The UK Prospective Diabetes Study (UKPDS): Its legacy for type 2 diabetes management

subjects (> 120% ideal body weight) randomised primarily to metformin, there was a substantial risk reduction for MI (39%, p=0.01) and all-cause mortality (36%, p=0.011). The blood pressure control part of the UKPDS, known as the Hypertension in Diabetes Study (HDS), demonstrated that tight blood pressure control over nine years (mean fall of 160/94 to 144/82 mmHg), with either atenolol or captopril, compared to a less tight blood pressure control group (mean fall of 161/94 to 154/87 mmHg) – a difference of 10/5 mmHg, sustained over the nine years – resulted in significant benefit. There was a reduction in overall risk of microvascular complications by 37% (p=0.0092), diabetes-related deaths by 32% (p=0.0046) but no significant effect was seen in all-cause mortality. After 6 years, 29% of the diabetic subjects required three or more drugs to achieve tight blood pressure control.