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Early diabetes treatment key for long term health


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Early diabetes treatment key for long term health

LONDON (Reuters) - People with diabetes given intensive drug treatment soon after diagnosis are healthier when they grow older, even if they become less rigorous about controlling their blood sugar later on, British researchers said on Wednesday.

This means it may be important to prescribe diabetes drugs early, even for people just diagnosed with type 2 diabetes, instead of trying to get them to diet and exercise first, the researchers reported in the New England Journal of Medicine.

"We now know not only that good glucose control from the time type 2 diabetes is diagnosed reduces the rate of diabetic complications but also that this early intervention leads to sustained benefits in the longer term," Rury Holman of Oxford University, who led the study, said in a statement.

In type 2 diabetes, the body gradually loses the ability to use insulin properly to convert food to energy. Sugar levels shoot up, which can damage the eyes and kidneys, and cause heart disease, stroke and limb amputations.

The condition affects an estimated 246 million adults worldwide and accounts for 6 percent of all global deaths. Type 2 diabetes accounts for about 90 percent of all diabetes cases and is closely linked to obesity and physical inactivity.

Very strict diet and vigorous, regular and sustained exercise can reverse type 2 diabetes, but can be difficult for many people. Several different classes of drugs are on the market for type 2 diabetes.

The new results from a large-scale study in progress since 1998 show the protective effects of early improved glucose control remained after 10 years for diabetic eye and kidney disease.

People given generic drugs in the sulfonylurea class to get their blood sugars down to desired levels had a 15 percent reduced risk of heart attacks and were 13 percent less likely to die than volunteers assigned to control their diabetes mostly with strict diet, the study found.

The impact was greater for people taking metformin, who had a 33 percent reduced risk of heart attack and were 27 percent less likely to die than those in the diet group. Metformin is sold generically and as Bristol-Myers Squibb's Glucophage.

The follow-up of 3,277 people who participated in the original study show these health benefits lasted for at least 10 years even when differences in blood sugar control disappeared.

Volunteers received an older class of drugs rather than a newer class known as glitazones such as GlaxoSmithKline's Avandia or Takeda Pharmaceutical Co Ltd's Actos.

The researchers also found that lowering blood pressure is key to minimizing diabetic complications but -- unlike with blood sugar -- the benefits do not increase over time.

"With glucose control it matters how well you are treated now and how well you were treated in the past. With blood pressure it seems to be related just to current therapy," David Mathews of Oxford, who worked on the study, said in a statement.

© 2008 Reuters Health.

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