Pedro J. Martinez, M.D. - Hope Diabetes Center - ARP (2001-2009)
U.K. Prospective Diabetes Study (1977 - 1998)
The objective of the U.K. Prospective Diabetes Study (UKPDS), initiated in 1977, was set up to determine whether improved blood glucose control in people with type 2 diabetes will prevent complications of diabetes. The UKPDS was also designed to determine whether there are differences between conventional policy (diet therapy) and three different regimens of intensive treatment policy, based on sulfonylurea, metformin, or insulin. Interim efficacy analyses revealed that the intensive policies with sulfonylurea, insulin and metformin were equally effective in reducing fasting plasma glucose concentrations. However, glucose and HbA1c (A1C) measurements steadily increased with time, reflecting ongoing deterioration of beta cell function. Cardiovascular disease was the major cause of complications, and the risk factors included raised LDL cholesterol concentrations, low HDL cholesterol complications, elevated blood pressure, elevated A1C concentrations, and smoking. A final study report was issued in September 1998, when the median duration of therapy was 11 years.
Summary and Comparisons
You will note in the UKPDS graph that in the conventionally treated patients, their A1C levels continued to climb after their initial evaluation, from almost 7 to 8.5 over a 10-year period. You will also note that the aggressive treatment protocols provided by this study succeeded in reducing the patients’ A1C levels down in various degrees due to the various treatments.
Nevertheless, the positive results lasted only ONE YEAR, after which they returned to their previous high levels.
They proved that a singular treatment regimen was ineffective in controlling the A1C levels past the first year – leading researchers to conclude that the subject patients’ beta cell functions had again begun to deteriorate. It is interesting to note that insulin treatments were the least effective of the group, but none of the treatments were effective in reducing A1C levels past the first year.
Dr. Martinez’ study, as overlaid on the UKPDS graph, reveals that more than 90% of the patients being treated by his multidisciplinary protocols were reduced to A1C levels of less that 6.0 within the first year – and critically important – remained there as long as they remained in his (DWCoA’s) program.
This raises the serious possibility of his patients’ beta cells being regenerated over time – Previously thought to be impossible.