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Pathophysiology/Complications

β-Cell Function and the Development of Diabetes-Related Complications in the Diabetes Control and Complications Trial

  1. Michael W. Steffes, MD, PHD1,
  2. Shalamar Sibley, MD, MPH2,
  3. Melissa Jackson, MPH3 and
  4. William Thomas, PHD3
  1. 1Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota
  2. 2Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
  3. 3Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, Minnesota
    Diabetes Care 2003 Mar; 26(3): 832-836. https://doi.org/10.2337/diacare.26.3.832
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      Figure 1—

      Percentages of subjects who experienced at least one episode of severe hypoglycemia over the first 6 years of the DCCT. χ2 analysis among the groups: intensive (P = 0.001); conventional (P = 0.006).

    Tables

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    • Table 1—

      Demographic characteristics of the DCCT subjects

      Stimulated C-peptide group
      UndetectableMinimalBaseline-onlySustained
      n (%)634 (44)519 (36)130 (9)159 (11)
      Intensive therapy* (%)52483655
      Retinopathy at baseline* (%)7341819
      Female (%)50454149
      Age (years) (%)26 ± .3a27 ± .3a27 ± .3ab29 ± .6b
      Duration (years)8.2 ± .1a4.5 ± .1b1.9 ± .3c2.3 ± .3c
      HbA1c at eligibility9.3 ± .1a9.2 ± .1a8.4 ± .1b8.4 ± .1b
      HbA1c at baseline9.0 ± .1a9.0 ± .1a8.4 ± .1b8.2 ± .1b
      AER (mg/24 h) (95% CI)13.5a (12.6–14.4)10.0b (9.4–10.7)9.2b (8.3–10.7)9.7b (8.7–10.7)
      • *

        ↵* Percentages differ significantly (χ2 test, P < 0.005). Where stimulated C-peptide group means differed significantly (P < 0.05), the groups with the same letter were indistinguishable. Data are n (%), %, means ± SE, or means (95% CI). All statistical comparisons are between stimulated C-peptide groups within a single row.

    • Table 2—

      Retinopathy (a single three-step change on the ETDRS scale) and albuminuria (a single event >40 mg/24 h) during the first 6 years of the DCCT, by stimulated C-peptide group

      Stimulated C-peptide group
      All
      UndetectableMinimalBaseline-onlySustained
      Retinopathy
        All7.8 ± 0.5a5.7 ± 0.5b5.2 ± 0.9bc3.5 ± 0.7c6.3 ± 0.3
        Intensive6.5 ± 0.7a3.5 ± 0.5b1.8 ± 0.9bc1.4 ± 0.6c4.5 ± 0.4
        Conventional9.2 ± 0.8a7.9 ± 0.8a7.3 ± 1.4a6.3 ± 1.4a8.2 ± 0.5
      Albuminuria
        All4.4 ± 0.4a2.7 ± 0.3b3.1 ± 0.7ab1.4 ± 0.4c3.3 ± 0.2
        Intensive4.0 ± 0.5a2.3 ± 0.4b1.7 ± 0.9bc0.9 ± 0.5c2.9 ± 0.3
        Conventional4.9 ± 0.6a2.9 ± 0.5b3.9 ± 1.0ab2.1 ± 0.8b3.8 ± 0.3
      • Data are rates ± SE per 100 participant-years. Rates were compared (horizontally) between stimulated C-peptide groups. For each comparison, rates with different letters were significantly different (P < 0.05), while rates sharing the same letter were indistinguishable.

    • Table 3—

      Hypoglycemia: first occurrence during the first 6 years of the DCCT, by stimulated C-peptide group and by treatment group

      Stimulated C-peptide group
      All
      UndetectableMinimalBaseline-onlySustained
      All13 ± 1a10 ± 1b7 ± 1c6 ± 1c12 ± 0.5
      Intensive21 ± 1a16 ± 1b17 ± 3ab7 ± 1c16 ± 0.8
      Conventional8 ± 1a6 ± 1b3 ± 1c5 ± 1bc6 ± 0.4
      • Data are rates ± SE per 100 participant-years. Rates were compared among stimulated C-peptide groups (horizontally) with each treatment group. For each comparison, rates with different letters were significantly different (P < 0.05), while rates sharing the same letter were indistinguishable.

    • Table 4—

      Hypoglycemia: first occurrence during the first 6 years of the DCCT, by stimulated C-peptide group and by HbA1c category

      Stimulated C-peptide groupHbA1c category
      <7.5%7.5–9.0%>9.0%
      Undetectable23 ± 2a13 ± 1b4 ± 1c
      Minimal20 ± 2a8 ± 1b3 ± 1c
      Baseline-only21 ± 4a4 ± 1b2 ± 1b
      Sustained8 ± 1a6 ± 0.2a1 ± 0.7b
      All19 ± 19 ± 0.73 ± 0.4
      • Data are rates ± SE per 100 participant-years. Rates were compared among HbA1c categories (horizontally) within each stimulated C-peptide group. For each comparison, rates with different letters were significantly different (P < 0.05), while rates sharing the same letter were indistinguishable.

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    Diabetes Care: 26 (3)

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    β-Cell Function and the Development of Diabetes-Related Complications in the Diabetes Control and Complications Trial
    Michael W. Steffes, Shalamar Sibley, Melissa Jackson, William Thomas
    Diabetes Care Mar 2003, 26 (3) 832-836; DOI: 10.2337/diacare.26.3.832

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    β-Cell Function and the Development of Diabetes-Related Complications in the Diabetes Control and Complications Trial
    Michael W. Steffes, Shalamar Sibley, Melissa Jackson, William Thomas
    Diabetes Care Mar 2003, 26 (3) 832-836; DOI: 10.2337/diacare.26.3.832
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