http://www.medpagetoday.com/MeetingCoverage/ADA/40047
CHICAGO -- Benefits seen with intensive therapy for type 1 diabetes in a large epidemiological study persist through extended follow-up, according to the latest data from the Diabetes Control and Complications Trial (DCCT) and Epidemiology of Diabetes Interventions and Complications (EDIC) trial.
Action Points
This study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
Benefits seen with intensive therapy for type 1 diabetes in a large epidemiological study persist through extended follow-up.
Point out that over 18 years, patients who had intensive management -- achieving a glycated hemoglobin (HbA1c) target of 7% -- had a lower risk of retinopathy, a reduced risk of microalbuminuria, and a lower risk of macroalbuminuria.
Over 18 years, patients who had intensive management -- hitting a glycated hemoglobin (HbA1c) target of 7% -- had a 46% lower risk of retinopathy, a 39% reduced risk of microalbuminuria, and a 61% lower risk of macroalbuminuria (P<0.0001 for all), several investigators involved in the trial reported during a special symposium at the American Diabetes Association (ADA) meeting here. "As we follow this population longer, we've been able to show that early benefits with regard to early complications has extended," study co-chair David Nathan, MD, of Massachusetts General Hospital (MGH) in Boston, told MedPage Today. "We've demonstrated that loss of kidney function is reduced, people develop less severe eye complications, and we see a host of other benefits on long-term severe complications that we didn't see during the initial trial because the patients were too young and had diabetes for a relatively short period of time." The 10-year DCCT was followed by the ongoing EDIC trial, and has now been running for a total of 30 years. The DCCT revealed that intensive therapy -- lowering HbA1c to 7% rather than the 9% which was standard practice at the time -- in patients with type 1 diabetes diminished a range of complications about 35% to 75%, establishing intensive therapy as the standard of care. The trial was extended into EDIC and Judith Fradkin, MD, director of diabetes at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) said during a press briefing that 95% of trial patients who are still alive continue to participate in the trial.