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Evid Based Nurs 6:110 doi:10.1136/ebn.6.4.110
  • Treatment

An intensive, target driven intervention reduced cardiovascular and microvascular events in patients with type 2 diabetes and microalbuminuria


 
 QUESTION: In patients with type 2 diabetes and microalbuminuria, what is the effect of a target driven, long term, intensive, multifactorial intervention compared with conventional treatment on cardiovascular and microvascular disease?

Design

Randomised {allocation concealed}*, blinded {data collectors and outcome assessors}*, controlled trial with mean follow up of 7.8 years (the Steno-2 Study).

Setting

A diabetes centre in Denmark.

Patients

160 patients (mean age 55 y) with persistent microalbuminuria. Follow up was 81%.

Intervention

80 patients were allocated to intensive treatment involving strict treatment goals with stepwise implementation of behaviour modification (diet plan, exercise, and smoking cessation) and target driven pharmacological therapy for hyperglycaemia, hypertension, dyslipidaemia, and microalbuminuria. All patients in the intervention group received either an angiotensin converting enzyme inhibitor or angiotensin II …

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