Prevention of deterioration of renal and sensory-nerve function by more intensive management of insulin-dependent diabetic patients. A two-year randomised prospective study
74 insulin-dependent diabetic patients with background retinopathy were randomised to continue with usual diabetic care (group U) or to a more intensive programme (group A) using ultralente insulin as basal cover and soluble insulin at mealtimes. Group A attended the clinic more frequently, received...
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| Veröffentlicht in: | The Lancet (British edition) 1983-01, Vol.1 (8318), p.204-208 |
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| creator | Holman, R R Dornan, T L Mayon-White, V Howard-Williams, J Orde-Peckar, C Jenkins, L Steemson, J Rolfe, R Smith, B Barbour, D McPherson, K Poon, P Rizza, C Mann, J I Knight, A H Bron, A J Turner, R C |
| description | 74 insulin-dependent diabetic patients with background retinopathy were randomised to continue with usual diabetic care (group U) or to a more intensive programme (group A) using ultralente insulin as basal cover and soluble insulin at mealtimes. Group A attended the clinic more frequently, received closer dietary supervision, and were taught home blood glucose monitoring. Group A had a significantly lower mean glycosylated haemoglobin level during the study, although the mean level also fell in group U towards the end of year 2. Renal and sensory-nerve function were significantly better preserved in group A than in group U. Significant improvements were also seen in low-density-lipoprotein-cholesterol and whole-blood low-shear viscosity. The rate of progression of retinopathy was similar in both groups. It appears that a modest improvement in diabetic control, obtainable in most clinics, has been associated with a reduction in the progression of diabetic tissue damage. |
| format | Article |
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Group A attended the clinic more frequently, received closer dietary supervision, and were taught home blood glucose monitoring. Group A had a significantly lower mean glycosylated haemoglobin level during the study, although the mean level also fell in group U towards the end of year 2. Renal and sensory-nerve function were significantly better preserved in group A than in group U. Significant improvements were also seen in low-density-lipoprotein-cholesterol and whole-blood low-shear viscosity. The rate of progression of retinopathy was similar in both groups. It appears that a modest improvement in diabetic control, obtainable in most clinics, has been associated with a reduction in the progression of diabetic tissue damage.</description><identifier>ISSN: 0140-6736</identifier><identifier>PMID: 6130244</identifier><language>eng</language><publisher>England</publisher><subject>Blood Glucose - analysis ; Blood Viscosity ; Cholesterol - blood ; Cholesterol, LDL ; Clinical Trials as Topic ; Diabetes Mellitus - diet therapy ; Diabetes Mellitus - drug therapy ; Diabetic Nephropathies - prevention & control ; Diabetic Neuropathies - physiopathology ; Diabetic Neuropathies - prevention & control ; Female ; Glycated Hemoglobin A - analysis ; Home Care Services ; Humans ; Insulin, Long-Acting - therapeutic use ; Lipoproteins, LDL - blood ; Male ; Prospective Studies ; Random Allocation ; Sensory Thresholds</subject><ispartof>The Lancet (British edition), 1983-01, Vol.1 (8318), p.204-208</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/6130244$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Holman, R R</creatorcontrib><creatorcontrib>Dornan, T L</creatorcontrib><creatorcontrib>Mayon-White, V</creatorcontrib><creatorcontrib>Howard-Williams, J</creatorcontrib><creatorcontrib>Orde-Peckar, C</creatorcontrib><creatorcontrib>Jenkins, L</creatorcontrib><creatorcontrib>Steemson, J</creatorcontrib><creatorcontrib>Rolfe, R</creatorcontrib><creatorcontrib>Smith, B</creatorcontrib><creatorcontrib>Barbour, D</creatorcontrib><creatorcontrib>McPherson, K</creatorcontrib><creatorcontrib>Poon, P</creatorcontrib><creatorcontrib>Rizza, C</creatorcontrib><creatorcontrib>Mann, J I</creatorcontrib><creatorcontrib>Knight, A H</creatorcontrib><creatorcontrib>Bron, A J</creatorcontrib><creatorcontrib>Turner, R C</creatorcontrib><title>Prevention of deterioration of renal and sensory-nerve function by more intensive management of insulin-dependent diabetic patients. A two-year randomised prospective study</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>74 insulin-dependent diabetic patients with background retinopathy were randomised to continue with usual diabetic care (group U) or to a more intensive programme (group A) using ultralente insulin as basal cover and soluble insulin at mealtimes. Group A attended the clinic more frequently, received closer dietary supervision, and were taught home blood glucose monitoring. Group A had a significantly lower mean glycosylated haemoglobin level during the study, although the mean level also fell in group U towards the end of year 2. Renal and sensory-nerve function were significantly better preserved in group A than in group U. Significant improvements were also seen in low-density-lipoprotein-cholesterol and whole-blood low-shear viscosity. The rate of progression of retinopathy was similar in both groups. It appears that a modest improvement in diabetic control, obtainable in most clinics, has been associated with a reduction in the progression of diabetic tissue damage.</description><subject>Blood Glucose - analysis</subject><subject>Blood Viscosity</subject><subject>Cholesterol - blood</subject><subject>Cholesterol, LDL</subject><subject>Clinical Trials as Topic</subject><subject>Diabetes Mellitus - diet therapy</subject><subject>Diabetes Mellitus - drug therapy</subject><subject>Diabetic Nephropathies - prevention & control</subject><subject>Diabetic Neuropathies - physiopathology</subject><subject>Diabetic Neuropathies - prevention & control</subject><subject>Female</subject><subject>Glycated Hemoglobin A - analysis</subject><subject>Home Care Services</subject><subject>Humans</subject><subject>Insulin, Long-Acting - therapeutic use</subject><subject>Lipoproteins, LDL - blood</subject><subject>Male</subject><subject>Prospective Studies</subject><subject>Random Allocation</subject><subject>Sensory Thresholds</subject><issn>0140-6736</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1983</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kMtOwzAQRb0AlVL4BCSv2BnZseO0y6riJVWCRffRxJ4go8QOdlKUf-IjMVBWI905Onc0Z2TJheJMV1JfkMuU3jnnSvNyQRZaSF4otSRfrxGP6EcXPA0ttThidCHCfxDRQ0fBW5rQpxBn5jEekbaTN79MM9M-RKTOjxlwedWDhzfss_RH4HyaOueZxQG9_QmtgwZHZ-iQW3KQ7uiWjp-BzQiRxtwVepfQ0iGGNGCuydI0Tna-IuctdAmvT3NFDg_3h90T2788Pu-2ezaUUrFK4AYNFhp1aQBUK1upeKmUligEF6IVAmwhzbqwKKBoSmUsB9RVY0QDWq7I7Z82H_AxYRrrfI_BrgOPYUr1mstyo3iVwZsTODU92nqIroc416fvym9n8nq9</recordid><startdate>19830129</startdate><enddate>19830129</enddate><creator>Holman, R R</creator><creator>Dornan, T L</creator><creator>Mayon-White, V</creator><creator>Howard-Williams, J</creator><creator>Orde-Peckar, C</creator><creator>Jenkins, L</creator><creator>Steemson, J</creator><creator>Rolfe, R</creator><creator>Smith, B</creator><creator>Barbour, D</creator><creator>McPherson, K</creator><creator>Poon, P</creator><creator>Rizza, C</creator><creator>Mann, J I</creator><creator>Knight, A H</creator><creator>Bron, A J</creator><creator>Turner, R C</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>19830129</creationdate><title>Prevention of deterioration of renal and sensory-nerve function by more intensive management of insulin-dependent diabetic patients. A two-year randomised prospective study</title><author>Holman, R R ; Dornan, T L ; Mayon-White, V ; Howard-Williams, J ; Orde-Peckar, C ; Jenkins, L ; Steemson, J ; Rolfe, R ; Smith, B ; Barbour, D ; McPherson, K ; Poon, P ; Rizza, C ; Mann, J I ; Knight, A H ; Bron, A J ; Turner, R C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p534-71e9ece26e65caa4f3f34054463e11011f11ad23c82de1a2b54cd0ae67bc1ba63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1983</creationdate><topic>Blood Glucose - analysis</topic><topic>Blood Viscosity</topic><topic>Cholesterol - blood</topic><topic>Cholesterol, LDL</topic><topic>Clinical Trials as Topic</topic><topic>Diabetes Mellitus - diet therapy</topic><topic>Diabetes Mellitus - drug therapy</topic><topic>Diabetic Nephropathies - prevention & control</topic><topic>Diabetic Neuropathies - physiopathology</topic><topic>Diabetic Neuropathies - prevention & control</topic><topic>Female</topic><topic>Glycated Hemoglobin A - analysis</topic><topic>Home Care Services</topic><topic>Humans</topic><topic>Insulin, Long-Acting - therapeutic use</topic><topic>Lipoproteins, LDL - blood</topic><topic>Male</topic><topic>Prospective Studies</topic><topic>Random Allocation</topic><topic>Sensory Thresholds</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Holman, R R</creatorcontrib><creatorcontrib>Dornan, T L</creatorcontrib><creatorcontrib>Mayon-White, V</creatorcontrib><creatorcontrib>Howard-Williams, J</creatorcontrib><creatorcontrib>Orde-Peckar, C</creatorcontrib><creatorcontrib>Jenkins, L</creatorcontrib><creatorcontrib>Steemson, J</creatorcontrib><creatorcontrib>Rolfe, R</creatorcontrib><creatorcontrib>Smith, B</creatorcontrib><creatorcontrib>Barbour, D</creatorcontrib><creatorcontrib>McPherson, K</creatorcontrib><creatorcontrib>Poon, P</creatorcontrib><creatorcontrib>Rizza, C</creatorcontrib><creatorcontrib>Mann, J I</creatorcontrib><creatorcontrib>Knight, A H</creatorcontrib><creatorcontrib>Bron, A J</creatorcontrib><creatorcontrib>Turner, R C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>The Lancet (British edition)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Holman, R R</au><au>Dornan, T L</au><au>Mayon-White, V</au><au>Howard-Williams, J</au><au>Orde-Peckar, C</au><au>Jenkins, L</au><au>Steemson, J</au><au>Rolfe, R</au><au>Smith, B</au><au>Barbour, D</au><au>McPherson, K</au><au>Poon, P</au><au>Rizza, C</au><au>Mann, J I</au><au>Knight, A H</au><au>Bron, A J</au><au>Turner, R C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevention of deterioration of renal and sensory-nerve function by more intensive management of insulin-dependent diabetic patients. A two-year randomised prospective study</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>1983-01-29</date><risdate>1983</risdate><volume>1</volume><issue>8318</issue><spage>204</spage><epage>208</epage><pages>204-208</pages><issn>0140-6736</issn><abstract>74 insulin-dependent diabetic patients with background retinopathy were randomised to continue with usual diabetic care (group U) or to a more intensive programme (group A) using ultralente insulin as basal cover and soluble insulin at mealtimes. Group A attended the clinic more frequently, received closer dietary supervision, and were taught home blood glucose monitoring. Group A had a significantly lower mean glycosylated haemoglobin level during the study, although the mean level also fell in group U towards the end of year 2. Renal and sensory-nerve function were significantly better preserved in group A than in group U. Significant improvements were also seen in low-density-lipoprotein-cholesterol and whole-blood low-shear viscosity. The rate of progression of retinopathy was similar in both groups. It appears that a modest improvement in diabetic control, obtainable in most clinics, has been associated with a reduction in the progression of diabetic tissue damage.</abstract><cop>England</cop><pmid>6130244</pmid><tpages>5</tpages></addata></record> |
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| identifier | ISSN: 0140-6736 |
| ispartof | The Lancet (British edition), 1983-01, Vol.1 (8318), p.204-208 |
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| subjects | Blood Glucose - analysis Blood Viscosity Cholesterol - blood Cholesterol, LDL Clinical Trials as Topic Diabetes Mellitus - diet therapy Diabetes Mellitus - drug therapy Diabetic Nephropathies - prevention & control Diabetic Neuropathies - physiopathology Diabetic Neuropathies - prevention & control Female Glycated Hemoglobin A - analysis Home Care Services Humans Insulin, Long-Acting - therapeutic use Lipoproteins, LDL - blood Male Prospective Studies Random Allocation Sensory Thresholds |
| title | Prevention of deterioration of renal and sensory-nerve function by more intensive management of insulin-dependent diabetic patients. A two-year randomised prospective study |
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