Evaluations of retinopathy in the VA Cooperative Study on Glycemic Control and Complications in Type II Diabetes (VA CSDM). A feasibility study

Diabetes Care
N V EmanueleN Johnson-Nagel

Abstract

The main goal of the study of 153 male veterans was to determine whether a statistically and clinically significant difference in HbA1c could be achieved between a standard therapy and an intensively treated group of patients with type II diabetes. A second major goal was to assess the feasibility of collecting reliable high-quality endpoint data, including microvascular and macrovascular events. Retinopathy was defined as a key microvascular endpoint. This was a randomized prospective trial of 153 men between the ages of 40 and 69 years, with type II diabetes for 15 years or less. Of the patients, 78 were assigned to the standard therapy arm and 75 to the intensive therapy arm. The goal of standard therapy was good general medical care and well-being and avoiding excessive hyperglycemia, glycosuria, ketonuria, or hypoglycemia. This was generally accomplished with one shot of insulin per day. The goal of intensive therapy was to obtain an HbA1c within two standard deviations of the mean of nondiabetic subjects (4.0-6.1%). This was obtained by a four-step management technique, with patients moving to the next step only if operational goals were not met. The steps were as follows: step 1: evening intermediate or long-acting insul...Continue Reading

Citations

Dec 1, 2001·Endocrinology and Metabolism Clinics of North America·S Mudaliar, S V Edelman
Sep 2, 2009·Diabetes Research and Clinical Practice·Nicholas EmanueleUNKNOWN Veterans Affairs Diabetes Trial Study Group
May 26, 1998·American Journal of Surgery·R A YeagerJ M Porter
Jul 5, 2005·Journal of Diabetes and Its Complications·Shailesh PitaleUNKNOWN VACSDM Study Group
Jan 9, 2009·Clinical Pharmacology and Therapeutics·B KomoroskiM Pfister
Jul 27, 2005·Diabetes Care·Nicholas EmanueleUNKNOWN Veterans Affairs Diabetes Trial Group
Jun 9, 2017·The Cochrane Database of Systematic Reviews·Marinella RuospoGiovanni Fm Strippoli
Jul 30, 2015·The Cochrane Database of Systematic Reviews·Bianca HemmingsenJørn Wetterslev
Sep 25, 2018·The Cochrane Database of Systematic Reviews·Clement LoSophia Zoungas

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