An introduction to new advances in diabetes

Diabetes is a potentially devastating disease with a high morbidity and mortality. There is an excess risk of both microvascular and macrovascular complications with diabetes1. Recent studies have emphasised and illustrated how we might be able to limit these diabetic complications. The Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS) found that improved control of blood glucose reduced the risk of major diabetic eye disease by 25%, serious deterioration of vision by nearly 50%, and early kidney damage by 33%. Other studies including the UKPDS have demonstrated the importance of blood pressure control and reduced cholesterol in addition to the use of aspirin in limiting progression of macrovascular disease. Diabetes is no longer viewed as a disease of sugar alone; a more holistic approach is required if our patients are to benefit from the information we have acquired through these recent studies. Some of the most recent developments in the field are presented in this review. Copyright © 2002 John Wiley & Sons, Ltd.