Multiple therapy 'best for type-2 diabetes'

Intensive treatment using multiple drug combinations remains the best way of treating type-2 diabetes, US research suggests.

GPs already offer multiple drug treatments to diabetic patients as part of the diabetes domain of the quality framework.

This latest study backs up the importance of intensive treatment, showing that it can halve the number of cardiovascular deaths. Researchers randomly assigned 160 patients with diabetes and persistent microalbuminuria to receive either intensive treatment or conventional treatment that only targetted blood glucose.

Those in the intensive treatment group were monitored for tight glucose control and were prescribed renin-angiotensin system blockers, aspirin and lipid-lowering agents.

Over a 13-year follow-up period, nine patients in the intensive treatment group died of cardiovascular causes, compared with 19 in the conventional group.

The intensive treatment group also had better control over cholesterol, BP and blood glucose levels than those in the conventional group.

Dr Brian Karet, diabetes lead for North Bradford PCT, said: 'This is a good reminder for GPs not to focus solely on controlling blood glucose.

'Some patients will be on lots of different medications and that can make it hard for them to remember to take them all.'

sanjay.tanday@haymarket.com

NEJM

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