Results from the world’s largest study of treatment for diabetes have revealed that the joint effects of blood pressure and blood glucose control can reduce serious kidney complications by 33 per cent among patients with type 2 diabetes. These results from Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) were presented on 8 September 2008 at the European Association for the Study of Diabetes (EASD) in Rome.

Previous findings from ADVANCE have shown that tight control of blood glucose with a regimen based on gliclazide (modified release) reduces major kidney complications, while routine blood pressure lowering with the fixed combination of perindopril and indapamide significantly reduces the risk of death, as well as the risks of heart and kidney disease. This new analysis of the joint effects of these two treatments has revealed even greater protection in a multi-factorial approach to treating diabetes.

Chief investigator, Professor John Chalmers from The George Institute for International Health, Australia said, "The combination of routine blood pressure lowering and tighter glucose control in ADVANCE confers very substantial benefits with reductions of one third for serious kidney disease, one quarter for cardiovascular death and close to one fifth for death from any cause. These results provide powerful incentives for the millions of people living with type 2 diabetes."

Diabetes mellitus is one of the greatest threats to the health of populations worldwide. Globally, there are over 250 million people with diabetes and that number is estimated to rise to around 400 million in 2025. ADVANCE was initiated and designed by researchers at Australia’s George Institute for International Health and involved a group of independent medical researchers from 20 countries worldwide. The study involved 11,140 patients with type 2 diabetes who were treated and followed for five years.

The new analysis confirms that the effects of the two treatments are independent of one another for all pre-specified clinical outcomes, suggesting that the separate effects of intensive glucose control and routine blood pressure lowering are fully additive.

The study was designed to determine the separate and the joint effects of routine blood pressure lowering, regardless of the starting blood pressure level, and of tighter glucose control regardless of the starting blood sugar level, on the risks of complications in patients with type 2 diabetes.

"Overall, the ADVANCE study has continued to find positive benefits for people living with type 2 diabetes across the world. Both blood pressure and blood glucose control have important roles to play in diabetes management," concluded Professor Chalmers.