Historically, people with type 1 diabetes tended to die earlier than the general population. Additionally, EDIC has shown that personalizing the frequency of eye screenings for people with type 1 diabetes based on their risk of severe eye problems and A1C level would result in.
These long-term benefits occurred even though all participants had an average A1C of 8 percent during the plus years of the EDIC study. When EDIC began, participants who used conventional treatment were taught about intensive treatment, and received follow-up care from their own health care teams. These people continue to take part in a variety of studies concerning diabetes-related health problems, including hypoglycemia, irregular heartbeats, hearing loss, weakened bones, trouble thinking clearly, physical frailty, and problems with the eyes, kidneys, nerves, feet, bladder, and sexual function.
Researchers are also looking at the small amount of insulin that some EDIC participants continue to make to determine whether it improves their health. Diabetes Control and Complications Trial DCCT DCCT Results The DCCT showed that people with type 1 diabetes who kept their blood glucose levels as close to normal as safely possible with intensive diabetes treatment as early as possible in their disease had fewer diabetes-related health problems after 6.
DCCT showed that people who used intensive treatment lowered their risk of diabetic eye disease by 76 percent; and advancement of eye disease by about half 54 percent , in people with some eye disease at the beginning of the study diabetic kidney disease by 50 percent diabetic nerve disease by 60 percent Researchers were not able to show whether people who used intensive treatment lowered their risk of heart disease during the DCCT, because only a few people had heart disease during the study.
DCCT participants were randomly assigned to one of the following groups intensive diabetes treatment group. Participants took insulin three or more times per day by injection or an insulin pump and self-monitored their blood glucose levels four or more times a day.
The treatment goal was to keep A1C levels as close to normal as safely possible. Participants met with their health care team monthly. The adults and 87 adolescents were randomized either to standard treatment 90 adults and 42 adolescents , designed to approximate conventional diabetes treatment, or to experimental treatment adults and 45 adolescents , designed to achieve near-normal blood glucose and HbA1c concentrations.
With few exceptions, baseline demographic, ophthalmologic, renal, and other medical characteristics were evenly distributed by randomization between the two treatment groups in both age strata. Glycemic control at baseline, as assessed by HbA1c concentrations and by blood glucose profiles, was comparable between the treatment groups in both age strata.
Participants were required to have had diabetes for at least 1 year but no longer than 15 years. Once enrolled, patients were randomized to receive standard therapy, consisting of not more than two injections of insulin per day, or intensive therapy, consisting of either subcutaneous insulin infusion by pump or at least three subcutaneous injections of insulin daily, targeting near-normal glycemia.
Both groups received the same dietary management and education program. Blood glucose and hemoglobin A1c measurements were used as primary indicators of metabolic control. The primary outcome measure was diabetic retinopathy. Other outcome measures included diabetic nephropathy, diabetic neuropathy, and cardiovascular events or their known or putative risk factors. The DCCT study found that intensive therapy showed beneficial effects on retinopathy, nephropathy, and neuropathy when compared with conventional therapy.
Following these findings, the Epidemiology of Diabetes Interventions and Complications EDIC study was initiated as follow-up to examine the long-term effects of the original DCCT interventions on diabetic complications such as cardiovascular events and advanced retinal and renal disease.
Except for an increased incidence of hypoglycemia in the experimental group, the two treatment regimens maintained or improved the clinical well-being of subjects in both groups. The feasibility phase of the DCCT demonstrated that a complex multicenter, randomized study of the relationship between diabetes control and complications can be performed.
The full-scale, long-term trial therefore has been initiated. Sign In or Create an Account. Advanced Search. User Tools. Sign In. Skip Nav Destination Article Navigation. Close mobile search navigation Article navigation. Volume 10, Issue 1.
0コメント