Craig Blackwell, MD
Ophthalmology

Santa Cruz, CA
Diplomate: American Board of Ophthalmology
Fellow: American Academy of Ophthalmology

Welcome to the Website of Craig Blackwell, MD

An Ophthalmology Practice in Santa Cruz, CA

Diabetes 3- UKPDS

United Kingdom Prospective Diabetes Study

The DCCT was only looking at Type 1 Diabetes, paatients that required Insulin. The UKPDS undertook the largest study of Type 2 Diabetes, patients that use medication other than Insulin to control blood sugar.

From 1977 to 1991 they recruited 5,102 patients and followed them for an average of ten years. They look at whether tight blood sugar control was beneficial, compared different medications, and examined the effect of blood pressure control on complications.

The microvascular complications measured were retinopathy, nephropathy, and neuropathy.

Summary of Results

A1c

Difference in A1c levels achieved in the two arms of the study.

  • Conventional Therapy: 7.9%
  • Intensive Therapy: 7.0%

Complication Rates

  • Retinopathy and nephropathy rates were reduced by 25% in the Intensive Therapy group.
  • For every percentage point decrease in A1c (eg. from 9% to 8%) there was a 35% reduction in the risk of microvascular complications.
  • For every percentage point decrease in A1c there was a 25% reduction in diabetes related deaths, and an 18% reduction in heart attack.
  • Any A1c above the normal 6.2% was associated with increased microvascular complications.

Blood Pressure

  • Lowering blood pressure to a mean of 144/82 significantly reduced strokes, diabetes-related deaths, heart failure, microvascular complications, and vision loss.

Suggested Goals

Aggressive efforts to lower blood glucose levels as close to normal as possible are successful at reducing complications.

Blood pressure should be kept below 130/85.

Reference

American Diabetes Association. Implications of the United Kingdom Prospective Diabetes Study . . .Diabetes Care. 25 (Suppl.1) S28-S32, 2002

The information contained here is for educational purposes and is not a replacement for the individual care of your physician.

C Blackwell,MD Dec 2008