Web of Science][Medline]
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- UK Prospective Diabetes Study 7: response of fasting plasma glucose to diet therapy in newly presenting type II diabetic patients, UKPDS Group. Metabolism 1990;3:905-12.
- Turner RC, Cull CA, Frighi V., Holman RR Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group. JAMA 1999; 281:2005-12.[Abstract/Free Full Text]
- Gray A., Raikou M., McGuire A. et al. Cost effectiveness of an intensive blood glucose control policy in patients with type 2 diabetes: economic analysis alongside randomised controlled trial (UKPDS 41). United Kingdom Prospective Diabetes Study Group. BMJ 2000; 320:1373-8.[Abstract/Free Full Text]
- Clarke P., Gray A., Adler A. et al. Cost-effectiveness analysis of intensive blood-glucose control with metformin in overweight patients with type II diabetes (UKPDS No. 51). Diabetologia 2001;44:298-304.[CrossRef][Web of Science][Medline]
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- Cost effectiveness analysis of improved blood pressure control in hypertensive patients with type 2 diabetes: UKPDS 40. UK Prospective Diabetes Study Group. BMJ 1998;317:720-26.[Abstract/Free Full Text]
- Keavney BD, Dudley CR, Stratton IM et al. UK prospective diabetes study (UKPDS) 14: association of angiotensin-converting enzyme insertion/deletion polymorphism with myocardial infarction in NIDDM. Diabetologia 1995;38:948-52.[Web of Science][Medline]
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- Saker PJ, Hattersley AT, Barrow B. et al. UKPDS 21: low prevalence of the mitochondrial transfer RNA gene (tRNA(Leu(UUR))) mutation at position 3243bp in UK Caucasian type 2 diabetic patients. Diabet Med 1997;14:42-5.[CrossRef][Web of Science][Medline]
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- Cox RD, Southam L., Hashim Y. et al. UKPDS 31: Hepatocyte nuclear factor-1alpha (the MODY3 gene) mutations in late onset Type II diabetic patients in the United Kingdom. United Kingdom prospective diabetes study. Diabetologia 1999;42:120-21.[CrossRef][Web of Science][Medline]
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- Varadi A., Lebel L., Hashim Y., Mehta Z., Ashcroft SJ, Turner R. Sequence variants of the sarco(endo)plasmic reticulum Ca(2+)-transport ATPase 3 gene (SERCA3) in Caucasian type II diabetic patients (UK Prospective Diabetes Study 48). Diabetologia 1999;42:1240-43.[CrossRef][Web of Science][Medline]
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- Gloyn AL, Hashim Y., Ashcroft SJ, Ashfield R., Wiltshire S., Turner RC Association studies of variants in promoter and coding regions of beta-cell ATP-sensitive K-channel genes SUR1 and Kir6.2 with Type 2 diabetes mellitus (UKPDS 53). Diabetic Med 2001;18:206-12.[CrossRef][Web of Science][Medline]
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The British Journal of Diabetes & Vascular Disease, Vol. 1, No. 1,
14-21 (2001)
DOI: 10.1177/14746514010010010301

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