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Stockholm Diabetes Intervention Study (SDIS)

Stockholm Diabetes Intervention Study (SDIS). Stockholm Diabetes Intervention Study (SDIS): Index to slides. 1. Goals 2. Overview 3. Design 4. Management regimens 5. Effects of management on microvascular complications 6. Conclusions. SDIS: Goals.

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Stockholm Diabetes Intervention Study (SDIS)

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  1. Stockholm DiabetesIntervention Study(SDIS)

  2. Stockholm Diabetes Intervention Study (SDIS): Index to slides 1. Goals 2. Overview 3. Design 4. Management regimens 5. Effects of management on microvascular complications 6. Conclusions

  3. SDIS: Goals • To determine whether improvements in glycaemic control are maintained after treatment groups return to routine care Reichard et al. N.Eng.J.Med. 1993;329:304–309.

  4. SDIS: Overview • 10-year, prospective, randomised trial • 102 people with Type 1 diabetes • unsatisfactory glycaemic control • nonproliferative retinopathy • normal serum creatinine • patients with albuminuria not excluded Reichard et al. N.Eng.J.Med. 1993;329:304–309.

  5. SDIS: Design Type 1 diabetes (n=102) Randomisation Conventional management (n=48) Intensive management (n=54) Reichard et al. N.Eng.J.Med. 1993;329:304–309.

  6. SDIS: Management regimens • Conventional management regimen • 1–2 insulin injections daily • treatment goal • to prevent hyperglycaemic symptoms and hypoglycaemia • Intensive management regimen • at least 3 insulin injections daily or continuous pump infusion of insulin • blood glucose measured at least 4 times daily and insulin doses adjusted to maintain normoglycaemia Reichard et al. N.Eng.J.Med. 1993;329:304–309.

  7. SDIS: Effects of management on microvascular complications Intensive Conventional Risk reduction (patients avoidingcomplication) Serious retinopathy (%) 33 63 29 Nephropathy (%) 7 26 20 Symptoms of 14 32 19 neuropathy (%) Reichard et al. Diabetologia 1996;39:1483–1488.

  8. SDIS: Conclusions • Intensive insulin therapy delays the onsetand slows the progression of microvascular complications in people with Type 1 diabetes Reichard et al. Diabetologia 1996;39:1483–1488.

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