Diabetes was defined by use of an oral glucose tolerance test done every 2 years during the trial (1986–92) and in 2006 or 2016 at the follow-up examinations, or from self-reported physician-diagnosed diabetes, or evidence of increased plasma glucose concentrations in the medical record or of the participant receiving glucose-lowering medications. Cardiovascular disease (CVD) events were defined as non-fatal or fatal myocardial infarction or sudden death, hospital admission for heart failure, or non-fatal or fatal stroke. Composite microvascular disease was defined as an aggregate outcome of retinopathy, nephropathy, and neuropathy. CVD deaths were defined as death due to myocardial infarction, sudden death, heart failure, or stroke. HR=hazard ratio (intervention vs control); p values derived from Cox proportional-hazards models, controlled for clinic randomisation.