Steno-2 follow-up study

The Steno-2 Follow-up Study: Intensive global risk intervention reduces all-cause- and cardiovascular mortality in patients with type 2 diabetes

Steno-2 Study, a prospective, randomized, open-label, blinded trial has previously shown that intensified multifactorial intervention-with the use of renin-angiotensin system (RAS) blockers, aspirin, lipid-lowering agents and a more tight glucose regulation compared with usual multifactorial treatment in line with national guidelines cuts the risk of microvascular complications and nonfatal cardiovascular disease by half in patients with type 2 diabetes and microalbuminuria.

In this ‘whole man approach’ patients were treated for a mean of 7.8 years, after which structured treatment stopped; however, doctors to whom the patients were referred were informed about the benefits of intensified treatment. After a mean period of 13.3 years (7.8 years of intervention and 5.5 years of follow-up), patients who received intensive therapy had an absolute reduction in risk of death from any cause (primary outcome) of 20% compared with patients who received usual multifactorial therapy. Intensive therapy was also associated with lower risks of cardiovascular death (hazard ratio 0.43; P <0.04) and cardiovascular events (hazard ratio 0.41; P <0.001). In addition, significantly fewer patients in the intensive-therapy group than in the conventional-therapy group developed microvascular complications (P  0.01 for all outcomes investigated).

Reference:
Gaede P, Lund-Andersen H, Parving HH, Pedersen O: Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 358: 580-591, 2008.