Yesterday, a new paper was published in the Journal of the American Medical Association (JAMA) by the authors of the groundbreaking DCCT study and its follow-on study EDIC.
Recall that this is the study, which ended in 1993, that showed that complications could be reduced by more than 60% with intensive control of blood sugar. The intensive control group had an A1C target of 7%.
The original study looked at microvascular complications (eye, kidney, etc damage). The follow on study looked at cardiovascular disease.
This study compares the two groups 27 years later to see if all-cause mortality was reduced or not. The results show that mortality in the intensive control group was reduced by 33%, just by being under intensive control for the first 7 years (after the initial study ended, A1C's in the two groups were about the same). Hypoglycemia did not lead to a higher overall death rate in the intensive control group.
The full paper can be read here:
http://jama.jamanetwork.com/article.aspx?articleid=2088851
A video interview with one of the authors is here:
http://jama.jamanetwork.com/multimediaPlayer.aspx?mediaid=8658352
The editorial in the same issue of JAMA talks about how while there is overwhelming evidence that tight control improves both complications and longevity in T1D, the average patient still has suboptimal A1c at 8.3%...so we have more room to improve in clinical treatment.
http://jama.jamanetwork.com/article.aspx?articleid=2088833
Newspaper story on the article here - as with most newspaper articles, it is not quite clear as compared to the real journal article: