Should we screen for diabetes? should we treat for diabetes intensively? The ADDITION-Europe Study

Posted by TL on May 18, 2014 in POEMs | 0 comments

Effect of Early Multifactorial Therapy Compared With Routine Care on Microvascular Outcomes at 5 Years in People With Screen-Detected Diabetes: A Randomised Controlled Trial: The ADDITION-Europe Study.

Sandbæk A1, Griffin SJ, Sharp SJ, Simmons RK, Borch-Johnsen K, Rutten GE, van den Donk M, Wareham NJ, Lauritzen T, Davies MJ, Khunti K.

It makes sense that we should screen people for diabetes and when found treat them intensively. What does the evidence show?

In this recent study, 2816 people with screening detected diabetes in 343 general practices in Denmark, the Netherlands and the UK.
Half received ‘routine care’ and half had target-driven intensive management.

It must have been disappointing for the researchers that there was no significant reduction in the frequeny of microvascular events at 5 years.

The same study has earlier reported that there was not a significant reduction in macrovascular events (cardiovascular mortality and morbidity, revascularisation, and non-traumatic amputation)

This is despite the patients having better HbA1C, Chol and BP levels.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60698-3/abstract