The largest-ever study of treatments for diabetes has shown that a combination of two blood pressure-lowering drugs reduces the risk of death, heart attack and kidney disease in diabetes sufferers. The "Action in diabetes and vascular disease" (ADVANCE) project involves 20 countries from around the world, 12 of them from the EU. The results were presented at the European Society of Cardiology Congress in Vienna, Austria, on 3 September.

A total of 11,140 patients took part in trials, which lasted over four years. Half of the participants received a fixed combination of two blood pressure-lowering drugs (perindopril and indapamide) in a single tablet, daily. The other half received a matching inactive placebo.

"These results represent an important step forward in health care for millions of people with diabetes worldwide," said Professor Stephen MacMahon from the George Institute for International Health in Australia. "This treatment reduced the likelihood of dying from the complications of diabetes by almost one-fifth, with virtually no side-effects."

Type 2 diabetes is the most common form of diabetes, mostly affecting adults. Sufferers are known to be at a high risk of developing major health problems earlier in life than those without diabetes. In particular, sufferers are more likely to experience a heart attack, stroke, blindness, kidney failure and leg ulcers that can lead to amputation.

The study participants were already receiving most of the standard treatments for diabetes, including other drugs to lower blood pressure. But the precise combination used in this study resulted in a 14% reduction in the risk of death, and an 18% reduction in the risk of death from cardiovascular disease. "In absolute terms, one death would be avoided for every 79 patients treated with the fixed combination of perindopril and indapamide for five years," said Study Director Dr Anushka Patel, also from the George Institute.

Currently around 250 million people worldwide have diabetes, and this number is growing rapidly. The majority of these people will either die or become disabled by the complications inherent in their condition.

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