Beneficial effects of intensive therapy of diabetes during adolescence: Outcomes after the conclusion of the Diabetes Control and Complications Trial (DCCT)

Diabetes Control and Complications Trial (DCCT), Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group

Research output: Contribution to journalArticle

330 Citations (Scopus)

Abstract

Objective: The Diabetes Control and Complications Trial (DCCT) demonstrated that intensive therapy of type 1 diabetes mellitus reduces the risk of development and progression of microvascular complications. The Epidemiology of Diabetes Interventions and Complications (EDIC) study assessed whether these benefits persisted after the end of DCCT. Results for the adolescent DCCT cohort are reported here. Study design: Of the DCCT adolescent cohort (n = 195), 175 participated in EDIC, 151 had fundus photography, and 156 had albumin excretion rate measured at year 3 or 4. The odds of progression of retinopathy and albuminuria from closeout of the DCCT until EDIC year 4 were assessed. Results: In contrast to the 7.4 years of the DCCT, during which mean hemoglobin A1c levels were significantly lower with intensive therapy than conventional therapy (8.06% vs 9.76%; P < .0001), the subsequent first 4 years of EDIC had mean hemoglobin A1c levels that were similar between the former intensive and the former conventional groups (8.38% vs 8.45%). However, the prevalence of worsening of 3 steps or more in retinopathy and of progression to proliferative or severe nonproliferative retinopathy were reduced by 74% (P < .001) and 78% (P < .007), respectively, in the former intensive therapy group compared with the former conventional group. Conclusions: These findings provide further support for the DCCT recommendation that most adolescents with type 1 diabetes receive intensive therapy aimed at achieving glycemic control as close to normal as possible to reduce the risk of microvascular complications.

Original languageEnglish (US)
Pages (from-to)804-812
Number of pages9
JournalJournal of Pediatrics
Volume139
Issue number6
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

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Diabetes Complications
Epidemiology
Therapeutics
Type 1 Diabetes Mellitus
Hemoglobins
Albuminuria
Photography
Group Psychotherapy
Albumins

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Diabetes Control and Complications Trial (DCCT), & Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group (2001). Beneficial effects of intensive therapy of diabetes during adolescence: Outcomes after the conclusion of the Diabetes Control and Complications Trial (DCCT). Journal of Pediatrics, 139(6), 804-812. https://doi.org/10.1067/mpd.2001.118887

Beneficial effects of intensive therapy of diabetes during adolescence : Outcomes after the conclusion of the Diabetes Control and Complications Trial (DCCT). / Diabetes Control and Complications Trial (DCCT); Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group.

In: Journal of Pediatrics, Vol. 139, No. 6, 01.01.2001, p. 804-812.

Research output: Contribution to journalArticle

Diabetes Control and Complications Trial (DCCT) & Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group 2001, 'Beneficial effects of intensive therapy of diabetes during adolescence: Outcomes after the conclusion of the Diabetes Control and Complications Trial (DCCT)', Journal of Pediatrics, vol. 139, no. 6, pp. 804-812. https://doi.org/10.1067/mpd.2001.118887
Diabetes Control and Complications Trial (DCCT), Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group. Beneficial effects of intensive therapy of diabetes during adolescence: Outcomes after the conclusion of the Diabetes Control and Complications Trial (DCCT). Journal of Pediatrics. 2001 Jan 1;139(6):804-812. https://doi.org/10.1067/mpd.2001.118887
Diabetes Control and Complications Trial (DCCT) ; Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group. / Beneficial effects of intensive therapy of diabetes during adolescence : Outcomes after the conclusion of the Diabetes Control and Complications Trial (DCCT). In: Journal of Pediatrics. 2001 ; Vol. 139, No. 6. pp. 804-812.
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abstract = "Objective: The Diabetes Control and Complications Trial (DCCT) demonstrated that intensive therapy of type 1 diabetes mellitus reduces the risk of development and progression of microvascular complications. The Epidemiology of Diabetes Interventions and Complications (EDIC) study assessed whether these benefits persisted after the end of DCCT. Results for the adolescent DCCT cohort are reported here. Study design: Of the DCCT adolescent cohort (n = 195), 175 participated in EDIC, 151 had fundus photography, and 156 had albumin excretion rate measured at year 3 or 4. The odds of progression of retinopathy and albuminuria from closeout of the DCCT until EDIC year 4 were assessed. Results: In contrast to the 7.4 years of the DCCT, during which mean hemoglobin A1c levels were significantly lower with intensive therapy than conventional therapy (8.06{\%} vs 9.76{\%}; P < .0001), the subsequent first 4 years of EDIC had mean hemoglobin A1c levels that were similar between the former intensive and the former conventional groups (8.38{\%} vs 8.45{\%}). However, the prevalence of worsening of 3 steps or more in retinopathy and of progression to proliferative or severe nonproliferative retinopathy were reduced by 74{\%} (P < .001) and 78{\%} (P < .007), respectively, in the former intensive therapy group compared with the former conventional group. Conclusions: These findings provide further support for the DCCT recommendation that most adolescents with type 1 diabetes receive intensive therapy aimed at achieving glycemic control as close to normal as possible to reduce the risk of microvascular complications.",
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T1 - Beneficial effects of intensive therapy of diabetes during adolescence

T2 - Outcomes after the conclusion of the Diabetes Control and Complications Trial (DCCT)

AU - Diabetes Control and Complications Trial (DCCT)

AU - Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group

AU - White, Neil H.

AU - Cleary, P.

AU - Dahms, W.

AU - Goldstein, D.

AU - Malone, J.

AU - Tamborlane, W.

AU - Genuth, S.

AU - Nathan, D.

AU - Shamoon, H.

AU - Duffy, H.

AU - Engel, S.

AU - Engel, H.

AU - Mayer, L.

AU - Pendegras, S.

AU - Zegarra, H.

AU - Miller, D.

AU - Singerman, L.

AU - Brillion, D.

AU - Lackaye, M.

AU - Heinemann, M.

AU - Rahhal, F.

AU - Reppuci, V.

AU - Lee, T.

AU - Whitehouse, F.

AU - Kruger, D.

AU - Carey, J. D.

AU - Bergenstal, R.

AU - Johnson, M.

AU - Kendall, D.

AU - Spencer, M.

AU - Noller, D.

AU - Morgan, K.

AU - Etzwiler, D.

AU - Jacobson, A.

AU - Golden, E.

AU - Soroko, D.

AU - Sharuk, G.

AU - Arrigg, P.

AU - Doyle, J.

AU - Fritz, S.

AU - Crowell, S.

AU - Godine, J.

AU - McKitrick, C.

AU - Lou, P.

AU - Service, J.

AU - Ziegler, G.

AU - Pach, J.

AU - Colwell, J.

AU - Wood, D.

AU - Olsen, Timothy

PY - 2001/1/1

Y1 - 2001/1/1

N2 - Objective: The Diabetes Control and Complications Trial (DCCT) demonstrated that intensive therapy of type 1 diabetes mellitus reduces the risk of development and progression of microvascular complications. The Epidemiology of Diabetes Interventions and Complications (EDIC) study assessed whether these benefits persisted after the end of DCCT. Results for the adolescent DCCT cohort are reported here. Study design: Of the DCCT adolescent cohort (n = 195), 175 participated in EDIC, 151 had fundus photography, and 156 had albumin excretion rate measured at year 3 or 4. The odds of progression of retinopathy and albuminuria from closeout of the DCCT until EDIC year 4 were assessed. Results: In contrast to the 7.4 years of the DCCT, during which mean hemoglobin A1c levels were significantly lower with intensive therapy than conventional therapy (8.06% vs 9.76%; P < .0001), the subsequent first 4 years of EDIC had mean hemoglobin A1c levels that were similar between the former intensive and the former conventional groups (8.38% vs 8.45%). However, the prevalence of worsening of 3 steps or more in retinopathy and of progression to proliferative or severe nonproliferative retinopathy were reduced by 74% (P < .001) and 78% (P < .007), respectively, in the former intensive therapy group compared with the former conventional group. Conclusions: These findings provide further support for the DCCT recommendation that most adolescents with type 1 diabetes receive intensive therapy aimed at achieving glycemic control as close to normal as possible to reduce the risk of microvascular complications.

AB - Objective: The Diabetes Control and Complications Trial (DCCT) demonstrated that intensive therapy of type 1 diabetes mellitus reduces the risk of development and progression of microvascular complications. The Epidemiology of Diabetes Interventions and Complications (EDIC) study assessed whether these benefits persisted after the end of DCCT. Results for the adolescent DCCT cohort are reported here. Study design: Of the DCCT adolescent cohort (n = 195), 175 participated in EDIC, 151 had fundus photography, and 156 had albumin excretion rate measured at year 3 or 4. The odds of progression of retinopathy and albuminuria from closeout of the DCCT until EDIC year 4 were assessed. Results: In contrast to the 7.4 years of the DCCT, during which mean hemoglobin A1c levels were significantly lower with intensive therapy than conventional therapy (8.06% vs 9.76%; P < .0001), the subsequent first 4 years of EDIC had mean hemoglobin A1c levels that were similar between the former intensive and the former conventional groups (8.38% vs 8.45%). However, the prevalence of worsening of 3 steps or more in retinopathy and of progression to proliferative or severe nonproliferative retinopathy were reduced by 74% (P < .001) and 78% (P < .007), respectively, in the former intensive therapy group compared with the former conventional group. Conclusions: These findings provide further support for the DCCT recommendation that most adolescents with type 1 diabetes receive intensive therapy aimed at achieving glycemic control as close to normal as possible to reduce the risk of microvascular complications.

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U2 - 10.1067/mpd.2001.118887

DO - 10.1067/mpd.2001.118887

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