Intensive drug therapy for type 2 diabetics is as effective at reducing the risk of death as prompt bypass surgery or angioplasty, U.S. researchers said.

The same proportion diabetic heart patients -- 88 percent -- were alive after five years whether doctors used a surgical or non-surgical approach to treatment, researchers reported at the American Diabetes Association Sunday.
Likewise, there was no statistical difference in how likely patients were to remain free of heart attack, stroke and other major heart problems.

The study, a multicenter trial led by the University of Pittsburgh Graduate School of Public Health, took place at 49 medical centers in six countries over five years.

"It's the first time any randomized clinical trial has shown a reduction in non-fatal heart attack rates in stable patients with diabetes and heart disease," said cardiologist Robert Frye, a professor of medicine at the Mayo Clinic and a study chairman.

The study evaluated two surgery approaches as well as a drug-focused approach in 2,368 people with type 2 diabetes and stable coronary artery disease to help determine the best way to reduce deaths and cardiovascular events (heart attacks and stroke).

For controlling diabetes, the found that drugs that increase insulin levels are as effective as those that increase the body's sensitivity to insulin and that no significant side effects are associated with either approach.

"The insulin sensitization drugs are not harmful . . . and may be a little better," said Dr. Trevor Orchard of the University of Pittsburgh, who led the study.

The patients who received them "didn't gain as much weight, had less hypoglycemia and it was easier for them to get control" of their diabetes, he said.

Experts noted, however, that the study covered only a relatively narrow range of patients -- those whose cardiovascular disease is largely asymptomatic. For those with severe blockage and strong symptoms, "medical therapy is not enough, and revascularization [surgically reopening arteries] may be a safe and effective option for improving their quality of life," said Dr. Steven R. Bailey of the University of Texas Health Science Center at San Antonio, president of the Society for Cardiovascular Angiography and Interventions.

Source: Xinhua