Yes, very necessary. In Type 2 diabetes diabetes, the major problem is complications from large artery disease and it has not been known whether more intensive therapy would be helpful, particularly as there was concern about whether in the long term some therapies could themselves cause large vessel disease. In addition, no larger scale studies had been done to show whether improved blood pressure control was effective. After 10 years of diabetes, the people with diabetes in the study had a 2-fold greater mortality than the general population. The study has also shown that after 10 years one third have a complication that requires clinical attention, including heart attacks, strokes, laser treatment of the eyes, treatment for renal failure or amputations.
Patients also develop cataracts requiring surgery.
The study was set up so that physicians could have a sound basis for deciding which treatments they should prescribe to patients. The patients were randomly allocated to different therapies, diet, sulphonylurea tablets, metformin tablets or to insulin. The therapies studied were each shown to be effective. Therefore in 1987, an additional study was set up in over 1100 people with diabetes and a high blood pressure. The tight blood pressure control policy decreased the risk of diabetic complications.