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. 2013 Apr 18;6(2):141-5.
doi: 10.3980/j.issn.2222-3959.2013.02.06. Print 2013.

Effects of intensive control of blood glucose and blood pressure on microvascular complications in patients with type II diabetes mellitus

Cai-Hong Zhu  1 , Shi-Sheng Zhang, Yan Kong, Yu-Fang Bi, Ling Wang, Qiong Zhang
Affiliations

Effects of intensive control of blood glucose and blood pressure on microvascular complications in patients with type II diabetes mellitus

Cai-Hong Zhu et al. Int J Ophthalmol. .

Abstract

Aim: To evaluate the effects of intensive control of blood glucose and blood pressure on microvascular complications in patients with type II diabetes by comparing the therapeutic effects of intensive and standard treatment in patients with type II diabetes.

Methods: A total of 107 patients with type II diabetes were randomly assigned into intensive and standard treatment groups. Patients in the intensive treatment group received preterax (perindopril/ indapamide) to control blood pressure, and gliclazide (diamicron) MR to control blood glucose. Patients in the standard treatment group received routine medications or placebo. Urinary microalbumin (UMA), urinary creatinine (UCR), the UMA/UCR ratio, and visual acuity were monitored according to the study design of the ADVANCE trial. Direct ophthalmoscopy and seven-field stereoscopic retinal photography were used to examine the fundi at baseline, and repeated after 5 years of treatment.

Results: The characteristics of patients in both groups were well balanced at baseline. After 5 years of treatment, visual acuity was found to be decreased in the standard group (P=0.04), but remained stable in the intensive group. The severity of diabetic retinopathy had not progressed in patients in the intensive group, but had deteriorated in the standard group (P=0.0006). The UMA/UCR ratio was not obviously changed in patients in the intensive group, whereas it was significantly increased in the standard group (P=0.00).

Conclusion: Intensive control of blood glucose and blood pressure can decrease the incidence or slow the progression of microvascular complications in patients with type II diabetes, and maintain stable vision.

Keywords: diabetes mellitus; diabetic retinopathy; intensive therapy; microvascular complications.

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Figures

Figure 1
Figure 1. Fundus model of the refined seven-field ETDRS method.
Figure 2
Figure 2. Fundus changes in the right eye of a patient in the standard group (male, 70 years old, 8-year history of diabetes and 10-year history of hypertension).
A, B: the fundus at baseline; C, D: the fundus at 5 years after standard treatment, showing microaneurysm, bleeding and exudation on the retina.
See this image and copyright information in PMC

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References

    1. UK Prospective Diabetes Study Group Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317(7160):703–713. - PMC - PubMed
    1. Albers JW, Herman WH, Pop-Busui R, Feldman EL, Martin CL, Cleary PA, Waberski BH, Lachin JM. Effect of prior intensive insulin treatment during the Diabetes Control and Complications Trial (DCCT) on peripheral neuropathy in type 1 diabetes during the Epidemiology of Diabetes Interventions and Complications (EDIC) Study. Diabetes Care. 2010;33(5):1090–1096. - PMC - PubMed
    1. The ADVANCE Collaborative Group. Patel A, MacMahon S, Chalmers J, Neal B, Billot L, Woodward M, Marre M, Cooper M, Glasziou P, Grobbee D, Hamet P, Harrap S, Heller S, Liu L, Mancia G, Mogensen CE, Pan C, Poulter N, Rodgers A, Williams B, Bompoint S, de Galan BE, Joshi R, Travert F. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358(24):2560–2572. - PubMed
    1. ADVANCE Collaborative Group. MacMahon S, Chalmers J, Neal B, Woodward M, Billot L, Harrap S, Poulter N, Marre M, Cooper M, Glasziou P, Grobbee DE, Hamet P, Heller S, Liu LS, Mancia G, Mogensen CE, Pan CY, Rodgers A, Williams B. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet. 2007;370(9590):829–840. - PubMed
    1. Lunetta M, Infantone L, Calogero AE, Infantone E. Increased urinary albumin excretion is a marker of risk for retinopathy and coronary heart disease in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract. 1998;40(1):45–51. - PubMed

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