Intensive Insulin Treatment for Type 1 Diabetes
Mary Perry Alexander
Takara Stanley
The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus
The Diabetes Control and Complications Trial (DCCT) Research Group. N Engl J Med. 1993;329(14):977–986
Background
Many patients with type 1 diabetes mellitus (T1DM) develop severe complications such as retinopathy, nephropathy, neuropathy, and cardiovascular disease. In the late 1980s, it was not certain whether these complications were related to insulin use or hyperglycemia. This study sought to assess whether tighter glucose control reduced complications.
Objectives
To determine whether intensive insulin treatment for T1DM decreased the frequency and severity of complications such as retinopathy and nephropathy.
Methods
Randomized controlled trial at 29 US centers from 1983 to 1989.
Patients
1,441 total patients ages 13 to 39 years with insulin-dependent T1DM: 726 primary-prevention patients with no retinopathy or nephropathy (albumin excretion ratio <40 mg/24 h) and 715 secondary-prevention patients with mild-to-moderate retinopathy and nephropathy (albumin excretion ratio <200 mg/24 h). Select exclusion criteria: hypertension, hypercholesterolemia, severe medical conditions.
