HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content Social Bookmarking                What's this?

Implications of the Diabetes Control and Complications Trial

	INTRODUCTION

 
The Diabetes Control and Complications Trial (DCCT) is a landmark multicenter trial designed to test the proposition that the complications of diabetes mellitus are related to elevation of the plasma glucose concentration. The study design was simple. Two groups of patients were followed long term, one treated conventionally (goal: clinical well-being; called the standard treatment group) and another treated intensively (goal: normalization of blood glucose; called the intensive treatment group). The intensive treatment group was clearly distinguished from the standard treatment group in terms of glycated hemoglobin levels and capillary blood glucose values throughout the duration of the study. Normalization of glucose values was not achieved in the intensively treated cohort as a group because mean glucose values were 40% above normal limits. Nonetheless, over the study period, which averaged 7 years, there was an 60% reduction in risk between the intensive treatment group and the standard treatment group in diabetic retinopathy, nephropathy, and neuropathy. The benefit of intensive therapy resulted in a delay in the onset and a major slowing of the progression of these three complications. Finally, the benefits of intensive therapy were seen in all categories of subjects regardless of age, sex, or duration of diabetes.

The American Diabetes Association believes that the study has both statistical and clinical significance. The DCCT is the longest and largest prospective study showing that lowering blood glucose concentration slows or prevents the development of diabetic complications. As such, it has major therapeutic implications for health care providers and their patients. Many questions remain to be answered, but the following conclusions appear warranted:

1. A primary treatment goal in type 1 diabetes should be blood glucose control at least equal to that achieved in the intensively treated cohort. This goal may not apply to all patients with type 1 diabetes and must . . . [Full Text of this Article]

	THE AMERICAN DIABETES ASSOCIATION RESPONSE TO THE DCCT

	Footnotes

	Bibliography

CiteULike

Del.icio.us

Digg

Reddit

Technorati