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Diabetes 53:S39-S47, 2004
© 2004 by the American Diabetes Association, Inc.

Section I: Insulin Resistance-Beta-Cell Connection in Type 2 Diabetes

Intensive Integrated Therapy of Type 2 Diabetes

Implications for Long-Term Prognosis

Peter Gæde1, and Oluf Pedersen1,2

1 Steno Diabetes Center, Copenhagen, Denmark
2 Faculty of Health Science, University of Aarhus, Aarhus, Denmark

The macro- and microvascular burden of type 2 diabetes is well established. A number of recent single risk factor intervention trials targeting hyperglycemia, dyslipidemia, hypertension, procoagulation, microalbumuria, and existing cardiovascular disorders have, however, shown major beneficial effects on long-term outcome. The results from these studies are anticipated to change the future management of type 2 diabetes, and most of the updated national guidelines for the treatment of type 2 diabetes recommend a multipronged approach driven by ambitious treatment targets. The outcome of this intensive integrated therapy has, however, only been investigated in a few studies of patients with type 2 diabetes. One of these trials, the Steno-2 Study, showed that intensive intervention for an average of 7.8 years cuts cardiovascular events as well as nephropathy, retinopathy, and autonomic neuropathy by about half when compared with a conventional multifactorial treatment. The challenge for now is to ensure that the trial experiences are widely adopted in daily clinical practice.

Address correspondence and reprint requests to Oluf Pedersen, MD, Steno Diabetes Center, Niels Steensens Vej 2, DK-2820 Gentofte, Copenhagen, Denmark. E-mail: oluf{at}steno.dk


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