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S. Rutkove (2009)
A 52-year-old woman with disabling peripheral neuropathy: review of diabetic polyneuropathy.JAMA, 302 13
入江 潤一郎 (2009)
Glucose control and vascular complications in veterans with type 2 diabetes, 104
Uk-Prospective-Diabetes-Study-Group (1998)
Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)The Lancet, 352
(1998)
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MD England, MD Gronseth, M. Franklin, MD Miller, MD Asbury, MD Carter, MD Cohen, MD Fisher, MD Howard, MD Kinsella, MD Latov, MD Lewis, MD Low, MD Sumner (2005)
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R. Turner, C. Fox, Matthews, H. Mcelroy, C. Cull, R. Holman, P. Neil, D. Hadden, D. Wright, É. Manley, I. Stratton, Uk Diabetes, E. Kohner, Frighi, Michael Gnant (1998)
Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group.The Lancet
S. Genuth (2006)
Insights from the diabetes control and complications trial/epidemiology of diabetes interventions and complications study on the use of intensive glycemic treatment to reduce the risk of complications of type 1 diabetes.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 12 Suppl 1
Anushka Patel, S. MacMahon, J. Chalmers, B. Neal, L. Billot, M. Woodward, M. Marre, M. Cooper, P. Glasziou, D. Grobbee, P. Hamet, S. Harrap, S. Heller, Li-sheng Liu, G. Mancia, C. Mogensen, C. Pan, N. Poulter, A. Rodgers, B. Williams, Severine Bompoint, B. Galan, R. Joshi, F. Travert (2008)
Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes.The New England journal of medicine, 358 24
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To the Editor: In his Clinical Crossroads article discussing diabetic polyneuropathy in a patient with type 2 diabetes, Dr Rutkove1 stated that improved glucose control should be recommended to all patients with that diagnosis, citing the Diabetes Control and Complications Trial (DCCT) that was conducted in patients with type 1 diabetes.2 He also cited 2 case series in type 1 diabetes as support that tight control can improve symptoms quickly. Three randomized controlled trials (RCTs) in type 2 diabetes (UKPDS 33,3 ADVANCE,4 and VADT5) have shown that tight control did not benefit diabetic neuropathy. In the largest of these,4 with more than 10 000 patients, there was a non–statistically significant increase in new or worsening neuropathy in the tight control group. Extrapolating evidence from type 1 diabetes to the treatment of type 2 diabetes is a foundation for the continuing strong belief in tight control. The RCTs, however, suggest that this belief is a mistake. Back to top Article Information Financial Disclosures: None reported. References 1. Rutkove SB. A 52-year-old woman with disabling peripheral neuropathy: review of diabetic polyneuropathy JAMA. 2009;302(13):1451-145819738078PubMedGoogle ScholarCrossref 2. Genuth S. Insights from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study on the use of intensive glycemic treatment to reduce the risk of complications of type 1 diabetes. Endocr Pract. 2006;12:(suppl 1) 34-4116627378PubMedGoogle ScholarCrossref 3. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837-8539742976PubMedGoogle ScholarCrossref 4. Patel A, MacMahon S, Chalmers J, et al; ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358(24):2560-257218539916PubMedGoogle ScholarCrossref 5. Duckworth W, Abraira C, Moritz T, et al; VADT Investigators. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009;360(2):129-13919092145PubMedGoogle ScholarCrossref
JAMA – American Medical Association
Published: Feb 3, 2010
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