Screening Adults for Type 2 Diabetes: A Review of the Evidence

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Table 1. Randomized Controlled Trials of Tight Glycemic Control

Study (Quality)	Study Years	Groups (Patients)	Glycemic Control	Renal Failure	Severe Visual Impairment	Myocardial Infarction	Stroke	Amputation	All-Cause Mortality
UGDP, 1971 (48); 1978 (49) (fair)	8.75	Placebo: n = 204	22.8% increase¹	NR	Acuity ≤20/200 either eye 11.2% 11.4% (NS)	Significant ECG abnormality 20% 17.6% (NS)	NR	1.5%	26.3%
UGDP, 1971 (48); 1978 (49) (fair)	8.75	Insulin variable: n = 198	13.5% decrease¹	NR	Acuity ≤20/200 either eye 11.2% 11.4% (NS)	Significant ECG abnormality 20% 17.6% (NS)	NR	1.6% (NS)	24.0% (NS)
UKPDS 33, 1998 (10) (good)	10	Conventional therapy: n = 1,138	7.9%²	<1%	Vision too poor to drive 11% 11% (NS)	16.3%	4.8%	1.6%	18.7%
UKPDS 33, 1998 (10) (good)	10	Intensive therapy: n = 2,729	7.0%²	<1% (p=0.45)	Vision too poor to drive 11% 11% (NS)	14.2% (p=0.052)	5.4% (p=0.52)	1.0% (p=0.099)	17.9% (p=0.44)
UKPDS 34, 1998 (47) (good)	10.7	Conventional therapy: n = 411 (primarily diet)	8.0%²	<1%	Blind in one eye 3.2% 3.5% (p=0.87)	17.8%	5.6%	2.2%	21.7%
UKPDS 34, 1998 (47) (good)	10.7	Intensive therapy: n = 342 (metformin)	7.4%²	<1% (p=0.90)	Blind in one eye 3.2% 3.5% (p=0.87)	11.4% (p=0.001)	3.5% (p=0.13)	1.8% (p=0.57)	14.6% (p=0.011)
Kumamoto, 1995 (55); 2000 (51) (fair)	8	Conventional therapy: n = 50	9.4%²	NR	NR	Major CVD event 1.3 events/100 p-y 0.6 events/100 p-y (NS)			NR
Kumamoto, 1995 (55); 2000 (51) (fair)	8	Intensive therapy: n = 52	7.1%²	NR	NR				NR
VA CSDM, 1997 (52); 1996 (54); 1995 (56); 1999 (50); 2000 (57) (fair)	2.25	Standard therapy: n = 78	9.2%²	NR	Unilateral or bilateral visual impairment 9.0% 6.7% (NS)	5.1%	2.6%	0	5.1%
	2.25	Intensive therapy: n = 75	7.1%²	NR	Unilateral or bilateral visual impairment 9.0% 6.7% (NS)	6.7% (NS)	6.7% (NS)	1.3% (NS)	6.7% (NS)
Steno 2, 1999 (53) (fair)	3.8	Standard therapy: n = 80	9.0%²	0	Blind in one eye 9.0% 1.3% (NS)	Nonfatal 5.1%	Nonfatal 10.2%	5.1%	2.6%
Steno 2, 1999 (53) (fair)	3.8	Intensive therapy: n = 80	7.6%²	0	Blind in one eye 9.0% 1.3% (NS)	5.2% (NS)	1.3% (NS)	5.2% (NS)	5.2% (NS)

¹ Change in fasting blood glucose from baseline
² Median hemoglobin A1C

Notes: NR = Not reported, UGDP = University Group Diabetes Program, UKPDS = UK Prospective Diabetes Study Group, Steno 2 = Steno type 2 randomized study, VA CSDM = VA Cooperative Study on Glycemic Control and Complications in Type 2 Diabetes

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