UKPDS 34 demonstrated that metformin reduces diabetes-related endpoints, death, and all-cause mortality by 32–42% in overweight patients with newly diagnosed type 2 diabetes, with superior cardiovascular outcomes compared with sulphonylurea or insulin, establishing metformin as the preferred first-line pharmacological therapy for type 2 diabetes for the subsequent three decades.
Browsing: Diabetes
Evidence summaries and landmark trials across type 1, type 2, prevention, glycaemic control, complications, and diabetes technology.
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.
A double-blind RCT finds vitamin D improves insulin secretion and HOMA-IR but not fasting glucose in women with prediabetes. PICO summary and clinical expert commentary.
An RCT finds Bluetooth glucometers match traditional meters on HbA1c during telehealth insulin titration but cut ED visits. PICO summary and expert commentary for clinicians.
An RCT reports resistance exercise plus metformin improves glycaemic control and sleep quality in elderly type 2 diabetes with sleep disorders. PICO summary and expert commentary.
Summary: In pregnant women diagnosed with gestational diabetes mellitus (GDM), continuous glucose monitoring (CGM) significantly improved glycemic control compared to…
A pilot RCT finds prebiotic inulin enriches SCFA-producing gut bacteria but does not improve HbA1c in Indian children with type 1 diabetes. PICO summary and expert commentary.
An RCT finds adding a ketogenic diet to dulaglutide improves glucose, lipids, and insulin resistance in type 2 diabetes. PICO summary and clinical expert commentary.