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Table 1 Treatment recommendations in the intensive treatment arm

From: The ADDITION-Cambridge trial protocol: a cluster – randomised controlled trial of screening for type 2 diabetes and intensive treatment for screen-detected patients

  Target Baseline 2 months
If above
target
4 months
If above
target
6 months
If above
target
9 months
If above
Target
12 months
If above
target
HbA1c <7.0% Diet HbA1c >6.5%
Metformin
(avoid using metformin
if creatinine level
>130 μmol/L)
HbA1c >6.5%
add a second
medication
Metformin
or PGR or
SU or TZD
HbA1c >6.5%
add a third
medication
Metformin
or PGR or
SU or TZD
Continue oral
hypoglycaemic
medication and
consider adding
insulin
As for 9
months
Blood
Pressure
135/85mmHg >120/80 mmHg
or CVD+
ACE Inhibitor
titrated to
maximum dose
If bp >135/85 mmHg
Add a Thiazide
diuretic or Ca
Antagonist (Change
ACE to ACE2
if creatinine
>130 μmol/L
or K+ >5.0 mmol/L
or intolerable side
effects)
As for 2 months If bp >135/85
mmHg
Add β blocker
orα Blocker
As for 6 months As for 6
months
Cholesterol
†IHD-
<5.0mmol/l Chol ≥ 3.5 mmol/l,
diet & statin
Chol >5.0 mmol/l
Increase statin
dose up to
maximum(If
CK> 1800 U/L,
stop statin)
As for 2 months Consider adding a
fibrate if
Chol >5.0 mmol/l
As for 6 months As for 6
months
Cholesterol
IHD+
<4.5mmol/l chol ≥ 3.5 mmol/,
diet & statin
Chol >4.5 mmol/l
Increase statin
dose up to
maximum(If
CK> 1800 U/L,
stop statin)
As for 2 months Consider adding a
fibrateif
Chol >5.0 mmol/l
As for 6 months As for 6
months
Acetylsalycilic acid 75 mg of aspirin daily to all patients without specific contraindications
  1. SU = Sulphonylurea, PGR = Prandial glucose regulator, ACE = angiotensin converting enzyme, TZD = thiazolinedione, ACE2: Angiotensin- II receptor Antagonist, K+: potassium, Ca: Calcium, IHD- = no history of ischaemic heart disease, IHD+ = history of ischaemic heart disease, CVD+ = Previous cardiovascular event or presence of cardiovascular risk factor other than diabetes, bp = blood pressure, Chol = cholesterol