The UKPDS: a diabetes nursing perspective

Blood glucose control Improved blood glucose control in type 2 diabetes substantially decreased the risk of microvascular complications (retinopathy and nephropathy), but not macrovascular disease (e.g. myocardial infarction, stroke). There was no difference in overall risk reduction among the different intensive treatment groups, suggesting that improved glycaemic control was the principal factor, rather than any specific treatment. Only 3% of the patients studied were able to achieve The United Kingdom Prospective Diabetes Study (UKPDS) was a randomised controlled trial of different therapies in type 2 diabetes, involving more than 5000 patients from 23 centres. Patients were allocated to the various treatment groups and followed from diagnosis for a median of 10 years. The original aims were to determine whether improved glucose control would reduce the risk of long-term diabetic complications, and whether treatment with a firstor second-generation sulphonylurea, insulin or metformin had any specific advantage or disadvantage. As 39% of patients entering the study were found to be hypertensive, a hypertension study was added, to examine whether tighter blood pressure control would reduce the risk of microvascular and macrovascular complications, and whether treatment with Introduction After 21 years of research, and an expenditure of £23 million, the findings of the United Kingdom Prospective Diabetes Study (UKPDS) have finally been released (UKPDS Group, 1998a,b). The publicity surrounding the announcement of the results of the world’s largest and most comprehensive study of type 2 diabetes ensured that news of the UKPDS reached everyone working in the field of diabetes care, even if they had not heard of it before. But what difference will it make? This article outlines the UKPDS and summarises its main findings. It reflects upon them and discusses their possible impact upon diabetes care, especially in relation to diabetes nursing.