Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)

Turner, R. C.; Holman, Rury R.; Cull, C A; Stratton, I M; Matthews,; Frighi, V; Manley, S E; Neil, Andrew; McElroy, Kevin; Wright, D.E.; Fox, Charles; Hadden, D. R.; Mehta, Ziyah; Smith, Andrea L.; Nugent, Zoann; Pető, Richárd; Adlel, A I; Mann, Jim; Bassett, Paul; Oakes, Suzy; Dornan, T.; Aldington, S J; Lipinski, H; Collum, R; Harrison, Kathleen A.; MacIntyre, Cecilia; Skinner, Stewart; Mortemore, A; Nelson, Danielle; Cockley, S; Levien, S; Bodsworth, L; Willox, R; Biggs, Timothy C.; Dove, Scott; Beattie, Edward J.; Gradwell, M.; Staples, Sophie; Lam, Raymond; Taylor, Frances C.; Leung, Lai-yee; Carter, R D; Brownlee, Stephen; Fisher, Karen; Islam, Kaisar; Jelfs, R.; Williams, Pete A.; Williams, Francesca; Sutton, Pauline; Ayres, Alison; Logie, Lisa; Lovatt, C; Evans, Mark A.; Stowell, L A; Ross, Iain; Kennedy, I A; Croft, Damien J.; Keen, Anne; Rose, Colin P.; Raikou, Maria; Fletcher, Astrid; Bulpitt, Christopher J.; Battersby, Clare; Yudkin, John; Stevens, R J; Stearn, M R; Palmer, S L; Hammersley, M S; Franklin, S L; Spivey, R S; Lévy, Jonathan; Tidy, C R; Bell, N J; Steemson, J; Barrow, B A; Coster, R. De; Waring, K; Nolan, Lesley A; Truscott, E; Walravens, N; Cook, L. S.; Lampard, H; Merle, Carole; Parker, Paul H.; McVittie, Janet; Draisey, I; Murchison, Lilian E.; Ahe., Brunt; Williams, Mark; Pearson, Donald; Xmp., Petrie; Mej., Lean; Walmsley, D.; Lyall, Fiona; Christie, Emily; Church, Jody; Thomson, Erin; Farrow, Alison; Stowers, J. M.; Stowers, M; McHardy, K C; Patterson, Noelle B.; Wright, Alex; Levi, N A; Aci., Shearer; Rjw., Thompson; Taylor, GW; Rayton, S; Bradbury, M. W. B.; Glover, Angelica V.; Smyth-Osbourne, A; Parkes, C; Graham, John; England, P; Gyde, S N; Eagle, Craig; Chakrabarti, B; Smith, James; Sherwell, J; Oakley, N. W.; Whitehead, Meredith; Hollier, G P; Pilkington, T. R. E.; Simpson, Jane; Anderson, Morgan; Martin, Stéphan; Kean, Jan; Rice, B; Rolland, Audrey; Nisbet, Janelle; Kohner, Eva M.; Dornhorst, Anne; Doddridge, M C; Dumskyij, M; Walji, S.; Sharp, Patrick; Sleightholm, Marcus A.; Vanterpool, Grace; Frost, G; Roseblade, M; Elliott, Simon; Forrester, Sara; Foster, Michael B.; Myers, K A; Chapman, Richard H.; Hayes,; Henry, Robert W.; Featherston, Marcelo; Gpr., Archbold; Copeland, M; Harper, Roy; Richardson, I. M.; Davison, H A; Alexander, Llaguno Pérez Guillermo; Scarpello, Jhb; Shiers, David; Tucker, Richard; Jrh., Worthington; Angris, S; Bates, A.; Walton, Judy L.; Teasdale, Mavis; Browne, Jessica L.; Stanley, Sarah; Davis, Barry; Strange, Richard C.; Hadden,; Kennedy, Laurence; Atkinson, A. B.; Bell, P. 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L.; Doshi, Mitesh; Wilson, J G; Howard-Williams,; Humphreys, Hilary; Graham, Ann; Hicks, Katherine; Hexman, S; Bayliss, Philip; Pledger, D R; Newton, Rob; Jung, R. T.; Roxburgh, C; Kilgallon, B; Dick, Lachlan; Waugh, Norman; Kilby, S.; Ellingford, A; Burns, John A.; Fox, Charles; Holloway, M C; Coghill, H M; Hein, N; Fox, Ann; Cowan, W. K.; Richard, M; Quested, K; Evans, Sharon; Npr., Brown; Tucker, Amy J.; Paisey, Richard; Garrett, Frank; Hogg, James C.; Park, P; Williams, Ken; Harvey, Patricia T.; Wilcocks, R; Mason, Shaun; Frost, Jennifer; Warren, C; Rocket, P; Bower, L; Roland, J. M.; Brown, Daniel J.; Youens, Jasmine; Stanton-King, K; Mungall, H; Ball, Vicky; Maddison, W; Donnelly, D; King, Sarah; Griffin, Peter S.; Smith, Steven A.; Church, S; Dunn, Graham; Wilson, Alan G. E.; Palmer, Katharine J.; Brown, Phil; Humphriss, D; Ajm., Davidson; Rose, Robert A.; Armistead, Lori T.; Townsend, S; Poon, Pat; Ida., Peacock; Njc., Culverwell; Charlton, M.; Bps., Connolly; Peacock, J. 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P.; Breislin, K; Parker, Robert A.; Raval, Pravin; Curwell, Janet; Davenport, Harold T.; Shawcross, G; Prest, A; Grey, Joanna; Cole, Harold S.; Sereviratne, C; Young, Robert J.; Clyne,; Gibson, Martin; O'Connell, Ian; Wong, Louise; Wilson, Sarah; Wright, Kristine; Wallace, C; McDowell, D; Burden, A C; Sellen, E M; Gregory, Robert; Mahdavi-Roshan, Marjan; Vaghela, N; Burden, Mary; Sherriff, C; Mansingh, Sudhir; Clarke, Janice L.; Grenfell, J; Tooke, JE; MacLeod, Kenneth M.; Seamark, Clare; Rammell, M; Pym, C; Stockman, J.A.; Yeo, C; Piper, Joyce M.; Leighton, Lisa; Green, E; Hoyle, M; Jones, Karen L.; Hudson, Adrienne; James, A J; Shore, AC; Higham, Andrew; Martin, B.C.; Herring, Neil; Wjh., Butterfield; Wrs., Doll; Eastman, Richard C.; Ferris, F R; Kurinij, Natalie; McPherson, Kasi C.; Mahler, R.F.; Meade, T W; Shafer, Gentrie; Watkins, P J; Keen, H.; Siegel, David M.; Betteridge, D. J.; Cohen, Rinat; Currie, David G.; Darbyshire, Julie; Forrester, John V.; Guppy, T; Johnston, Desmond G.; McGuire, Alistair; Murphy, Maryanne; El-Nahas, A.M.; Pentecost, B L; Spiegelhalter, D; Alberti, Kgmm; Denton, R M; Home, Philip; Howell, Scott J.; Jarrett,; Marks, Vincent; Marmot, Michael; Ward, J. D.; Ukpds., Grp

doi:10.1016/s0140-6736(98)07019-6

Cited by 16,749 publications

(852 citation statements)

References 34 publications

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“…Many studies have confirmed that these patients experience memory loss, impaired consciousness, and visuospatial deficits during complex activities such as driving and walking [5].…”

Section: Resultsmentioning

confidence: 95%

“…In moderate hypoglycemia, symptoms arise from an inadequate supply of glucose to the brain, termed "neuroglycopenia"; symptoms vary widely depending on blood glucose levels and patient characteristics (nondiabetic or diabetic, young or elderly, having long-term diabetes, drug use, and basal neurological performance status). Symptoms characteristic of moderate hypoglycemia may include the following: blurred vision, drowsiness, short-term memory loss, attention deficit or difficulty concentrating, defective psychomotor skills, numbness, impaired ability to remain awake, neurological focalities, and seizures [5]. Severe hypoglycemia induces hypoglycemic coma.…”

Section: Resultsmentioning

confidence: 99%

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Syncope and Hypoglycemia

Lagi¹

2011

IJCM

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“…Many studies have confirmed that these patients experience memory loss, impaired consciousness, and visuospatial deficits during complex activities such as driving and walking [5].…”

Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Syncope and Hypoglycemia

Lagi¹

2011

IJCM

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“…This is an important finding as previous clinic trials have reported that reduction of HbA1c by 1% is associated with reduction of diabetes complications by 21% [82]. The proposed intervention of this study was an education program with no change of medication by the investigator.…”

Section: Glycated Haemoglobinmentioning

confidence: 73%

Pharmacist intervention in home care program for diabetes patients

Gillani¹,

Sulaiman²,

Baig³

et al. 2012

JDM

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Majority of research reports identified moderate reduction in glycated haemoglobin with education interventions regardless of age group. Our study objective was to evaluate the pharmacist interventions in providing patient home care. A 24-week longitudinal quasi-experimental-pretest/post-test study design was used to assess the effectiveness of a diabetes education program to enhance self-care practices. A doubleblinded randomized study design was considered but was not feasible as the investigator was responsible for implementing the intervention and collecting data on outcomes. Since this was a longitudinal study a 25% attrition rate was included in the calculation of sample size. Hence the sample size for the proposed study was 106 subjects with 53 subjects in each group. All analyses were done using SPSS version 18 ® . The level of significance was set at 0.05. The Research Ethics Committee of hospital and the Malaysian Medical Research and Ethics Committee approved the study. Of the 109 subject who met the study-entry criteria, 3 subjects declined to participate due to lack of time and interest. There was no significant relationship between the demographic and clinical characteristic of participants who completed the study. No significant relationship between the intervention and control groups who completed the study in demographic, clinical and psychosocial contexts. Of the 47 subjects from the intervention group who reported adherent to their daily medication intake after the education intervention, 51 subjects (31.9%) reported taking their medication at the wrong time. The recommended times for oral anti-hyperglycemic medication (OAM) are: sulphonylureas 30 minutes before food, acarbose with food, metformin with or within 30 minutes after food. This research has shown a brief structured education program that incorporated behavior science specifically selfefficacy was effective in enhancing self-care practices (SMBG and medication adherence) and improving glycaemic control in the intervention group.

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“…The results of the diabetes control and complication trials (DCCT) and the United kingdom prospective diabetes study (UKPDS) had shown that individual who adhere to daily self-care of diabetes followed a meal plan, take medication as prescribed, exercise regularly and monitor their blood glucose levels usually achieved better short-and long-term health outcomes [34,35]. This is because more than 95% of diabetes self-care tasks involved the individuals with diabetes and/or their family members [36,37].…”

Section: Significance Of Self Care In Diabetes Managementmentioning

confidence: 99%

Clinical critics in the management of diabetes mellitus

Gillani¹,

Sulaiman²,

Sundram³

et al. 2012

Health

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There is a global epidemic of diabetes with its prevalence expected to increase from 5.1% in 2003 to 6.3% in 2025. This increase in diabetes is occurring in all nations, however, developing nations are particularly at risk. It spares no group and affects men, women, the elderly, young and people from very racial and socioeconomic background. Nevertheless, certain ethnic groups including Asians are affected more than Caucasians. Large randomized clinical trials have shown that improvement in glycaemic control, together with management of diabetes-related risk factors like blood pressure and lipid control significantly reduce the micro and macro complications in individuals with type 1 and type 2 diabetes. Patient education plays a crucial role in the prevention of diabetic fool problems. In Geneva, the rate of lower limb amputations was reduced by almost 75% after an educational intervention. People with diabetes must acquire the knowledge and skills through education to provide daily self-care in diabetes management which involves maintenance of healthy living, recognition and management of diabetes problems when they arise and taking preventive measures. Some factors include patients' biomedical variables, the psychosocial environment, the knowledge, attitudes and beliefs of patients themselves, home careers and health care providers, healthcare systems' accessibility and availability and even the national political context may influence these self-care behaviors.

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Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)

Cited by 16,749 publications

References 34 publications

Syncope and Hypoglycemia

Syncope and Hypoglycemia

Pharmacist intervention in home care program for diabetes patients

Clinical critics in the management of diabetes mellitus

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