Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC)


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Abstract

It is well established that people with diabetes have an increased risk of cardiovascular disease and cardiovascular death compared to people without diabetes. Until recently there has been a lack of information on cardiovascular risk reduction in people with type 1 diabetes, especially the younger population. Previous studies looking specifically at glycaemic control have been few in number and the results inconsistent. The DCCT trial demonstrated that a period of intensive insulin therapy and improvement in HbA1c% reduced the incidence and progression of microvascular complications, but macrovascular events were not significantly reduced. The DCCT/EDIC study was the long-term observational follow up of patients from DCCT, and was used to evaluate whether intensive therapy reduced cardiovascular events in patients with type 1 diabetes. The patients treated intensively in the original DCCT trial had a 42% reduction in any first cardiovascular event when compared to the conventionally treated group, and the risk of first occurrence of non-fatal myocardial infarction, stroke or death from cardiovascular disease was reduced by 57%. DCCT/EDIC provides us with long-term, objective documentation of glycaemic control and its relationship to cardiovascular complications. However, until we find methods of bringing down HbA1c% without the added problem of frequent hypoglycaemia, we may find it difficult to translate these findings into our everyday practice. Copyright © 2007 John Wiley & Sons.

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