A Danish study indicates that when early type 2 diabetes is detected by screening intensive management doesn’t seem to cut the risk of certain complications later on

-Team@CMHF

• No statistically significant effect of intensive multifactorial treatment was found on the prevalence of diabetic peripheral neuropathy and peripheral arterial disease compared with routine care, says a report in Diabetes Care
• Screening for diabetes is increasingly accepted, but its value is uncertain.
• Earlier this year in The Lancet reported in international ADDITION study that intensive management of screen-detected type 2 diabetes yielded a non significant reduction in cardiovascular events over five years.
• The current study focused on 1,533 Danish participants in ADDITION and they were managed in general practices that were randomized to deliver either intensive multifactorial treatment or routine care.
• Six years after screening, the prevalence of an ankle-brachial index of 0.9 or less was 9.1% in the routine-care arm and 7.3% in the intensive treatment arm.
• Similarly, abnormal test results for neuropathy were seen in 34.8% and 30.1% in the routine- and intensive-treatment groups, respectively.
• While these differences were not statistically significant, all observed risk estimates favored multifactorial intervention at a non-statistically significant level.
• It was also pointed out that the prevalence of peripheral neuropathy and peripheral arterial disease were high, so clinicians should be aware of these high prevalences when dealing with patients with screen-detected diabetes.
• The researchers offered another caveat: “It is conceivable” that when diabetes is in its initial stages, “a longer duration of intensive treatment is necessary to observe an effect.”
• A future repeated examination of the participants after a longer follow-up period will show whether this is the case.

For further reading log on to

http://www.endocrineweb.com/professional/news/diabetes/2011/08/6870-value-intensive-treatment-early-diabetes-questioned