L'etude clinique du mois. L'etude Steno-2: plaidoyer pour une prise en charge globale et intensive du patient diabetique de type 2.

Cardiovascular morbidity is a major burden in patients with type 2 diabetes. The Steno-2 Study compared the effect of a targeted, intensified, multifactorial intervention (n = 80) with that of a conventional treatment (n = 80) on modifiable risk factors for cardiovascular disease in patients with type 2 diabetes and microalbuminuria. After a mean follow-up of 7.8 years, the risk of cardiovascular events was reduced by 53% in the intensive group, and the risk of microvascular events (nephropathy, retinopathy, autonomic neuropathy) by 58-63%. Thus, a target-driven, long-term, intensified intervention aimed at multiple risk factors should be recommended in patients with type 2 diabetes and microalbuminuria.