Importance of early blood sugar control for type 2 diabetes

Scientists from the Universities of Oxford and Edinburgh reviewed data from the UK Prospective Diabetes Study, one of the longest type 2 diabetes clinical trials, which spanned more than four decades.

The researchers have discovered that early control of blood glucose levels, using either insulin injections or tablets that stimulate cells to make more insulin such as sulfonylureas, resulted in significantly fewer complications.

The research was carried out by Oxford and Edinburgh University scientists (Image: Ben Seymour via UnSplash)

They saw a 10 per cent reduction in deaths, 17 per cent fewer heart attacks, and a 26 per cent decrease in diabetic complications.

The use of metformin, a drug which helps the insulin the body produces to work better, led to 31 per cent fewer heart attacks and a 20 per cent decrease in deaths.

Professor Rury Holman, the founding director of the University of Oxford Diabetes Trials Unit and chief investigator of the UK Prospective Diabetes Study, said: "These remarkable findings emphasise the critical importance of detecting and treating type 2 diabetes intensively at the earliest possible opportunity.

"People may have type 2 diabetes for several years before being diagnosed as they may have few symptoms until their blood sugars become substantially elevated."

The UK Prospective Diabetes Study trial began almost 50 years ago in 1977, with newly-diagnosed type 2 diabetes patients assigned to either an intensive or conventional blood glucose control strategy.

The intensive strategy involved using insulin therapy, sulfonylurea or metformin therapy to control blood glucose, while the standard approach focused on dietary changes.

Findings showed that compared to diet, controlling blood glucose with sulfonylurea or insulin, or with metformin, led to a lifelong reduction in the risk of an early death and heart attacks.

Guidelines were changed worldwide to recommend these intensive therapies for those with type 2 diabetes.

Professor Amanda Adler, director of the Diabetes Trial Unit, said: "This shows that treating type 2 diabetes early and thoroughly is crucial.

"Playing catch-up with blood glucose control is not sufficient."

Professor Philip Clarke, director of the University of Oxford Health Economics Research Centre, added: "A major life-time benefit is the increased life-expectancy in those allocated to intensive blood glucose control.

"The reduced rate of many diabetes-related complications will have a positive impact on overall quality of life."

The follow-up of the UK Prospective Diabetes Study was presented at the 67th Japan Diabetes Society Meeting in Tokyo and also published in The Lancet.