ADDITION-EUROPE (Anglo- Danish- Dutch Study of intensive Treatment in People with Screen-Detected Diabetes in Primary Care) is an international, population-based screening and intervention study for type 2 diabetes in general practice.

Study aim

The main aim of the study is to examine the effect of intensive, multifactorial treatment compared to routine treatment on cardiovascular disease among people identified with type 2 diabetes by screening. In total participate 379 general practices in the study and 3,057 persons identified with type 2 diabetes by screening were included (Denmark, n=1,533; UK (Cambridge, n=867; Leichester, n=159) and the Netherlands, n=498).

Routine care or intensive care

The general practitioners were randomised to either routine care or the intensive care. The routine care group followed national guidelines for diabetes treatment, while the intensive care group was educated to give intensive, multifactorial treatment according to the treatment algorithm developed for the study.

Five-year follow-up

Primary endpoint data were available for 3055 (99·9%) of the screen-detected participants. The mean duration of follow-up was 5.3 years. The improvements  in cardiovascular risk factors (HbA1c and cholesterol concentrations and blood pressure) were slightly but significantly better in the intensive treatment group. The incidence of first cardiovascular event was 7.2% (13.5 per 1000 person-years) in the intensive treatment group and 8.5% (15.9 per 1000 person-years) in the routine care group (HR: 0.83, 95% CI 0.65–1.05), and of all-cause mortality 6.2% (11.6 per 1000 person-years) and 6·7% (12.5 per 1000 person-years; 0.91, 0.69–1.21), respectively.

Ten-year follow-up

The ten-year follow-up of the ADDITION study is currently taking place and the main results will be presented later this year.