The case against aggressive treatment of type 2 diabetes: critique of the UK prospective diabetes study Commentary: UKPDS is well designed and clinically important
| Autor: | R M Ewart, R. R Holman, D. R Matthews, T. Meade |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Research design
medicine.medical_specialty business.industry General Engineering MEDLINE General Medicine Type 2 diabetes medicine.disease Surgery law.invention Clinical trial Randomized controlled trial law Diabetes mellitus Family medicine General Earth and Planetary Sciences Medicine Prospective cohort study business Mass screening General Environmental Science |
| Zdroj: | BMJ. 323:854-858 |
| ISSN: | 1468-5833 0959-8138 |
| Popis: | The case against aggressive treatment of type 2 diabetes: critique of the UK prospective diabetes study {#article-title-2} #### Summary points During the course of the UK prospective diabetes study the length of follow up was changed, and changes seem to have been made to the end points and the groups under analysis These changes are not in keeping with accepted scientific principles and make the results of the trial suspect An independent review of the trial's design and analysis is needed The results of the study do not justify aggressive treatment of type 2 diabetes I searched Medline (Ovid's CD version) from 1976 to March 2000, using various combinations of the keywords “UKPDS” and “prospective diabetes study” and the names of the principal authors of the study's reports. I reviewed the resulting articles for any description of the design of the UKPDS. I reviewed reference lists for other references. The authors have presented various end points over the life of the study (box). The UKPDS grew originally out of the authors' interest in the use of basal rather than postprandial glucose in monitoring diabetes. They concluded, “A prospective controlled trial of different ways of obtaining basal normoglycaemia is needed to determine whether the improved control of mild diabetes is beneficial.”3 In the first report of the study, published in 1983, the authors set out their rationale: “If, after dietary therapy, the fasting plasma glucose continues to be raised, there is little information available to determine whether one should continue with diet alone, or add a sulphonylurea, biguanide or insulin.”4 Specific end points were not laid out in this original description but were set out the following year in a letter discussing the paper. 4 5 The authors later argued (1999) that this “brief letter” had only “minor differences in wording.”6 It seems, however, that the letter was written specifically to clarify the vagueness and ambiguities of the … Correspondence to: R Holman |
| Databáze: | OpenAIRE |
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