A 453-patient non-inferiority trial found once-daily prolonged-release pregabalin worked about as well as immediate-release pregabalin for diabetic peripheral neuropathy, with both beating placebo. PICO summary and expert commentary.
Browsing: Diabetes Complications
Microvascular and macrovascular complications of diabetes: retinopathy, nephropathy, neuropathy, and cardiovascular risk.
ADVANCE demonstrated that intensive glucose control targeting HbA1c below 6.5% using a gliclazide-based strategy reduces nephropathy by 21% and the microvascular composite by 14% in high-risk type 2 diabetes, without the mortality hazard observed in ACCORD, providing important context for how glycaemic targets and treatment strategies interact with safety outcomes.
UKPDS 38 demonstrated that tight blood pressure control targeting below 150/85 mmHg reduces stroke by 44%, diabetes-related endpoints by 24%, and microvascular complications by 37% in hypertensive type 2 diabetes over 8.4 years, establishing blood pressure control as a therapeutic target of at least equal macrovascular importance to glycaemic management.
UKPDS 33 established that intensive blood-glucose control with sulphonylurea or insulin reduces microvascular complications by 25% in newly diagnosed type 2 diabetes over 10 years with a 0.9% HbA1c differential, confirming the glucose hypothesis for type 2 diabetes microvascular disease and forming the foundational evidence for tight glycaemic management from diagnosis.
The EDIC study demonstrated that 6.5 years of intensive glycaemic therapy during the DCCT reduced cardiovascular events by 42–57% over 17 years of follow-up despite subsequent HbA1c convergence between groups, establishing the concept of metabolic memory and providing foundational evidence that early intensive glycaemic control produces durable cardiovascular protection extending decades beyond the intervention period.
The Diabetes Control and Complications Trial demonstrated that intensive insulin therapy targeting near-normal blood glucose reduced the risk of developing retinopathy by 76% in primary prevention and slowed progression by 54% in secondary intervention, while also substantially reducing nephropathy and neuropathy, establishing the foundational evidence for tight glycaemic control in type 1 diabetes.
An RCT finds an intravitreal dexamethasone implant during diabetic vitrectomy cuts reproliferation and improves vision. PICO summary and expert commentary for clinicians.
A phase 2 RCT finds placenta-derived cells improve diabetic foot ulcer closure in the peripheral artery disease subgroup. PICO summary and expert commentary for clinicians.
An RCT finds adding sitagliptin to standard care improves diabetic foot ulcer healing via an EPC/SDF-1α mechanism. PICO summary and expert commentary for clinicians.
An RCT finds 660 nm photobiomodulation reduces diabetic foot ulcer area but does not beat 904 nm; ≥8 J/cm² works best. PICO summary and expert commentary for clinicians.