These 2 articles were printed in the October 9, 2008 issue of The New England Journal of Medicine.
1. Long-Term Follow-up after Tight Control of Blood Pressure in Type 2 Diabetes
NEJM -- Long-Term Follow-up after Tight Control of Blood Pressure in Type 2 Diabetes
Conclusions
The benefits of previously improved blood-pressure control were not sustained when between-group differences in blood pressure were lost. Early improvement in blood-pressure control in patients with both type 2 diabetes and hypertension was associated with a reduced risk of complications, but it appears that good blood-pressure control must be continued if the benefits are to be maintained.
My take: this studied showed that if you have high blood pressure, getting it down and keeping it down reduces the risk of developing PAD.
2. 10-Year Follow-up of Intensive Glucose Control in Type 2 Diabetes
NEJM -- 10-Year Follow-up of Intensive Glucose Control in Type 2 Diabetes
Conclusions
Despite an early loss of glycemic differences, a continued reduction in microvascular risk and emergent risk reductions for myocardial infarction and death from any cause were observed during 10 years of post-trial follow-up. A continued benefit after metformin therapy was evident among overweight patients.
My take: get that A1c down to a normal level to reduce long term risk of blocked arteries.
Previous studies in the USA indicate that a gradual, not rapid, reduction in A1c resulted in a substantial risk reduction for MI, CAD, PAD, etc. These studies show that those benefits continue for a long term.
These studies are necessary because governments and insurance companies do not base decisions on opinions. They must have hard facts and data. So good, now they have the facts and data to show that treating diabetes long term is a lot cheaper than treating its complications like a heart attack or CAD, PAD or screwed up kidneys. Now I wonder how long it will take for them to act.
