Muhammad Kamel Frozanfar, Nobuyuki Hamajima, Said Hafizullah Fayaz, Abdullah Darman Rahimzad, Hedayatullah Stanekzai, Souphalak Inthaphatha, Kimihiro Nishino, Eiko Yamamoto
Factors associated with pentavalent vaccine coverage among 12-23-month-old children in Afghanistan: A cross-sectional study
PloS one
20year uk prospective diabetes study showed major clinical benefits people newly diagnosed type 2 diabetes randomly allocated intensive glycaemic control sulfonylurea insulin therapy metformin therapy compared conventional glycaemic control 10year posttrial followup identified enduring emerging glycaemic metformin legacy treatment effects aimed determine whether effects would wane extending followup another 14 years 5102 patients enrolled 1977 1991 4209 825 participants originally randomly allocated receive either intensive glycaemic control sulfonylurea insulin overweight metformin conventional glycaemic control primarily diet end 20year interventional trial 3277 surviving participants entered 10year posttrial monitoring period ran sept 30 2007 eligible participants study surviving participants end 10year posttrial monitoring period extended followup participants done linking routinely collected national health service nhs data another 14 years clinical outcomes derived records deaths hospital admissions outpatient visits accident emergency unit attendances examined seven prespecified aggregate clinical outcomes ie diabetesrelated endpoint diabetesrelated death death cause myocardial infarction stroke peripheral vascular disease microvascular disease randomised glycaemic control strategy intentiontotreat basis using kaplanmeier timetoevent logrank analyses study registered isrctn registry number isrctn75451837 oct 1 2007 sept 30 2021 1489 976 1525 participants could linked routinely collected nhs administrative data mean age baseline 502 years sd 80 413 female mean age still alive sept 30 2021 799 years sd 80 individual followup baseline ranged 0 42 years median 175 years iqr 123268 overall followup increased 21 66 972 80 724 personyears 24 years trial end glycaemic metformin legacy effects showed sign waning early intensive glycaemic control sulfonylurea insulin therapy compared conventional glycaemic control showed overall relative risk reductions 10 95 ci 217 p0015 death cause 17 626 p0002 myocardial infarction 26 1436 p00001 microvascular disease corresponding absolute risk reductions 27 33 35 respectively early intensive glycaemic control metformin therapy compared conventional glycaemic control showed overall relative risk reductions 20 95 ci 532 p0010 death cause 31 1246 p0003 myocardial infarction corresponding absolute risk reductions 49 62 respectively significant risk reductions trial stroke peripheral vascular disease observed intensive glycaemic control groups significant risk reduction microvascular disease observed metformin therapy early intensive glycaemic control sulfonylurea insulin metformin compared conventional glycaemic control appears confer nearlifelong reduced risk death myocardial infarction achieving near normoglycaemia immediately following diagnosis might essential minimise lifetime risk diabetesrelated complications greatest extent possible university oxford nuffield department population health pump priming