1. Controlling the blood sugar
2. Prevention of complications
3. Management of complications as and when they occur.

The ultimate purpose of the above is to ensure long term survival with as few complications as possible.  To that end one needs to identify the various organs/systems that tend to be more affected in diabetes, especially uncontrolled diabetes and to try to prevent problems, or at the very least, delay the onset of problems, and if they do occur, to manage them.

Diabetes is a multi-organ problem as far as complications are concerned.  The major more common areas that are affected are:

1. The central nervous system
2. The skin
3. The kidneys
4. The eyes
5. The limbs
6. The heart

These will be dealt with in other posts.

Professor Chan was principal investigator of the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation Trial) team at the University of Malaya
Medical Centre, one of the five participating centers in Malaysia.

“What we can say from ADVANCE is that if we lower sugar blood level safely towards normal, without causing hypoglycemia and weight gain, we can reduce the complications from diabites,” Chan told the audience in a media tutorial organized by Servier Malaysia, to announce the results of the ADVANCE blood glucose arm.

“Importantly, we did not see an excess of death from improving glucose control down to normal. I think that is a very important point. And although we did not see a clear benefit in terms of reducing heart attacks or
stroke, we did not cause more harm to our patients.”

The ADVANCE glucose arm showed a significant reduction in the risk of serious complications among intensively controlled patients – a 10 percent relative risk reduction in combined major macro- and microvascular events.

Chan said this reduction was mainly due to the 21 percent relative decrease in new or worsening nephropathy in patients treated intensively. Severe proteinuria was noted reduced in intensively controlled diabetes patients.