Diabetes Control and Complications Trial DCCT

The Diabetes Control and Complications Trial (DCCT), the Stockholm Diabetes Intervention Study (DIS), the United Kingdom Prospective Diabetes Study (UKPDS), and the Japanese Kumamoto study show unequivocally that vigorous treatment of diabetes can decrease both the morbidity and mortality of the disease by reducing chronic complications. 

The most frequent complication of insulin therapy is inadvertent hypoglycemia (21-23). Over 5% of deaths in diabetes can be attributed to hypoglycemia. The frequency increases with rigorous maintenance of normogly-cemia (24,25). In the Diabetes Control and Complications Trial (DCCT) (26) the frequency of serious hypoglycemia was more than three times increased in the intensively treated group, and the frequency of the attacks was related to the concentration of HbAlc (27). The UK Prospective Diabetes Study in patients with type 2 diabetes also showed an increased risk of hypoglycemia with more intensive treatment (28). 

A long-term randomized prospective study involving 1441 type 1 patients in 29 medical centers reported in 1993 that "near normalization" of blood glucose resulted in a delay in onset and a major slowing of progression of microvascular and neuropathic complications of diabetes during followup periods of up to 10 years (Diabetes Control and Complications Trial [DCCT] Research Group,... 

The National Glycohemoglobin Standardization Program (NGSP) used the CRMLN model to establish a reference laboratory network to standardize glycated hemoglobin (i.e., HbAlc) [33, 34], The purpose of the NGSP is to standardize HbAlc so that clinical laboratory results are comparable to the Diabetes Control and Complications Trial (DCCT) where relationships were established to mean blood glucose and risk for vascular complications. 

The Diabetes Control and Complications Trial (DCCT) has shown that intensified diabetes therapy resulted in HbAlc reductions of approximately 2% compared to conventional therapy, and that patients practicing intensified diabetes therapy enjoyed significant reductions in the feared microvascular complications of diabetes (DCCT Research Group, 1993). As such, the current aim of diabetes therapy is to achieve glycemic control that is as close to normal as possible while maintaining an acceptable quality of life for those patients for whom the therapy is prescribed.The DCCT also demon-... 

The Diabetes Control and Complications Trial (DCCT) Group (1994) demonstrated that tight control and management of blood glucose levels decreases the risks of complications both in terms of microvascular (retinopathy and renal failure) and macrovascular (stroke, angina, myocardial infarction) complications. 

The Diabetes Control and Complications Trial (DCCT) Research Group. The elfect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993 329 977-986. 

Gautier JF, Beressi JP, Leblanc H, et al. Are the implications of the Diabetes Control and Complications Trial (DCCT) feasible in daily clinical practice Diabetes Metab 1996 22 415 19. 

I Microvascular Complications. Insuhn has been shown to be as efficacious as any oral agent for treating DM. The Uiuted Kingdom Prospective Diabetes Study, which used suhonylureas or insuhn, showed equal efficacy in lowering the risk of microvascular events in newly diagnosed type 2 DM. Similarly, in type 1 DM the Diabetes Control and Complications Trial (DCCT) showed efficacy in reducing microvascular complications. ... 

Diabetes Control and Complications Trial (DCCT) 1446 Diabetes mellitus 13... 

The risk of major events was reported between 0.6% and 2% in the ADOPT-study and the UKPDS [11], being markedly lower than in intensively treated type 1 diabetic patients in the Diabetes Control and Complications Trial (DCCT)... 

There is compelling evidence that tight glycaemic control reduces diabetic microangiopathy and neuropathy. Both the original randomized and observational data from the UK prospective diabetes study (UKDPS) documented a relation between hyperglycaemia and macrovascular disease, but weaker and less clear than that of microvascular complications [48,49]. The Diabetes Control and Complication Trial (DCCT) has provided indirect [50] and direct evidence... 

Table 28.1 Approximate relationship between the Diabetes Control and Complications Trial (DCCT)-aligned HbAic, HbAic and the estimated average glucose concentration based on population studies. This should be used with caution in cases of individual patients.

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