Tight Control of Glucose Can Reduce Serious Diabetes Complications
An ADVANCE(Action in Diabetes and Vascular Disease)study in the New England journal of medicine showed that improved glycemic control with Gliclazide Modified Release Tablets and other essential drugs could protect diabetics from serious complications. The findings were presented at the American diabetes association's (ADA) annual meeting.
Glucose down to 6.5% is safe
Diabetes is one of the biggest threats to global human health. Currently, there are about 250 million diabetics in the world, and there are about 27 million diabetics in China. The global number of people with diabetes is expected to rise to 380 million by 2025. At that time, developing countries such as India and China will replace developed countries as the regions with the fastest growth in diabetes prevalence.
Although no one denies that lowering blood sugar will improve symptoms and reduce complications in people with diabetes but each country has different opinion to reduce hemoglobin A1C. For example, the standard for diabetes treatment in the United States is 7%, that in some European countries is 6.5%, and that in China is 6.5%, but these are all epidemiological data. Prior to the ADVANCE study, there was no evidence-based evidence that lowering blood sugar to 6.5% was safe.
ADVANCE research project is designed and launched by Australia’s George International Health Research Center experts, including an independent research group of more than 20 countries around the world medical researchers, covering Asia, Europe, America and so on many countries and regions in different diabetic population. There are 11140 patients with type 2 diabetes in total as the research object. They accept five-year intervention and follow-up. And they take glycosylated hemoglobin down to 6.5% as the treatment object. ADVANCE research provides evidence-based data for clinical trials showing that intensive Diamicron-based hypoglycemic therapy is feasible and safe to reduce hba1c in type 2 diabetes patients to 6.5%.
The world health organization (WHO) defines diabetes mellitus as a metabolic disease caused by multiple causes, characterized by chronic hyperglycemia, accompanied by insufficient insulin secretion, defective insulin action, or both, resulting in disordered metabolism of carbohydrates, fats and proteins.In addition to diabetes itself, various complications caused by diabetes are also increasing.
The complication of diabetes mellitus is very common in our country and the prevalence rate has reached quite high levels. Among them, the patients with hypertension, cardiovascular and cerebrovascular disease, eye and nephropathy account for about 1/3, and the patients with neuropathy account for more than half. The prevalence of macrovascular diseases, such as hypertension, cerebrovascular and cardiovascular diseases, is significantly higher than before. Although the prevalence of cardiovascular complications in diabetes is lower than that in western countries, it has become the most serious complication with the highest disability rate and fatality rate in China.
Kidneys are important to each of us. Proteinuria is a good indicator to evaluate the risk of cardiovascular and renal vascular diseases and microvascular diseases. In China, the proportion of type 2 diabetes patients with microalbuminuria is about 40%, indicating that the incidence of diabetic microangiopathy is very high.
ADVANCE showed that intensive hypoglycemic therapy significantly reduced the risk of serious complications from diabetes by about 10 percent, including a 20 percent or more reduction in the risk of diabetic nephropathy and a 30 percent reduction in the risk of proteinuria. This indicates that intensive hypoglycemic therapy can indeed play a role in protecting the kidney.
In the world, many dialysis or kidney transplant centers accept more Diabetic Nephropathy patients. The cost of treating diabetic nephropathy is 13 times that of treating diabetes alone. Therefore, from the perspective of health economics, intensive hypoglycemic therapy and the reduce of Diabetic Nephropathy complications will help to reduce the economic burden of patients.
In ADVANCE's study of 11140 patients with type 2 diabetes, more than 3,000 people in China had diabetes, and 80% of people with diabetes in China had hemoglobin a1c reduced to 6.5%. This study was successful in China, and ADVANCE's data and results can be well interpreted and applied in our country.
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