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Tight glucose control lowers CVD by about 50 percent in diabetes

A significantly lower risk of heart disease can now be added to the list of proven long-term benefits of tight glucose control in people with type 1 diabetes. Researchers announced this finding today at the annual scientific meeting of the American Diabetes Association after analyzing cardiovascular (CVD) events such as heart attack, stroke, and angina in patients who took part in the Diabetes Control and Complications Trial (DCCT) years ago.

"The longer we follow patients, the more we're impressed by the lasting benefits of tight glucose control," said Saul Genuth, M.D., of Case Western University. Dr. Genuth chairs the follow-up study of DCCT participants, called the Epidemiology of Diabetes Interventions and Complications (EDIC) study, which has been looking at the long-term effects of prior intensive versus conventional blood glucose control. "The earlier intensive therapy begins and the longer it is maintained, the better the chances of reducing the debilitating complications of diabetes."

The DCCT was a multicenter study that compared intensive management of blood glucose to conventional control in 1,441 people with type 1 diabetes. Patients 13 to 39 years of age were enrolled in the trial between 1983 and 1989. Those randomly assigned to intensive treatment kept glucose levels as close to normal as possible with at least three insulin injections a day or an insulin pump, guided by frequent self-monitoring of blood glucose. Intensive treatment meant keeping hemoglobin A1c (HbA1c) levels as close as possible to the normal value of 6 percent or less. (The HbA1c blood test reflects a person's average blood sugar over the past 2 to 3 months.) Conventional treatment at the time consisted of one or two insulin injections a day with daily urine or blood glucose testing.

In 1993, researchers announced the DCCT's main findings: intensive glucose control greatly reduces the eye, nerve, and kidney damage of type 1 diabetes. Tight con
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17-Jun-2005


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