{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T13:33:36Z","timestamp":1781530416458,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T00:00:00Z","timestamp":1545177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006149","name":"Oxford University Hospitals NHS Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006149","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Diabetes treatment algorithms recommend intensive intervention in those with a shorter duration of disease. Screening provides opportunities for earlier multifactorial cardiovascular risk factor control. Using data from the ADDITION\u2010Leicester study (NCT00318032), we estimated the effects of this approach on modelled risk of diabetes\u2010related complications in screen\u2010detected patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 345 (41% South Asian) people with screen\u2010detected type 2 diabetes were cluster randomised to receive 5\u00a0years of (1) intensive multifactorial risk factor intervention or (2) standard treatment according to national guidance. Estimated 10 to 20\u2010year risk of ischaemic heart disease, stroke, congestive cardiac failure, and death was calculated using UK\u2010PDS risk equations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with standard care, mean treatment differences for intensive management at 5\u00a0years were \u221211.7(95%CI: \u221215.0, \u22128.4) and \u22126.6(\u22128.8, \u22124.4) mmHg for systolic and diastolic blood pressure, respectively; \u22120.27 (\u22120.66, \u22120.26) % for HbA1c; and \u22120.46(\u22120.66; \u22120.26), \u22120.34 (\u22120.51; \u22120.18), and \u22120.19 (\u22120.28; \u22120.10) mmol\/L for total cholesterol, LDL\u2010cholesterol, and triglycerides, respectively. There was no significant weight gain in the intensive group despite additional medication use. Modelled risks were consistently lower for intensively managed patients. Absolute risk reduction associated with intensive treatment at 10 and 20\u00a0years were 3.5% and 6.2% for ischaemic heart disease and 6.3% and 8.8% for stroke. Risk reduction for congestive heart failure plateaued after 15\u00a0years at 5.3%. No differences were observed for blindness and all\u2010cause death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Intensive multifactorial intervention in a multi\u2010ethnic population with screen\u2010detected type 2 diabetes results in sustained improvements in modelled ischaemic heart disease, stroke, and congestive cardiac failure.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dmrr.3111","type":"journal-article","created":{"date-parts":[[2018,12,6]],"date-time":"2018-12-06T21:43:03Z","timestamp":1544132583000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Intensive versus standard multifactorial cardiovascular risk factor control in screen\u2010detected type 2 diabetes: 5\u2010year and longer\u2010term modelled outcomes of the ADDITION\u2010Leicester study"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3932-3339","authenticated-orcid":false,"given":"David","family":"Webb","sequence":"first","affiliation":[{"name":"Leicester Diabetes Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolyon","family":"Dales","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Zaccardi","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sian","family":"Hill","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corran","family":"Moore","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azhar","family":"Farooqi","sequence":"additional","affiliation":[{"name":"National Health Service (NHS) Leicester City Clinical Commissioning Group  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Griffin","sequence":"additional","affiliation":[{"name":"Primary Care Unit Cambridge Institute of Public Health  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Davies","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamlesh","family":"Khunti","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706245"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-016-4065-6"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw106"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-S012"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2840-9-51"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-017-4299-y"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-2459"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2010.11.021"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12410"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60698-3"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30327-3"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-11-16"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-011-2189-2"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-013-2940-y"},{"key":"e_1_2_13_16_1","unstructured":"nomis.Labour Market Profile\u2014Leicester Durham: Office for National Statistics;2017[cited 2017 1st August]. 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