Abstract
Introduction: Type 2 diabetes mellitus and its management continue to evolve. UKPDS 33 demonstrated that a regimen of intensive blood glucose control with sulfonylureas or insulin compared with conventional glucose control substantially decreases the risk of microvascular complications. However, a macrovascular benefi t did not reach statistical signifi cance. A recent UKPDS analysis extending the results on these end points for an additional 10 years beyond the termination point of the randomized glucose control regimens did confi rm a sustained microvascular benefi t and a macrovascular benefi t, with a statistically signifi cant reduction in myocardial infarction (MI) despite convergence of the hemoglobin A1c (HbA1c) levels. These UKPDS 80 results indicate that there is a benefi t associated with prolonged glycemic control over the fi rst 10 years of the study that did not disappear despite worsening of glycemia in the follow-up phase. This “legacy” effect (ie, with intensive glucose control) was also observed in the DCCT/EDIC study.
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