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Two long-awaited reports from the U.K. Prospective Diabetes Study (UKPDS) shed light on the question of whether good control of type 2 diabetes with intensive treatment helps to reduce complications. In UKPDS 33, 3,867 patients (median age, 54 years) with newly diagnosed type 2 diabetes (fasting plasma glucose [FPG] between 108 and 270 mg/dl after three months dieting) were randomized to either intensive or conventional treatment. The intensive group received sulfonylurea (chlorpropamide, glyburide [glibenclamide], or glipizide) or insulin sufficient to keep FPG below 108 mg/dl. The conventional group received diet advice; drugs were added only if needed to keep FPG below 270 mg/dl or for symptomatic hyperglycemia.
During a 10-year follow-up…