Authors

  1. Chu, Julie MSN
  2. Cutugno, Christine PhD, RN

Article Content

According to this article:

 

* Risks of death from any cause and from cardiovascular causes are lower in patients with type 2 diabetes and microalbuminuria who undergo an intensive multifactorial intervention.

 

* There are also fewer cardiovascular complications with intensive treatment.

 

 

Intensive treatment for type 2 diabetes and microalbuminuria afforded patients a reduced risk of nonfatal cardiovascular disease, according to the findings of the Steno-2 study, conducted in Denmark. In the original study, researchers randomly assigned 160 patients with type 2 diabetes and microalbuminuria either to an intensive regimen or to conventional treatment for a mean of 7.8 years. The intensive regimen (n = 80) included tight glucose control, renin-angiotensin system blockers, and aspirin. The current study followed these patients for an additional mean of 5.5 years to examine the intensive treatment's effects on the risk of death from any cause and from cardiovascular causes. The time to death after the mean 13.3 years of follow-up was the primary end point. Secondary end points included death from cardiovascular causes as well as specific cardiovascular events.

 

Fewer patients died in the intensive treatment group than in the conventional treatment group (30% versus 50%, respectively), an absolute risk reduction of 20%. The authors reported a hazard ratio of 0.54, which indicates that patients receiving the intensive treatment had slightly more than half the risk of death, compared with patients receiving the standard treatment. Nine patients died from cardiovascular causes in the intensive treatment group, compared with 19 patients in the conventional treatment group. Similar reductions were found in rates of cardiovascular events. Patients in the intensive treatment group experienced less diabetic nephropathy, progression to end-stage renal disease, progression of diabetic retinopathy, and progression of autonomic neuropathy.

 

Intensive multifactorial intervention in high-risk patients with type 2 diabetes and microalbuminuria appears to be needed and beneficial.-JC

 
 

aede P, et al. N Engl J Med 2008;358(6):580-91.