Diabetics could live eight years longer with special treatments
There is light on the horizon for some type 2 diabetic patients, shows new research. Patients lived significantly longer when following an intensive form of treatment that tackles a broad range of symptoms.
A large group of patients with type 2 diabetes who took part in a randomised trial 21 years ago, have prolonged their lives by following a so-called holistic treatment plan focusing on more than just blood sugar levels.
A new study analysing the longevity of the original test groups shows that the so-called high-risk patients not only lived up to eight years longer on average, but the treatment gave patients a significantly improved quality of life and reduced the incidences of cardiovascular disease.
“The results are really fantastic news for diabetics,” says project leader Oluf Borbye Pedersen from the Novo Nordisk Foundation Center for Basic Metabolic Research, at the University of Copenhagen, Denmark.
“In the extra eight years there were no new, serious cases of atherosclerosis in either the heart or the brain of the patients who underwent the broad spectrum, intensive treatment,” says Pedersen.
Co-author Professor Hans-Henrik Parving from Rigshospital, Denmark, is equally enthusiastic.
“Long-term follow-up of the Steno-2 study demonstrates without a doubt the sustainability of the comprehensive and intensified treatment of type 2 diabetes. The benefits of significantly more years of life and a halving of cardiovascular disease speak for themselves,” he said in a press release.
A 21 year-long study
The randomised trial, known as the 'Steno-2 study', started in 1994 in Denmark with 160 patients suffering from type 2 diabetes.
All of the participants had a condition called microalbuminuria, where unwanted proteins leak into the blood stream. This places them at a high risk of developing serious complications in the heart, brain, eyes, and kidneys.
The 160 patients in the study were divided into two groups. One received the standard treatment for that time in 1994, with a focus on treating problems with blood sugar.
The second group followed an intensive, multi-faceted treatment regime, comprising both lifestyle intervention and tailored drug treatment of elevated blood pressure, blood glucose, blood lipids, blood clotting and urinary excretion of protein. It focused on multiple complications all at once and implemented lifestyle changes, and was seen as experimental at the time.
Broad spectrum, intensive treatment affords a better quality of life
The good news, says Pedersen, is that the broad-spectrum treatment that was once seen as experimental is today widely applied as a standard treatment for type 2 diabetes.
“The treatment comprises the multiple risk factors for poor health that type 2 diabetic patients typically deal with, which is more than just raised blood sugar,” says Pedersen.
When the trial started in the 1990s, the treatment was radically new and treated both increased blood-pressure and cholesterol content in the blood, clumping of platelets, and raised protein in urine, he says.
In addition to taking drugs to treat this broad range of symptoms, patients were also taught how to adopt a healthier lifestyle by researchers, dieticians, and nurses, with surprisingly positive effects.
“Lots of people shrugged us off and said we were over ambitious. But already after four years, the cases of eye and kidney damage among patients receiving the experimental treatment declined by half,” says Pedersen.
Read More: Hormone may offer new approach to diabetes
Control group eventually offered the new treatment
After eight years of following the broad treatment, cases of blood clots, stroke, eye and kidney problems, and the number of amputations declined by half. At this point, the treatment was opened up to the control group.
“After eight years evaluation it became clear that it was unethical to not offer the same multi-pronged and intensive treatment to the control group,” says Pedersen.
In the following 13 years, all the patients received the new treatment and the scientists continued to analyse the survivors’ health. Over the years, they have published their results, which led to new international recommendations for the treatment of diabetes. The new study checked in with the patients’ progress, and correlated the life span of the original test groups with the treatment they received.
Read More: Diabetes epidemic threatens Greenland
Treatment is probably beneficial for all type 2 diabetics
But does this broad treatment benefit all patients with type 2 diabetes, or just the so-called high-risk patients?
“Our starting point for the study was high-risk patients, so we cannot tell whether all type 2 diabetics will experience the same benefits. But following a broader and much more holistic and ambitious treatment has certainly had some beneficial effect for all patients,” says Pedersen.
Henning Beck-Nielsen in no doubt that the versatile treatment has benefited everyone.
“It's a really good study that’s been very important for the development of treatment,” he says.
“Over the past 15 years, the mortality rate for diabetics has dropped by half, and it continues to fall year on year because of better treatment. The Steno-2 study of 1994 has played a major role,” he says.
But more treatments are needed for all diabetic patients to achieve an extra eight years longevity, he says.
Translated by: Catherine Jex
- "Years of life gained by multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: 21 years follow-up on the Steno-2 randomised trial." Diabetologia (2016), DOI: 10.1007/s00125-016-4065-6