Effects of intensive control of blood glucose and blood pressure on microvascular complications in patients with type Ⅱ diabetes mellitus

作     者：Cai-Hong Zhu Shi-Sheng Zhang Yan Kong Yu-Fang Bi Ling Wang Qiong Zhang 

作者机构：Department of Ophthalmology Ruijin Hospital School of Medicine Shanghai Jiaotong University New Vision Eye Clinic Ruijin Hospital School of Medicine Shanghai Jiaotong University Department of Hypertension Ruijin Hospital School of Medicine Shanghai Jiaotong University Department of Endocrinology Ruijin Hospital School of Medicine Shanghai Jiaotong University 

出 版 物：《International Journal of Ophthalmology(English edition)》 (国际眼科杂志（英文版）)

年 卷 期：2013年第6卷第2期

页      面：141-145页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：French Pharmaceutical Company Servier, Australian National Health and Medical Research Council (No. NCT00145925) National Natural Science Foundation of China (No. 60978030) Shanghai Leading Academic Discipline Project (No. S30205) 

主　　题：diabetes mellitus intensive therapy microvascular complications diabetic retinopathy 

摘      要：AIM: To evaluate the effects of intensive control of blood glucose and blood pressure on microvascular complications in patients with type Ⅱ diabetes by comparing the therapeutic effects of intensive and standard treatment in patients with type Ⅱ diabetes. METHODS: A total of 107 patients with type Ⅱ diabetes were randomly assigned into intensive and standard treatment groups. Patients in the intensive treatment group received preterax (perindopril/ indapamide) to control blood pressure, and gliclazide (diamicron) MR to control blood glucose. Patients in the standard treatment group received routine medications or placebo. Urinary microalbumin (UMA), urinary creatinine (UCR), the UMA/ UCR ratio, and visual acuity were monitored according to the study design of the ADVANCE trial. Direct ophthalmoscopy and seven-field stereoscopic retinal photography were used to examine the fundi at baseline,and repeated after 5 years of treatment. RESULTS: The characteristics of patients in both groups were well balanced at baseline. After 5 years of treatment, visual acuity was found to be decreased in the standard group (P=0.04), but remained stable in the intensive group. The severity of diabetic retinopathy had not progressed in patients in the intensive group, but had deteriorated in the standard group (P=0.0006). The UMA/UCR ratio was not obviously changed in patients in the intensive group, whereas it was significantly increased in the standard group (P=0.00). CONCLUSION: Intensive control of blood glucose and blood pressure can decrease the incidence or slow the progression of microvascular complications in patients with type Ⅱ diabetes, and maintain stable vision.