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Therapeutics
An intensive intervention reduced cardiovascular and microvascular events in type 2 diabetes and microalbuminuria

https://doi.org/10.1136/ebm.8.5.142

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    (2003) N Engl J Med 348, 383. Gaede P, Vedel P, Larsen N, et al.. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes.. ;. :. –93.
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 QUESTION: In patients with type 2 diabetes and microalbuminuria, is a targeted intensive multifactorial intervention more effective than conventional treatment?

    Design

    Randomised {allocation concealed*}†, blinded {data collectors and outcome assessors}†,* controlled trial with mean follow up of 7.8 years (the Steno-2 Study).

    Setting

    A diabetes centre in Denmark.

    Patients

    160 patients (mean age 55 y) with type 2 diabetes and persistent microalbuminuria. Follow up was 81%.

    Intervention

    80 patients were allocated to intensive treatment involving strict treatment goals with a stepwise implementation of behaviour modification (diet plan, exercise, and smoking cessation) and pharmacological therapy that targeted hyperglycaemia, hypertension, dyslipidaemia, microalbuminuria, and secondary prevention of cardiovascular disease with aspirin. 80 patients were allocated to conventional treatment of multiple …

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    Footnotes

    • Source of funding: no external funding.

    • For correspondence: Dr O Pedersen, Steno Diabetes Center, Gentofte, Denmark. oluf{at}steno.dk

    • Abstract and commentary also appear in ACP Journal Club.

    • ↵* See glossary.

    • ↵† Information provided by author.