Physical and emotional burden of dialysis could be lessened by 21%
MONTREAL, June 6 /CNW Telbec/ - Ground-breaking results of the
largest-ever study of people with type 2 (adult-onset) diabetes show that
treating the disease aggressively can have a dramatic result in preventing
kidney failure, one of the major health threats for patients with the disease.
The ADVANCE (Action in Diabetes and Vascular Disease) study results were
announced today at the annual meeting of the American Diabetes Association and
published simultaneously in the New England Journal of Medicine (NEJM) and
have the potential to change the way doctors treat this disease. For the first
time, study results show that treating diabetes aggressively prevents new and
worsening of kidney damage and thus can reduce the need to go on expensive and
debilitating hemodialysis due to kidney failure by 21 per cent.
Other than a kidney transplant, kidney failure can only be treated by
dialysis, in which patients must go to hospitals every two to three days to
spend several hours having their blood artificially cleansed of impurities,
work normally done by the kidneys. More than 17,000 Canadians are surviving by
"Dialysis changes everything in your life. You have to be hooked up to a
machine three times a week to give you quality living and without it you don't
have a life, literally." says Shirley Mironchuck, the daughter of a
hemodialysis patient at the CHUM. "It's encouraging to know that doctors have
found a way to prevent people with diabetes from ending up in the hemodialysis
Type 2 diabetes is marked by a high level of blood glucose, often
referred to as blood sugar. Canadian doctors currently aim for blood glucose
levels of 7.0 mmol/L or lower for type 2 diabetics. The ADVANCE study show
that patients with type 2 diabetes benefited with more aggressive treatment to
near normal blood glucose levels (6.5 mmol/L or lower). The study is the first
to target and evaluate the impact of treating type 2 diabetes patients to
achieve near normal blood glucose levels.
"These findings will change the way we treat people with type 2 diabetes
since it shows aggressive treatment can prevent costly complications," said
Dr. Pavel Hamet Chief of Gene Medicine Services of the Centre hospitalier de
l'Université de Montréal (CHUM) who led the large Canadian portion of the
international study. "Preventing kidney damage and thus ultimately the need
for dialysis and a kidney transplant, has huge benefits for patients, their
families and for the healthcare system."
This major international study involved more than 11,000 patients in
20 countries, including 11 Canadians sites coordinated by the Centre
hospitalier de l'Université de Montréal (CHUM).
Health Canada estimates close to 2 million Canadian adults have type 2
diabetes, a number that is rising significantly as a result of sedentary
lifestyles and higher rates of obesity. More than 17,000 Canadians rely on
kidney dialysis to keep them alive. That figure is expected to double by 2013.
ADVANCE was initiated and designed by investigators at the George
Institute for International Health in Australia. Along with studying the
effect of intensive lowering of blood glucose in diabetic patients, ADVANCE
had another arm which looked at the effect of more aggressively lowering high
blood pressure in diabetic patients. Results of that part of the study were
announced last September and published in the Lancet and showed clear benefits
to patients of lowering blood pressure aggressively, providing new treatment
evidence for the current guidelines.
Patients who were randomly assigned to have aggressive treatment to lower
their blood sugar levels to close to normal levels benefited not only from the
21 per cent reduction in kidney damage, but also had fewer heart attacks, and
other complications normally seen in diabetes patients.
The trial received funding from the National Health and Medical Research
Council of Australia, and from Servier, the maker of Coversyl and
Diamicron MR, respectively the hypertension and blood-glucose lowering
medications used in the study. The sponsors had absolutely no role in the
study design, data collection, data analysis, data interpretation or writing
of the study reports.
The Centre hospitalier de l'Université de Montréal (CHUM) provides
specialized and ultra-specialized services to a regional and supra-regional
clientele. Within its more immediate coverage area, the CHUM also provides
general and specialized hospital care and services. The CHUM uses an
integrated network model to carry out its five-part mandate of care, teaching,
research, the assessment of technologies and health care methodologies, and
the promotion of health care. Through its determined efforts to continuously
improve quality of care and patient safety, the CHUM has again received
accreditation from the Canadian Council on Health Services Accreditation, for
the 2007-2010 period. Hôtel-Dieu, Hôpital Notre-Dame, and Hôpital Saint-Luc
make up the CHUM, with approximately 10,000 employees, 900 physicians,
270 researchers, 6,000 students and trainees and 700 volunteers providing
services to over a million patients each year. www.chumontreal.qc.ca.
About Université de Montréal
The Université de Montréal with its two affiliate schools, HEC Montréal
and l'Ecole Polytechnique, constitutes the leading centre for higher learning
and research in Québec, the second in Canada, and one of the largest in North
America. Its faculty of medicine is the largest in Canada in terms of student
enrolment, and one of the major centres for health research in the country.
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