Major study shows significant death risk reduction in type 2 diabetic
patients given a combined approach of blood pressure lowering and intensive
glucose control

    
       Results presented at International Diabetes Federation Congress
                                 in Montreal
    

MONTREAL , Oct. 20 /CNW Telbec/ - New analyses of the largest-ever clinical trial of patients with type 2 diabetes show that the combination of blood pressure lowering treatment and intensive glucose (blood sugar) control improved patients' vascular condition and resulted in a significant 18 percent reduction in the risk of death from all causes.

The results were presented yesterday by Dr. Pavel Hamet , Chief of Gene Medicine Services at Centre hospitalier de l'Université de Montréal (CHUM) and professor of Medicine, Université de Montréal, the study's principal investigator for Canada , at the International Diabetes Federation (IDF) Congress 2009 in Montreal and published in the journal Diabetes Care.

The findings come from the ADVANCE (Action in Diabetes and Vascular Disease) trial, the largest-ever clinical trial of patients with type 2 diabetes, coordinated in Canada by the Centre hospitalier de l'Université de Montréal (CHUM).

The new results presented yesterday suggest that the overall management of patients with established type 2 diabetes should incorporate routine blood pressure lowering and more intensive glucose control with the best care available to reduce the burden of further disease complications.

"These new findings of ADVANCE provide considerable reassurance that the widely used clinical approach of joint management of blood pressure and glucose in patients with type 2 diabetes is both appropriate and effective," said Dr. Hamet . "Our findings provide further evidence for the benefits of a multi-faceted treatment approach that includes blood pressure lowering and intensive glucose control in patients with type 2 diabetes."

The face of diabetes in Canada

By 2010, more than 3 million Canadians will have diabetes and that number will continue to grow by nearly 550 every day. More than 60% of people with diabetes have high blood pressure, and almost 60% have high cholesterol. As a result, cardiovascular disease such as heart attacks and strokes is the leading cause of death in people with diabetes.

Key results

There was no interaction between the effects of the routine blood pressure lowering and intensive glucose control for any of the pre-specified clinical outcomes. When compared to neither intervention, combination treatment reduced the risk of new or worsening nephropathy by 33%, new onset macroalbuminuria by 54% and new onset microalbuminuria by 26%. Combination treatment was associated with an 18% reduction in the risk of all-cause death.

"We anticipate that the combined treatment strategy employed by ADVANCE may further reduce cardiovascular risk in the long term," said Dr. Hamet . "From the blood pressure part of the ADVANCE study we already knew that treating blood pressure with Coversyl Plus offers a vascular protection for type 2 diabetic patients. We now have an additional proof that we can have better results by combining good treatments."

About ADVANCE

ADVANCE (Action in Diabetes and Vascular Disease: Pretarax and Diamicron MR Controlled Evaluation) is a multi-centre, factorial randomized trial of perindopril-indapamide (Coversyl Plus) versus placebo and intensive glucose control with a gliclazide MR-based regimen (Diamicron MR) versus standard glucose control. The study involved more than 11,000 patients with type 2 diabetes and vascular disease studied in 215 centres in 20 countries, including 11 in Canada . Patients who participated in the study suffered from type 2 diabetes, were aged 55 years and older and had a history of major macrovascular and microvascular disease, or at least one other risk factor for vascular disease. Annual event rates and risks of major macrovascular and microvascular events, renal events and death during an average 4.3 years of follow-up were assessed

The ADVANCE trial was conducted by an independent collaborative group of medical researchers with support from the National Health & Medical Research Council of Australia and the Institut de Recherche International Servier.

About Centre hospitalier de l'Université de Montréal: www.chumontreal.qc.ca

About the Université de Montréal: www.med.umontreal.ca

For further information: Jonathan Gendron, HKDP Communications and Public Affairs, [phone], ext. 222, [email protected]; Nathalie Forgue, Centre hospitalier de l'Université de Montréal, [phone], ext. 14342; Sylvain-Jacques Desjardins, Université de Montréal, [phone], [email protected]